HIST 123 Quiz 1 and Midterm Flashcards

Question

How big are Parasites?

Answer 1

- Malaria -> caused by microparasite - Hookworm -> macroparasite. -> Both cause anemia.

Answer 2

Small: 1 to 5 um are prokaryotes - Free-living or parasitic - Organisms (just a very small one) - Play many important roles in nature - Both a source of disease - And a source of antibiotics, used to treat disease - Cannot be seen without assistance - First microscope from mid 17th c.

Answer 3

- Much smaller than bacteria - Only visible with the intervention of microscopes - Even before they could see the viruses, they knew they were causing sickness - Knew of their existence from late 19th cent. -> First was tobacco mosaic virus in 1892 -> First animal virus, 1898m foot-and-mouth disease -> First human virus c. 1900, yellow fever virus

Answer 4

- 12th c. BCE to 600 CE - Had own understanding of health and sickness

Answer 5

Healing through: divination (prophecy), exorcism, pharmaceutical remedies - Believed that people who were sick could do sth to heal. - Mix of spiritual and practical beliefs and healing techniques. (herbs), and surgery. - Diet -> as both a positive and negative influence (source of ill health and treatment for poor health)

Answer 6

Skilled doctor in c. 1200 BCE (mentioned in Homer's Illiad) - A real person -> later honoured as a hero and worshipped as a God. -> (his son, Machaon (from the words for battle and knife) labelled as the father of surgery. -. fighting a nd healing through surgery using knives. - In myth, he was known as the son of Apollo (the Greek God of healing, truth, prophecy) and a mortal princess. - The centaur Chiron (famous for wisdom and knowledge of medicine) taught Asclepius and later his son, Machaon. - Divine origins of medical expertise - Eventually he was killed by Zeus, who feared that Asclepius would render all people immortal (and so killed him) -> religious cult spread across much of Greece and Rome

Answer 7

- theatre built between 4th and 2nd c. BCE - could seat up to 12,300 people. - Hosted music and drama contests, as well as performance related to the worship of Ascelpius. -> folk festival but for the God of Healing. - Abaton at Epidaurus, the main site for healing the sick. -> Enclosed areas where ppl could sleep and dream. -> Would be followed by an incubation sleep where you would have dreams and visions.

Answer 8

- God of Sleep, Epnos. - Incubation sleep was a ritual sleep to induce a dream. - Incubation sleep: images of Aslepius (as a proponent of incubation sleep) attended by Hygiea, treating a sleeping woman. - Incubation sleep: sleep monitored by priests, included baths, maybe drugs, instructions on what to eat and what not to eat. - DREAMS as DIAGNOSTIC of particular conditions and SOURCES OF INSIGHT into HOW TO HEAL A PERSON.

Answer 9

c. 460 BCE - c. 370 BCE - Real person - Trained in Kos Asclepion -Kos included Temple of Apollo (God of Healing) -> Spiritual and natural healing beliefs

Answer 10

- Body of ~70s works (also called treatises) - Several different authors, including Hippocrates - Continuity with Asclepius - CHANGE: newer ideas about nature: -> Beginning of shift from supernatural to natural explanation > Non-Gods related causes for diseases: -> epilepsy might be genetic bc it seemed to pass through families; tuberculosis having natural causes (eg. drought) - DETAILED DESCRIPTIONS OF SYMPTOMS Writings about SURGICAL PRACTICES, PHARMACUETICALS - Hippocratic oath: DO NO HARM.

Answer 11

Yes! - Said: Human body contains blood, phlegm, yellow bile, black bile. - "Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed." - "Pain occurs when one of the substances presents either a deficiency or an excess, or is separated from the body and not mixed with the others." - Thought to be 4 humours -> in order to be in good health, those 4 humours had to be in balance. - Sth did cause the humours to become unbalanced: mainly diet; they would say if u were drinking too much wine or eating too much meat, that could make them become unbalanced. -> anger or a curse could also cause an imbalance.

Answer 12

Corresponded to the 4 elements of matter. - As described by Empedocles, Greek philosopher and contemporary of Hippocrates. Humour: Blood -> corresponded to air (hot and wet qualities) Humour: Phlegm -> corresponded to water (cold and wet qualities) Humour: Yellow bile -> corresponded to fire (hot and dry) Humour: Black bile -> corresponded to Earth (cold and dry)

Answer 13

- Epi = on - demos = the people - 7 books in Hippocratic corpus titled Epidemics - Described disease "which circulates or propagates in a country" - books 1 and 3 are lists of disease with descriptions of clinical cases.

Answer 14

A parasite. - Mosquito responsible for Malaria -> Anopheles - First infected mosquito 2. first person infected -> 3. infected liver cells - 4. infected red blood cells -> 5. second infected mosquito -> 6. second infected person

Answer 15

1. Plasmodium falciparum 2. Plasmodium vivax

Answer 16

1. Plasmodium falciparum 2. Plasmodium vivax 3. Plasmodium malariae 4. Plasmodium ovale 5. Plasmodium knowlesi

Answer 17

- Severe anemia - Untreated -> epilepsy, blindness, cognitive impairments, coma, death - Mortality in young children - After repeated infections, survivors develop some immunity. - If survived to age of 5, relapses and complications.

Answer 18

- Debilitates/sickens during fevers - Can get more severe after relapses - Death if undernourished or compromised immune system. - Death rate rarely exceeds 1% - Seasonal infections, most active in summer - All age groups

Answer 19

- Established as early as 8th c. BCE, most likely arrived from south (Africa) or east (Asia minor) - 6th c. BCE poems describe intermittent or recurring fevers - key symptom By 400 BCE most common disease

Answer 20

- 2 Kinds of malaria: one with recurrent fevers every 2nd day (tertian) (P. vivax or P. ovale) - Hippocrates did not describe the symptoms that follow from infection by Plasmodium falciparum. -> Rare at this time -> Became established in Europe by 2nd century CE. - Described those living near marshes had enlarged spleens. -> claimed bc of smelly air and bad water. -> swollen belly sign of malaria

Answer 21

- Drained marshes -> found less fever -> but didn't realize it was the mosquitos causing the problem - Mal - bad; aria - air (marshes) - Ancients associated mosquitos with disease but not with malaria - Mosquitos, parasites, and humans - And proximity to water -> marshlands - Speculated on environmental causes of disease (if you drained a marsh, got rid of mosquito habitat -> less disease/malaria) - Change over time: spread of more virulent P. falciparum into Roman Empire - Malaria became a (at time fatal) disease of children.

