Plagues and People Midterm

1. How did transportation advances affect the spread of diseases?

• Impact: Advances in transportation, such as ships, trains, and later airplanes, facilitated the rapid spread of diseases across regions and continents. For example, the Columbian Exchange led to the transmission of diseases like smallpox and syphilis between the Old and New Worlds.

• Examples:

  • Smallpox: Spread to the Americas via European ships, devastating Indigenous populations.

  • Yellow Fever: Transported via ships from Africa to the Americas, thriving in tropical climates.

• Modern Context: Globalization and air travel have accelerated the spread of diseases like COVID-19.

2. Who bore the brunt of the blame for the pox in late 16th and early 17th century London, and why?

• Blame: Marginalized groups, particularly the poor and sex workers, were blamed for the spread of syphilis (the "pox").

• Reason: The disease was associated with immoral behavior, and societal stigma led to scapegoating. The upper classes often blamed the lower classes for spreading the disease through promiscuity.

3. What did the term “Virgin Soil Epidemic” mean?

• Definition: A "Virgin Soil Epidemic" refers to the introduction of a disease to a population that has no prior immunity, leading to catastrophic mortality rates.

• Example: The introduction of smallpox to Indigenous populations in the Americas, who had no prior exposure, resulted in mortality rates of 50-90%.

4. What was the relationship between efforts to control yellow fever and the politics of race in late eighteenth-century Philadelphia?

• Race and Disease: Enslaved Africans were believed to have immunity to yellow fever, which was used to justify their exploitation in plantation economies.

• Philadelphia Outbreak (1793): The outbreak led to racialized responses, with African Americans being both praised for their perceived immunity and exploited for labor during the crisis.

5. What is modern about the plantation complex?

• Modern Aspects:

  • Global Scale: Plantations were part of a transoceanic economic system, financed by joint-stock companies.

  • Export-Oriented Monocultures: Focused on single crops like sugar for export, rather than subsistence farming.

  • Labor Exploitation: Relied on enslaved labor, which was race-based and hereditary, unlike earlier forms of slavery.

6. What is retrospective diagnosis, and why is it a problem?

• Definition: Retrospective diagnosis is the process of identifying diseases in historical populations using modern medical knowledge.

• Challenges:

  • Pathogen Evolution: Diseases evolve, making it difficult to match ancient pathogens to modern ones.

  • Limited Evidence: Degraded or incomplete historical evidence complicates accurate diagnosis.

7. What is a vector?

• Definition: A vector is an organism (e.g., mosquito, flea) that transmits pathogens from one host to another.

• Examples:

  • Mosquitoes: Transmit yellow fever and malaria.

  • Fleas: Transmit the bubonic plague.

8. Contagion: What is it?

• Definition: Contagion refers to the spread of disease through direct or indirect contact with an infected person or object.

• Example: The bubonic plague spread through flea bites, while smallpox spread through respiratory droplets.

9. What factors prompted more modern epidemiology?

• Factors:

  • Yellow Fever and Tropical Medicine: Research into vector-borne diseases like yellow fever led to advancements in understanding disease transmission.

  • Decline of Humoral Theory: The rejection of outdated theories like miasma and humoral imbalance in favor of germ theory.

  • Quarantine Failures: The realization that quarantine alone was insufficient to control diseases like cholera and yellow fever.

10. Why did Guaiac wood seem like it worked?

• Humoral Theory: Guaiac wood was believed to have warm and dry qualities, counteracting the cold and wet humors associated with syphilis.

• Placebo Effect: While it didn’t cure syphilis, it provided temporary relief by inducing coughing, which cleared phlegm and made patients feel better.

11. What was the thought process of bloodletting, and how was it done?

• Theory: Bloodletting was based on humoral theory, which posited that diseases were caused by imbalances in the four bodily fluids (blood, phlegm, yellow bile, black bile).

• Practice: Physicians would open a vein to remove "excess" blood, often using leeches or lancets. It was believed to restore balance and treat conditions like the plague.