Answer 22

- 129 to 216 CE - Greek physician who practiced in the Roman Empire - Influential among medieval Christians and Early Muslims - Hippocrates and humours (related/similar to humours) - Anatomical study (importance of dissection to perform surgery and for research) - Practiced dissection as a way to try and understand the body. - Disease as located in different organs - Scientific but as PREOCCUPIED WITH MORALITY as a CAUSE of disease: sickness from ignorance, harshness, improper behaviour - proper behaviour (diet and conduct) could prevent most disease. - Practiced under Roman Empire - Families could perform rituals and sacrifices to maintain health, but would call in foreigners (like Greeks) as physicians. - Physicians in Greece more akin to craftsmen.

Answer 23

- No distinction between medicine/science and religion - Physicians remained associated with Asclepian temples (left those as they were even during war -> sites were associated with healing and health -> bc romans also worshipped Asclepius. - Sacrifices, offerings, prayers all essential parts of healing. - Practice of medicine relatively unspecialized. -> two exceptions: Obstetrics (pregnancy and birth -> predominantly practice by women in Greece and Rome) and the care of the eyes.

Answer 24

- General language (pestilent, plague, fever) -> back then, it was a generic term to refer to sickness or a plague. - Some of the ancient epidemics have well-known causes: some pathogens leave traces on skeletons or other genetic materials. - Others remain unclear -lack of pathogenic evidence on human remains. - Rise of epidemic diseases and spread, alongside agriculture and urbanization. -> the denser the human populations, the more opportunities for diseases to spread and more opportunity for new diseases to arise.

Answer 25

- Plague of Athens (430-426) in Ancient Greece - Antonine Plague (164-180 CE) in Roman Empire - Plague of Justinian (541-549) in the Byzantine Empire

Answer 26

430-426 BCE in Ancient Greece

Answer 27

164-180 CE in the Roman Empire

Answer 28

541-549 CE in the Byzantine Empire

Answer 29

- Ancient Greek economy rested on transport of goods by ship -> they traded wine and olive oil for grains, etc. - Through this system, saw the rise of polis (the city state) and urban centre (with acropolis or harbour controlling surrounding territory, called a chora) -> were large urban centres in the ancient world as well -> large collections of ppl -> play big role in disease. - Big ones were Syracruse, Athens - There was also the Peloponnesian War: -> two of these city states (Athens and Sparta) came to fight each other -> engulfed rest of Greek world in a large scale war) -> in order to get tthe navy to wear out the Spartans, Pericles destroyed fields -> led to large number of peasants coming into the city due to war in the countryside -> more ppl

Answer 30

two of these city states (Athens and Sparta) came to fight each other -> engulfed rest of Greek world in a large scale war) -> in order to get the navy to wear out the Spartans, Pericles destroyed fields -> led to large number of peasants coming into the city due to war in the countryside -> more ppl -> would eventually lead to easier spread of plague - and during plague people said that the plague was a result of the Polyponnesians poisoning the water (Thucydides)

Answer 31

- 460-400BCE - One of the earliest historians. - General during the Peloponnesian War -> detail oriented: tried to capture everything in as much detail as possible -> History of the Peloponnesian War

Answer 32

- In 430 BCE epidemic brought from Egypt by ship to Piraeus. - Raged for 2 years - Many deaths, including Pericles in 429 BCE. - Described at length by Thucydides - Mass graves: -> couldn't practice proper rituals (reason for mass graves) -> found 90 complete skeletons (might have contained as many as 150) -> No soil between the bodies -> suggested they were buried in a panic.

Answer 33

- "...bodies of dying men lay one upon another, and half-dead people rolled about in the street, and in their longing for water, near all the fountains." - "...the customs which they had hitherto observed regarding burial were all thrown into confusion, and they buried their dead each one as he could." - Claimed it first began in parts of Ethiopia above Egypt, and thence descended into Egypt and Libya and into most of the King's country. - In Athens, it first attacked the population of Piraeus -> which was the occasion of their saying that the Polyponnesians had poisoned the reservoirs - Set out to simply explain the symptoms so that they may be recognized -> claimed to have had the disease himself

Answer 34

- Typhus? -> bc of symptoms: fever, pustules, rash on extremities - Doctor's Disease -> a lot died bc they dealt with and saw the plague most often - Or multiple epidemics? -> disease synergies? (having one disease makes you susceptible to another; or having one provides immunity for another)

Answer 35

- Established the patterns of the Plague Narrative - The concept that it came from "over there" (and specifically Ethiopia) - Poisoned reservoirs (role of an enemy using disease to undermine the ppl, biological warfare) -> personal experience - Did these actually happen? Or is it just part of the plague narrative?

Answer 36

1. Detailed description and foundational plague narratives 2. Unknown pathogen/uncertainty 3. Arose because of war, and had an impact on the war's outcome. -> demoralized Athenians -> Weakened their military strength -> And blockage meant that Spartans were not infected, and led to win by Spartans

Answer 37

- Trade and Disease Routes - Pandemics picked up during the time of Alexander the Great (356-323) - Increased reports of plague and disease after opening to trade

Answer 38

- There were more frequent reports after trade increased with population centres to the east (Mesopotamia, India, China) -> but also have plague narrative formula for Thucydides) - Epidemic in 461 BCE described by Livy (Roman historian) when cattle and ppl died and corpses thrown into the Tiber. (plague narrative?) - Carthaginian siege of Syracruse in 396 BCE ended when attackers killed by a plague - Cult of Asclepius introduced in Rome to avert a pestilence in 293 BCE.

Answer 39

- Plague in Roman Empire from 164-180 CE - The worst plague - The cult of Asclepius - aka Plague of Rome - Marcus Aurelius Antoninus emperor 140-180 CE (named after him) - Plague brought to Rome in 164 BY TROOPS that had served on the EUPHATES - Killed as much as 1/3 of the population - Lasted for 15 years throughout much of Asia Minor and Europe - Broke out again in 189 CE -> caused mass mortality in Rome, as many as 2000 deaths a day. -> don't know what caused it (similar to plague of Athens)

Answer 40

164-180 CE in the Roman Empire

Answer 41

- Galen says that he was unaffected by the disease, although it killed almost all the slaves he had in Rome. -> he fled but was forced to come back to Rome. -> and killed many of the people around him. - Said that he knew how to treat the sick, but did not have the time. -> similar to Thucydides -> said he was there, he knows that happened -> but he was a doctor -> said he knew how to treat it, but it was too chaotic for him to treat it. -> was maybe making it up to give him more authority. - DESCRIBED SYMPTOMS: Higher fever, inflammation of mouth and throat, thirst, pustules on the skin (about 9 days after the first infection) -> smallpox? -> first outbreak of smallpox in part of Europe? -> so Galen would not have had any preexisting exposure -> immunologically naive.

Answer 42

To have no previous exposure with a novel pathogen. - Has never dealt with or encountered the pathogen, so they would be immunologically naive.

Answer 43

- 541-549 CE - Byzantine Empire (476-1453 CE) - Justinian Plague or First Plague Pandemic - Yersinia pestis -- same pathogen responsible for the Black Death -> Bubonic, septicemic, or pneumonic forms - Bacteria spread by fleas (vectors) from rats (reservoir) to humans (susceptible population) - Zoonosis - Swept through Asia minor, Africa, and ultimately Europe between 541 and 544 - Arrived in Constantinople on 542 - Justinian himself got sick and survived. -> consequences of this plague and his name had big impact on his empire. - Thought to originate in reservoirs in Africa and Asia -> as goods were shipped from these places through imperial trade routes it brought this pathogen and rats together -> when they arrived in Constantinople from Egypt, grain storehouses were a great breeding ground for rates and more of the disease.

Answer 44

- Trade -> rats and grains (thought to originate in reservoirs in Africa and Asia -> as goods were shipped from these places through imperial trade routes it brought this pathogen and rats together -> when they arrived in Constantinople from Egypt, grain storehouses were a great breeding ground for rates and more of the disease.) - Climatic changes -> colder temps, disrupted harvests - Procopius described the plague in Constantinople in his Secret History (written shortly after the plague, c. 550-562 CE) - Described experience of plague (many attributed the illness to the touch of a supernatural being that happened in their dreams -> didn't let anyone visit them, barred their doors -> lack of access to food, resources lead to quicker death) - Supernatural beings

Answer 45

- Plague of Justinian (541-549 CE) - Mild fever - Within days developed bubonic swellings - Most then fell into a coma or delirium (some became paranoid and suicidal) - Most died within days (unless buboes filled with pus -> then recovered) - Doctors had difficulty predicting course of disease or success of treatments (difficult to feed and care for the sick) - Contact with the sick did not seem to increase chances of falling ill.

Answer 46

- Estimated at 5000/day for 4 months. - 20-40% of inhabitants. - Food shortages likely hastened deaths of plague victims.

Answer 47

- Justinian's court fell into chaos -> triggered a crisis in gov't. - Combined with floods and earthquakes at the same time, disrupted agriculture -> famine - Losses in population meant losses in tax revenues - Plague spread by Justinian armies, but disruption meant that he was unable to hold territories. - Estimated to have killed 25-30 million ppl, 25% population of Byzantine Empire - First Plague Pandemic: recurred every 3-4 years for 225 years, disappearing in 750 CE. - Spread as far as Gaul and Britain - End of classical world? -> diminished trade, decline of cities, rise of feudalism, fatalistic beliefs

Answer 48

Study of genetic material from the past. - aDNA = ancient DNA - Study. migrations (when arrived, how changed in relation to environment) - PCR = polymerase chain reactions -> take a DNA sample and make lots of copies to study. - In 2005 -> use PCR to work with DNA for bones and teeth -> Value for study of those disease that leave genetic traces (eg. plague) Eg. a mummified body of Asru a temple chantress, dating from c. 700 BCE. Immunocytochemistry was used to identify that she had schistosomiasis. - Eg. Spanish Flu - Challenges: methodological issues; ethical issues (ppls bodies, burial sites), expertise and interdisciplinarity (work from own expertise and have to work with others bc skills are quite different)

Answer 49

- Evidence of what the disease was - Evidence of how the disease spread... and how many people were affected and in what ways - But not evidence of how ppl responded - And NOT evidence of the social, economic, political effects of the disease - and more often than not, we don't have physical evidence, but we might still want to identify a disease in addition to answering some questions.

Answer 50

A Byzantine historian who documented the Justinian Plague.

Answer 51

300 - 800 CE to c. 1350-1550 (preceded by Antiquity, followed by Early Modern Period in European history)

Answer 52

ANCIENT MEDITERRANEAN - Long-distance trade and military campaigns - Significant urban centres (Athen, Rome, Constantinople) - Relatively advanced urban sanitation - Sophisticated political systems MEDIEVAL EUROPE - Far more rural and agricultural - Poor sanitation - Highly fragmented political authority - Literary was rare

Answer 53

Major epidemics were largely absent from Europe until plague returned in the 14th century. -> not continuous, recurs during that period.

Answer 54

- Most deaths were from disease, not war of violence - Endemic respiratory, gastrointestinal, and childhood pathogens - Zoonosis -> disease spread by animals (bc this was an agricultural society, lived close with animals) - Normal mortality = 3% per year (pre-industrial) (now is about 1%) -> extremely high death rates among infants and children.