12. How and why are some diseases eradicated from nature, and some are not?

• Eradication Factors:

  • Human-Only Pathogens: Diseases like smallpox, which only infect humans, are easier to eradicate because they have no animal reservoir.

  • Vaccination: Effective vaccines and global immunization campaigns led to the eradication of smallpox.

  • Non-Eradicable Diseases: Diseases like yellow fever and malaria persist due to animal reservoirs and vector-borne transmission.

13. Yellow fever, slavery, and racism: How was slavery justified through disease?

• Justification: Europeans claimed that Africans were "immune" to tropical diseases like yellow fever and malaria, using this as a rationale for enslaving them to work on plantations.

• Reality: While some Africans had genetic resistance to malaria (e.g., sickle cell trait), they were still vulnerable to yellow fever.

14. What’s the history of sexuality and class disparity within the pox?

• Sexuality: Syphilis was heavily stigmatized due to its association with sexual behavior. Men were often excused for premarital encounters, while women were expected to remain pure.

• Class Disparity: The poor and sex workers bore the brunt of the blame for spreading syphilis, while the wealthy used makeup and beauty patches to hide symptoms.

15. What was the Industrial Revolution, and what was its impact on cholera?

• Industrial Revolution: A period of rapid industrialization, urbanization, and technological advancement in the 18th and 19th centuries.

• Impact on Cholera: Overcrowded cities with poor sanitation created ideal conditions for cholera outbreaks. Contaminated water supplies, like the River Thames in London, became breeding grounds for Vibrio cholerae.

16. What was the colonization of Haiti and India, and how did it affect diseases?

• Haiti: The colonization of Haiti (Saint-Domingue) led to the exploitation of enslaved Africans for sugar production, which created ideal conditions for yellow fever. The Haitian Revolution (1791-1804) was influenced by yellow fever, which decimated European forces.

• India: British colonization led to the spread of cholera through contaminated water systems and famine conditions. The British also implemented ineffective public health measures, contributing to high mortality rates.

17. What were perspectives on cholera considering social, cultural, and epidemiological factors?

• Social: Cholera was often blamed on the poor, who were seen as unclean and morally deficient.

• Cultural: Religious groups sometimes viewed cholera as divine punishment for sin.

• Epidemiological: Early theories, like miasma, were later replaced by germ theory, which identified contaminated water as the source of cholera.

18. Why was cholera such a big problem - urbanization/modernity?

• Urbanization: Rapid urban growth during the Industrial Revolution led to overcrowded cities with inadequate sanitation.

• Modernity: The lack of understanding of germ theory and reliance on outdated medical practices (e.g., humoral theory) exacerbated the spread of cholera.

19. Smallpox as bioterrorism:

• Example: During the Seven Years’ War (1756-1763), British forces gave smallpox-infected blankets to Native Americans, intentionally spreading the disease as a form of biological warfare.

• Impact: This act of bioterrorism weakened Indigenous resistance and contributed to the devastation of Native populations.

Key Concepts and Themes:

• Epidemics as Social Constructs: While diseases have biological realities, societal responses (e.g., scapegoating, quarantine) are shaped by cultural, political, and economic factors.

• Public Health Measures: From quarantine to vaccination, public health interventions have evolved in response to epidemics, often reflecting broader societal values and power dynamics.

• Colonialism and Disease: The spread of diseases like smallpox and yellow fever was deeply intertwined with European colonization, leading to the devastation of Indigenous populations and the exploitation of enslaved Africans.

• Medical Advancements: The transition from humoral theory to germ theory marked a significant shift in understanding and treating diseases, leading to modern epidemiology and vaccination.

Plagues and People

Odelia Fan

Dr. Geoff Bil

HIST 170 Plagues and Peoples in Human History

February 5th, Wednesday - Introduction

Retrospective Diagnosis

• The process of identifying diseases or causes of death in historical figures or populations using modern scientific methods.

• Example: Pharaohs’ causes of death determined through bone fragments, DNA analysis, and other archaeological evidence.

Challenges

• Pathogens evolve over time, making it difficult to match ancient diseases to modern counterparts.

• Limited or degraded evidence from the past complicates accurate diagnosis.