Answer 55

- In the first year of life: between 150 and 250 of each 1000 live births died. -Of every 1000 children that survived infancy, 150-250 died by age 7. - Only between 4 and 7 of 10 live babies survived into adolescence. - Life expectancy vs. maximum life span -> Medieval Europe life span lumped together those who died in childhood and those who didn't -> skewed the maximum lifespan numbers -> if you survived the first 7 years, your life expectancy went up. -> People did live up to old age -> significance of childhood and infant death on numbers - Mortality linked to poverty/wealth -> richer ppl less likely to die of disease -> Made up of small portion of society so that statistical part of that was not as significant as it otherwise could have been. - Famine and war triggered regional mortality crises -> - Annual death rate in Medieval Europe could rise as high as to 10% during times of famine and war. - Displaced ppl → moving into safer areas → Regional mortality crises

Answer 56

- Leprosy - Tuberculosis (including scrofula) - Malaria - Macroparasites (intestinal worms)

Answer 57

- Dietary deficiencies (protein, iron, vitamins) -> Eg. Rickets (vitamin D deficiency) -> softening/weakening of bones -> Scurvy (Vitamin C deficiency)-> break down of connective tissues - Spoiled foods -> Ergotism - Sapronoses (from sapron = to decay) -> human diseases transmissible from abiotic/nonliving environment (soil, water, decaying matter) - Also include anthrax, botulism, Legionnaires' disease, gangrene - Ergot -> fungus that produce chemical toxic to humans and animals -> Cool, cloudy, wet weather contributed to development of ergot -> If ergot bodies stayed (bc weather remained that way) the next spring, they would be released and infect other plants. mass poisonings -> any feed made from ergot infected cereals.

Answer 58

St. Anthony's Fire - St. Anthony was the patron saint of ergot sufferers. - Ergot lead to the loss of the extremities.

Answer 59

An epidemic in an animal population.

Answer 60

Animal diseases the spread to humans.

Answer 61

In 1314-25 there was a cattle plague that crossed Europe form east to west as far as Ireland - Killed 62% of bovine animals in England Wales in 1319-20 - It killed 0.5 million oxen in England -> so many animals dead -> famine -> ppl get infected with a different pathogen -> epidemic - Halved all the herds it affected -> Great Bovine Pestilence

Answer 62

- Epizootic that killed 62% of bovine animals in England and Wales in 1319-20. - aDNA evidence inconclusive - Related to Rinderpest? (ancestor of measles) (word for cattle plague) -> Mobilivirus related to dog distemper and human measles -> Confers immunity (only in that generation), but can kill more than 80% of animals in a herd without prior exposure. - Sheep murrain -> Non-specific term, refers to widespread disease -> Grazing in flooded grasslands - >Sheep losses greatest in 1315-17.

Answer 63

- Each lie on a continuum -> famine acts similar to pandemic -> small food crisis -> larger regional hunger -> about distribution of food over different regions as well -> those who do not have food can't provide it to other places - But are also distinct events - Synergistic effects of malnutrition and infectious disease (if you are malnourished, your body is not able to fight off disease well -> if a population is malnourished -> easier to spread disease) - Secondary infections - Usually hard to rule if they died of famine or disease -> we just say they died during a famine.

Answer 64

- It was prolonged both in time and geographically extensive - Spread across much of northern Europe, Germany, Northern France, the British Isles, as well as Scotland, edge of Poland, edge of Austria.

Answer 65

- Two centuries of population growth in Northern Europe - Area of cultivated land expanded significantly - Growing income inequality (population kept growing, economy didn't -> more and more ppl fell into poverty, wealthy got richer). - Environmental factors -> in the 2nd decade 14th c. it rained in Europe incessantly -> lead to uncharacteristically warm sea surface temperatures -> cluster of wet years in 1st half of 14th c. -> linked to larger climatic change -> medieval warm period (period of warmer weather) -> followed by extreme cole (little ice age) -> historians linked the end of this medieval warming period to more farming -> bad rains linked to down-swing of this period -> excessive rains -> for ppl living in England and Northern Europe during this time, there was a sense of impending doom -> thought about God and rain and how to end their sins. -> 1315 harvest a disaster -> widespread flooding -> sheep dying in fields -> prices rise due to salt shortage (sued to preserve food, eg. salted herring) and grain shortage

Answer 66

- Crop failures began in 1315, continued for 20 years. - Worst years: 1315-18. - Planted diverse crops to protect against harvest failures, but environmental conditions often destroyed different grains at once. - Crisis built up.

Answer 67

- Manorial Records (accounts, harvest, daily events → like account ledgers) - Chronicles (historical writing) -> Historians writing histories. Eg. Nuremburg chronicle. -> Eg. John of Trokelowe chronicle: scarce meats, horse meat precious, plump dogs stolen, according to reports, men and women in places secretly ate their own children. (maybe exagerated -> "according to reports' = not sth he actually observed -> can't determine if there was or wasn't cannibalism -> horse meat -> if you're killing working animals then you're really in a state of desperation

Answer 68

- Widespread enteric (intestinal illness) epidemic in 1316. - Typhoid? - Death from starvation -> urban poor -> Flemish town of Ypres (Urban poor entirely dependant on food coming in from countryside and countryside is in a state of crisis) - Wealthy and poor affected by epidemic - Mortality rose to 10% or even higher - Mortality in cities was high during the Great Famine. In 5 months in 1316, the Flemish town of Ypres lost 10% of its population (2,794)

Answer 69

- Increase in lawlessness - Smallholders (1-2 acres) sold off land - Thousands of acres abandoned - Tenants who remained worked smaller plots - Refugees -> usually those who had smaller plots of land and abandoned them in order to survive. -> Epizootic killed so many cattle they couldn't get cattle to work the land -> reason for working smaller plots - Local and regional depopulation

Answer 70

A predominant rural society--reflected in health and disease: - Malnutrition - St. Anthony's Fire - Great Bovine Pestilence (1314-1325) - Great Famine (1315-1322)

Answer 71

a long-standing and recurrent ailment.

Answer 72

One you get and that quickly passes (either you get it and recover, or get it an die)

Answer 73

- Most prominent disease in medieval culture prior to the Black Death (1346-1353) - Taught us how medieval societies associated sickness with Divine Will.

Answer 74

- A chronic condition - (Today: Hansen's Disease) - Causative agent: Mycobacterium leprae -> slow-growing bacterium -> Slowly contagious -> you will not get it just from sitting beside someone one time. -> only contagious by long, prolonged exposure. -> if you are exposed for a long time and have hereditary resistance you probably wouldn't get it. -> Very long incubation period. - Lepromatus leprosy: cellular deformity of nerves and other tissues and a gradual process of disfiguration of the person who has the disease. -> the 'leper'. -> SYMPTOMS: legions on face, disfigure from nerve and bone damage - Good skeletal remains of leprosy.

Answer 75

Leper 'hospitals', places were lepers were sent once they were identified as having leprosy. -> more like hostels, housing. - 54% found in the leper graveyard had leprosy (medieval ppl pretty good at diagnosing leprosy) - Most of the time they correctly identified. - established by wealthy ppl - to isolate lepers due to their perceived moral pollution. - Dress of a leper modelled on clerical dress - separated gender similar to how a church would - Ppl would sometimes care for the lepers - Larger leper houses had more resources due to the lepers working the land. - Limited medical care (some bathing, some herbal remedies offered to them) - Lepers had to pay a fee to enter the leprosarium (had to also bring their own things that they would need -> coffin, and nails and lid for coffin when they died) - Used a clapper to announce their presence in a community -> to tell ppl they were there and that they were collecting alms

Answer 76

- Physical evidence from 4th c. CE - Earliest legal references 8th c. CE - Cultural significance peaked from 1000 to 1250. - By 1500, leprosy was unusual in Europe. (rare by era of Black Death) - Persisted globally, often very local, into 19th c. - Leprosy was NEVER an EPIDEMIC, it was always a chronic disease, just widespread. - In places where it was concentrated -> ability to treat it was undermined and did not spread super easily. In those places it was endemic.

Answer 77

- It had a limited impact on mortality or demography so why did they care?: - Because: -> widespread disease -> significant physical effects (deformation) -> Some of the most severe impacts on those with meat-rich diets = well-fed people (the elite) -> If the elites are disproportionately affected by a disease, it was looked into more. -> leprosy requires cholesterol to form

Answer 78

Military-religious order of crusading warriors suffering from leprosy.

Answer 79

- Physical afflictions as evidence of moral pollution. - And then how Medieval ppl and society responded to this

Answer 80

- Due to Old Testament book of Leviticus - Hebrew tsara'ath = "repulsive, scaly skin-disease" - Interpreted by MEDIEVAL CHRISTIANS as leprosy. - Disease became ASSOCIATED with SIN, IMMORALITY and DIVINE PUNISHMENT -> had to be cast out until they were considered clean. - The individual suffering from the disease was paying the price of immorality (according to Medieval Christians)

Answer 81

- Viewed as a moral affliction - Sin most often held responsible was lechery (lepers thought to be overwhelmed by powerful sexual desires) - Between 1000 and 1250 leprosy subject of significant legal intervention and intervention by the church -> began with public accusation by neighbours -> examination by priest (original diagnosis -> sometimes misdiagnosis)

Answer 82

- It formalized the leper from the community into a ritual: ceremony in which the leper was declared to be socially and culturally dead. - Covered in black cloth, priest would throw dirt over them -> their remaining time on Earth would be spent in purgatory so that when they died they would go straight to Heaven. - Lepers could never leave their house without their leper costume - Lepers could never wash their hands in a stream - Lepers could not meet/drink/eat with others unless they were also lepers - Lerpers could not live with any woman other than their own. - Forbidden to ever touch children or give the manything - New rules to keep lepers separate from society -> leper lost their rights to land, other property could not have sexual intercourse unless it was with their spouse. - Lower class lepers sent to leprosarium.

Answer 83

They had to collect alms (charity) to support themselves. - Spent a lifetime in a leprosarium; but both men and women didn't interact - Leprosariums at the edges of towns, at a crossroads (so they could still collect alms) - Important objects of charity bc they were thought to be in purgatory (therefore closer to God) -> if you gave charity to a leper, they would pray for you to God -> bc they're closer to God, your prayers were more likely to be heard. - Were cast out bc of the idea of moral pollution, NOT physical contagion.

Answer 84

- 4th c. (earliest evidence) - 1250 c. - Religious and medical responses -> priests and physicians -> confession (as a therapeutic tool) - Galenic humoural medicine: leprosy as a disorder of BLACK BILE -> leprosy a disease of imbalance of balck biles -> due to features on face (legions, "burnt lips", bad breath) -> triggered by: imbalance from fornication; imbalance from diet (meat and wine -> where meat actually played a significant role) -> physicians made references to Galen.

Answer 85

- Rooted in perceived immorality: they were unclean. - Explicitly contagionist reference to "I forbid you to go in a narrow lane, so that should you meet any person, he should not be able to catch the affliction from you." - Leprosaria go from places for devotional isolation to isolation wards

Answer 86

It declined! - Leprosy conferred some immunity against plague -> made ppl angry bc leprosy was associated with being unclean -> how could these unclean ppl have some immunity? -> best possible reason for this decline - The disease share some cross immunity: if you have tuberculosis, you are more likely to be immune to leprosy. -> Tuberculosis is a lot more contagious than leprosy -> if an infant had tuberculosis when they were young, then they are way less likely to get leprosy when they are older. - Urban/rural changes?

Answer 87

form of non-pulmonary tuberculosis - Blotches on skin and face and neck and swollen lymph nodes. - Rarely fatal -> flare up and then they would go away on their own - Could go into remissions -> Kings would have their courts, ppl suffering from scrofula would come to the courts -> King would wash his hands in water that was claimed to have healing powers -> he would touch their face and given them a gold coin -> healed!

Answer 88

- Feudal society: sharp division where elite ruler all of society - Kings have secular and religious power -> Monarchs as having magical/religious power -> Your king has a right to be your king and have control over you. Eg. Halfdan the Black -> body cut up when died and put in different places -> so places could have a good harvest -> he was said to have magical powers - Pius kings (religious) had reputations as healers (due to their religious devotion and secular power) -> eg. the King of England - By 13th c. kinds of Queens were said to heal scrofula -> just by touching the infected person

Answer 89

- French documents about the practice from reign of Philip IV (1285-1314) - In England Henry III (1216-1272) probably started the touch - His successor, Edward I (1272-1307) touched 533 of his subjects in one month. -> remission was actually on its own lol (but could come back) - Kings would have their courts, ppl suffering from scrofula would come to the courts -> King would wash his hands in water that was claimed to have healing powers -> he would touch their face and given them a gold coin -> healed!

Answer 90

- their significance lies in what they told us about medieval experience and understandings of disease -> relatively inconsequential in terms of mortality - Legislative repercussions - Material culture -> representation -> leprosaria

Answer 91

Plague of Justinian (541-549 CE)

Answer 92

- Black Death (even tho it wasn't referred to as such during that time). - Most severe in 1347 but kept recurring: 1750, 1947. -> in 1346 1 in 3 ppl died from Black Plague -> and again in 1750 (Europe) - Recurrence of plague contributed a lot to changes in health governance and biological impacts: disease that provides some immunity to plague in Turkey.

Answer 93

Trade routes. - Plague break out in China in 1320s (know this from medical records and cemetary records) - Travelled to Mongolia - Travelled to lower part of India - Made its way to Europe through trade - Movement of plague most likely due to trade routes

Answer 94

- From the Crimea, the disease first spread to Constantinople - First in Dec 1347 moved to Italy, then France, and Central Europe (took 6 months to cross France) -> took another year to reach the British Isles, Germany, Moscow - Even though Moscow was closer to the Crimea than Europe, it travelled through Europe first because it followed the main trade connections through Europe during the time. - Took about 4 years (Dec 1347-1351/52) -> Burned through a particular place for a few months, then went away. - Poland and Bohemia had low plague mortality (and Milan, Normeburg and some towns in Flanders)

Answer 95

- A few place, relatively free of plague -> Bohemia and part of Poland - Cities with lower mortality -> Milan, Nuremburg, towns in Flanders - Why differences in mortality? -> Timing: plague in summer vs. fall/winter COME BACK TO: -> and synergistic effects with other illnesses; more likely to die if it was also a season of influenza -> Actions by towns to moderate impact.

Answer 96

The number of people who contract a disease.

Answer 97

The number of people contracting a disease who then die from it.

Answer 98

The number of people dying from a disease in a defined population considered as a whole.

Answer 99

- Morbidity: 60-80% of Europeans infected. - Case Fatality Rate: 75-90% of those people died. - Mortality or Death Rate: between 30% and 50% of the European population (20-25 million people)

Answer 100

BLACK PLAGUE: Morbidity: 60-80% of Europeans infected. - Case Fatality Rate: 75-90% of those people died. - Mortality or Death Rate: between 30% and 50% of the European population (20-25 million people) 1918-19 FLU PANDEMIC (SPANISH FLU) - 2.6 millions deaths in Europe - Between 50-100 million deaths globally - Moratality rate globally around 2.5% high estimates of localized mortality rates up to 20% - Flu is hard to see in a historical document as a cause of death (no one was medically recording in the same kind of way as now)

Answer 101

BLACK PLAGUE: Morbidity: 60-80% of Europeans infected. - Case Fatality Rate: 75-90% of those people died. - Mortality or Death Rate: between 30% and 50% of the European population (20-25 million people) COVID-19 - 705 million cases globally, 7 million reported deaths - Not counting excess mortality, estimated in 2022 at 14.83 million excess deaths globally - Excess mortality → how many deaths were more likely attributable to the pandemic → when looking at historical deaths and epidemics, we are almost always looking at excess mortality - Mortality rate estimated around 0.28% (not counting excess deaths) → deaths peaked and then cases peaked → due to vaccines, which stopped ppl from dying (did not have this interference to prevent ppl from dying in the Black Death and flu pandemic)

Answer 102

Yersinia pestis (we can actually test it from biological evidence) - so the data for the numbers we have about it is pretty strong. - Estimates: -> 60% of London residents (100,000 people) died in 1 year -> 66% of the students at Oxford University died. 80% of the residents of Marseilles died. -> Evidence includes manorial accounts, where households or most of named tenants disappeared from one year to the next.

Answer 103

Eg. Florence - One of the richest cities in Europe at this time, hit with particular intensity. - Giovanni Boccaccio's The Decameron (1353) is a fictional story and also the best-known eyewitness account of the plague. - The Decameron, a story of seven men and three women who escape the disease by fleeing to a villa outside Florence. -> In the intro, he gives a graphic description of the effects of both the disease on ppl and the city as a whole. -> Describes how it appeared most dramatically as swelling or bugles that would appear on the armpits or groin (most people died) -> then spread on whole body -> then turned black (claimed most certain sign of death) -> welling followed boils or black spots on skin -> then vomited foul-smelling blood. -> Medieval Christians were thinking of disease mostly as morality, religion and behaviour. -> some ppl thought that if they behaved themselves and ate well and didn't eat too much, then they would survive this disease. - Some ppl also thought: "an infallible way of warding off this appalling evil was to drink heavily, enjoy life to the full, go round singing and merry-making..."

Answer 104

Siena, Italy: economic and political activity ceased from July -- August 1348. - woollen cloth industry stopped working - olive oil imports ceased - courts went to recess - Government ordered processes (religious) and ended legalized gambling (religious purpose, morality) - Fields in surrounding countryside were neglected, animals wandered, mills closed.

Answer 105

- Winter 1347 and spring 1348 - 45-75% of residents died in 6 months - Shops and factories closed, prices soared - Doctors charged extraordinary prices - Breakdown of social order -> The sick weren't being cared for, so even those who might have survived died. -> "such terror struck the hearts of men... brother abandoned brother.. and very often the wife her husband" - The Decameron - Focused efforts on moving dead bodies from the streets and burying them.

Answer 106

- small city: 11,000 people, 30km NW of Florence - Small executive council made up of Elders of the People - Debated all issues and made recommendation to a general city council (Council of the People) - Issued ordinances when plague arrived - only 25% of the city and nearby population died (due to their ability to maintain social orders) - RESILIENT SOCIAL FABRIC -> few months of disruption, then government worked, then ppl went back to work.

Answer 107

- No citizen shall in any way come or go - Gatekeeper should not permit those people coming from other cities or leaving. - Restrictions on movement of ppl or goods - Any used cloth, woolen or linen, may not come in either (indication that they thought goods could be repsonsible for spread of disease as well) - Bodies of dead should be placed in wooden casket and nailed shut → so no smell could come out → thought smell was making them sick (bad smells could make you sick) → - Butchers and retail vendors had to also control the smell from their shops - Ordinances are useful bc they speak to the maintenance of government and legal authority → were trying to control things - Stop tolling bells for mourning so as not to incite undue fear → otherwise bells would ring incessantly - People shouldn’t get mourning clothing unless it was actually husband or wife

Answer 108

To stop undue fear, and to keep a strong social fabric and prevent the social breakdown in order to prevent large-scale death.

Answer 109

- Legal and political business stopped. - Except... continued to write wills (not complete social order breakdown) -> so still some maintanence of social order -. bc it required lawyers to continue meeting with ppl and writing wills. - After worst had passed, other legal documents reappeared. -> Estate, settlements, disputes among heirs, apprenticeship contracts. -> if you survived the Black Death, things were economically better for you -> more opportunities, better distribution of wealth.

Answer 110

- Lepers -> bc they had some immunity -> and due to their immorality -> leprasariums were attacked and lepers killed - Urban Jewish populations -> Frankfurt, Mainz, Cologne, Brussels -> 1348-51 accused of poisoning food, wells, streams -> Massacres (rounded up and killed en masse - God's Anger: ease of divine rage - Religious processions - New laws enforcing morality (eg. ending legalized gambling, swearing forbidden; unmarried couples that were cohabiting were told to get married) - Apocalyptic movements - Flagellants in the Netherlands -> would punish their own bodies to ward off evil, for the sake of society. -> These were radical Christians that moved through processions in Germany and Netherlands -> they saw plague as indicative of the apocalypse and viewed themselves as armies of saints

Answer 111

Culture attempted to normalize the Great Dying - Medieval artists started emphasizing that you needed to confront death: looking death in the face. - Memento mori - to "remember death" as always waiting and sparing no one.

Answer 112

Black Death refers to initial most severe pandemic (1347-1353), part of longer Second Plague Pandemic (continued into 18th c. in Europe) -1/3 of European population killed - Social breakdown and resilience - Enduring cultural effects

Answer 113

- Environment: Disease has environmental causes (bad air, water) - Contagion: Disease is caught from other people, animals -> In different historical contexts, one mode of thinking has dominated over the other. -> in general, both coexist as understandings of disease causation and spread (etiology)

Answer 114

- Most people turned to God's wrath as an explanation for such a comprehensive disaster. - Human race being collectively punished -> From previous disasters draught and famine to Black Death -> Believed the apocalypse was happening.

Answer 115

- Pistoia ordinances had elements of contagion and environment as playing a role. ->bc they stopped ppl from moving, there was a sense that ppl were spreading it. - Medical faculties at universities at the time -- steeped in Galenic understanding emphasized hot, moist air putrefied by God's anger (action) as entering the lungs and causing a disorder of blood. -> incorporates idea of god's wrath, humoural theory, as well as ideas of the environment which was more prevalent at this time (instead of contagion)

Answer 116

- Rejected authorities and emphasized experience - Tried to come up with ways to avoid contagion from person or bad air (coming into contact with the air) -> Environment and contagion -> bc in a sense the environment (bad air) is a source of contagion. - Eg. costume worn by plague doctors (in 15th and 16th c. in particular) -> response/ways of dealing with disease -> covering themselves so they don't have to touch ppl -> mask and beak -> beak is where you stuck things that smelled nice (rose petals, mint, camfor) to purify the air -> things that smelt better were thought to have protected them.

Answer 117

- Heavenly -> conjunction of Jupiter and Saturn, eclipses, comets, moon (influencing the spread of plague) - Plutonic -> volcanoes (with everything from volcano came corrupt air) (also Italy had volcano which is where the plague stated), earthquakes. - Supernatural -> Demons, angels -> eg. a small blue flame had been seen in the sky in Disldorf in 13... and was thought to be a cause of plague. -> Witches: L'Ulcereuse

Answer 118

- 1347 Catanians tried to keep out people fleeing Messina - 1348-50: attempts at controlling movement across Europe -> stop and examine travellers -> port cities refused to allow ships with plague victims to land - Shunned the bodies of victims -> bodies left to rot, thrown over city walls, mass graves (burial mounds) - Dogs and cats were massacred -> Ironic: in killing dogs and cats, it probably increased the rat population (counter-productive)

Answer 119

Quarantine (quarante giorni) was first introduced in 1377 in Dubrovnik -> fairly recent after first wave -> ships were banned from coming to land for 40 days and then would be allowed in. - Ships were forced to anchor for 40 days. -> generally understood as length of time needed for the disease to burn out. - No contact - 1720 military-enforced quarantine a Marseilles -> successul -> ships from Ottoman Empire came into Marseilles with ppl who were sick on board. -> Quarantine imposed and military enforced it -> troops stationed to keep a barrier and enforce the quarantine -> anyone who wasn't respecting it would be shot - End of 2nd plague pandemic in Europe in 18th c.

Answer 120

- Caused by Yersinia pestis (pathogen) -> Alexandre Yersin and Kitasato Shibasaburo were investing plague in China in late 19th century. - Discovered the bacteria responsible for plague. - Yersin claimed it was the same one that had hit Europe in the 14th c.

Answer 121

Rattus rattus (black) - Bubonic plague understood as a disease of rodents who acted as reservoirs for yersinia pestis. - Timid, good climbers, like human dwelling, live in colonies close to humans who give them food and shelter. - Endemic plague in rat population -> low level can cause low mortality over time - Circulates among rates in flees

Answer 122

Xenopsylla cheopsis (rat fleas) - Transmits it by taking the blood meal from an infected rate, the bacteria multiplies in the flea and when it goes to bite the next rodents. it spreads to the next rodents. - If you get a more severe epizootic among the rats -> rats suffering from malnutrition so more vulnerable or more virulent -> rats start dying off -> fleas more hungry so they look for more food -> go to human populations - Humans are not permanent hosts for yersinia pestis -? humans die quickly from it. -> How you get the plague epidemics burning out and ending.

Answer 123

Bubonic - Characteristic buboes/swellings, groin and armpit (at the site where the person was first bitten by the flee) - Spread by fleas on rates (epizootic) - No immunity to Bubonic plague - Acute, high mortality -> outbreak ends very quickly -> die too quickly to spread it too far Pneumonic -> infected the lungs -> spread by contaminated saliva between humans (spread between humans directly) -> acute, high mortality -> outbreak ends very quickly -> die too quickly to spread it too far Septicemic -> Infect the blood -> Spread between humans -> Acute, high mortality ->outbreak ends v quickly -> die too quickly to spread it too far.

Answer 124

- After 1353, recurrences of plague - 1356-66 Pestis secunda -> covered most of Europe, killed many children -> adults had some acquired immunity - Again 1372 -> another wave - And after that through 15th c. - Last major European outbreak in 1720. - But Second Plague Pandemic endured elsewhere... -> specifically in the Ottoman Empire

Answer 125

- Last recorded plague outbreak in Turkiye dates to 1947. - Plague as the dominant epidemic disease in Ottoman life. - Formation of a public health system (from 16th c.) - Cleanliness and hygiene in urban spaces, especially Istanbul. -> air, water, morals. - Biological legacy of long history with plague: familial Mediterranean fever (FMF) -> genetic disease -> offers protecting from plague (yersinia pestis) (gives resistance to Y. pestis)

Answer 126

- Formed a demographic crisis - Fall-off of growing population -> took centuries for reproduction to restore the population. - Also due to Great Famine - Black Death -> killing 30-50% of population - Collapse of European populations - Ongoing migration (instability) - Europe went from having expensive land and cheap labour before plague to rising labour costs and falling land prices

Answer 127

the study of statistics as births, death, income or the incidence of disease which illustrate the changing structure of human populations.

Answer 128

- Landlords lost power, lives of peasants improved. - Land use shifted from arable (grain) (requires lots of human labour) to pasture (livestock). - Marginal lands abandoned -> focused on richer lands - Survivors wealthier than before, more disposable income. -> end of medieval period 1350-1550 -> Black Death was an economic departure in terms of creating new relationships between land and labour.

Answer 129

- Plague deaths at all levels of society and in all age groups - Authority of the Church as an institution declined -> Bc the church wasn't really able to help anyone against "God's wrath" -> opposition to the church (another marker to end of this period in European history) - Even as religious beliefs strengthened -> Flagellans -> Spirituality and belief in god and god's wrath was reinforced. -> radicals

Answer 130

- 1980s and 1990s before good aDNA research - Discrepancies between 19th century plague and recorded medieval experience of Black Death -> impacts on children -> immunity -> 15th c.: less mortality in subsequent outbreaks -> 19th c: no evidence of immunity - No rat remains -> partly bc rat remains don't make for good archealogical findings, past not concerned about rats - Spread too quickly -> medieval plague much quicker and aggressive than 19th c. - Resolved in part through aDNA research, showed a mutation of Y. pestis (from the teeth) in early 1300s. → 2 strains → one now extinct, one significantly changed -> So it was the same, but also different (extinct strains) → yes it is all Black Death, but pathogens also change over time. → we can’t always think of the exact same disease moving through a population → different strains

Answer 131

- Syphillis and typhus (linked to warfare) - Malaria (environment change) - peak in about 1200 - Leprosy in decline, Tuberculosis on the rise (urbanization)

Answer 132

- 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

Answer 133

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

Answer 134

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

Answer 135

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

Answer 136

- 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

Answer 137

- 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)

Answer 138

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

Answer 139

- 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

Answer 140

referred to great medical physicians

Answer 141

- 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.

Answer 142

- 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.

Answer 143

- 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

Answer 144

- 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 - Ibn al-Nafis’ (d. 1288) description of the movement of blood

Answer 145

- 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

Answer 146

- 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

Answer 147

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

Answer 148

- 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

Answer 149

- 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)

Answer 150

- 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 troops 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

Answer 151

- Different names given to Syphilis - Blaming disease on the countries next door - In France, they are calling it the Italian disease - In Italy they are calling it the French disease - In Scotland → Grandgore referred to how awful the disease was in 15th and 16th c. - Also a certain amount of colonial/imperialism - Canton/Chinese rahs/ulcer referred to Guangzhou → the only part of China at the time open to Europeans - Speaks to Charles’ the 8th’s army who was pulled from different parts of the continent and sent back - Blamed “the other” who was seen to be dirty, unclean, and an unwelcome enemey (connotation attached to the names)

Answer 152

- “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.”

Answer 153

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 - Some of his crew joined the army of Charles VIII of France

Answer 154

- 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

Answer 155

- 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

Answer 156

- **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

Answer 157

- 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

Answer 158

- 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

Answer 159

- 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

Answer 160

- 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.

Answer 161

- 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

Answer 162

- 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

Answer 163

- 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)

Answer 164

- Girolama Fracastoro - 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

Answer 165

- 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

Answer 166

- 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

Answer 167

- 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

Answer 168

- 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

Answer 169

- 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