• Importance: Helps understand historical disease patterns and their impact on societies.

Humoral Theory

• A medical theory originating in ancient Greece and Rome, later formalized by Galen.

• Diseases were attributed to imbalances in the four bodily fluids (humors): blood, phlegm, yellow bile, and black bile.

Miasma Theory

• A related concept where diseases like cholera and typhoid were blamed on "bad air" (miasma) from poor sanitation.

• Victims were often unfairly blamed for their conditions due to lack of understanding of bacteria and pathogens.

• Later discoveries revealed that these diseases were caused by bacteria in contaminated food and water (e.g., Vibrio cholerae for cholera).

Galen (129 - 210 AD)

• Background: Greek physician, philosopher, and writer during the Roman Empire.

Contributions

• Advanced understanding of anatomy, physiology, the circulatory system, and the nervous system.

• Developed the humoral theory, which dominated Western medicine for over a millennium.

• Wrote extensively on medical theory and practice, influencing both Islamic and European medicine.

• Legacy: One of the most influential figures in medical history, though some of his theories were later disproven.

Epidemics and Modernity

• Public Health: State-sanctioned medical interventions to protect and improve population health.

• Modernity: Characterized by the rise of nation-states, borders, and the extension of state powers.

• Key measures: quarantine, vaccinations, veterinary medicine, and border control.

Examples of Public Health Measures:

• Positive: Vaccination campaigns, sanitation improvements, and disease surveillance.

• Negative: Missteps like the widespread use of DDT (a toxic pesticide) to combat malaria-carrying mosquitoes.

• DDT had severe environmental and social repercussions, including ecological damage and human health risks.

Trucker Protests (2022)

• Overview: Known as the “Freedom Convoy,” a series of protests in Canada against COVID-19 measures, including vaccine mandates and quarantine policies.

Key Features

• Primarily led by truckers but included a diverse range of participants, with small but vocal Indigenous involvement.

• Controversial elements: Some protesters displayed swastikas and Confederate flags, leading to public backlash.

Impact

• Protesters occupied Ottawa for a month, disrupting daily life with constant horn-blowing.

• Prime Minister Justin Trudeau invoked the Emergencies Act, allowing the suspension of civil liberties, freezing protesters’ assets, and deploying law enforcement to clear the protests.

Aftermath

• Protests dissolved, but concerns arose among Indigenous communities and socialists about the potential misuse of state power and the implications for civil rights.

Additional Notes

• Historical Context: Understanding past epidemics (e.g., Black Death, Spanish Flu) helps contextualize modern public health challenges.

Lessons Learned

• Importance of balancing public health measures with civil liberties.

• Need for evidence-based policies to avoid unintended consequences (e.g., DDT, vaccine skepticism).

February 10th, Monday - Bubonic Plague and the Modern State Part 1

Epidemics as Non-human Historical Agents

• Concept: Epidemics are often seen as forces of nature that act independently of human control, yet they profoundly shape human history.

• Focus: The interplay between epidemics and human social tensions, including how societies respond to disease outbreaks.

• Key Question: What is more important in understanding epidemics—the biological nature of the disease itself, or the human reactions, government decisions, and social consequences?

• Biology: The pathogen’s characteristics (e.g., transmission, mortality rate) are critical.

• Human Affect: Government policies, public fear, stigma, and social inequalities often determine the course and impact of an epidemic.

Are Epidemics Socially Constructed?

• While the biological reality of disease is undeniable, the way societies perceive, respond to, and remember epidemics is shaped by cultural, political, and economic factors.

• Example: The labeling of diseases (e.g., “Spanish Flu”) often reflects social biases rather than scientific facts.

Bubonic Plague

• Overview: A devastating pandemic caused by the bacterium Yersinia pestis, transmitted via fleas on rats.

Impact on Society:

• General Collapse of Social Norms: The plague led to widespread fear, panic, and breakdown of societal structures.

• Mass deaths disrupted economies, labor systems, and religious practices.

• Scapegoating and persecution of marginalized groups (e.g., Jews during the Black Death) were common.

• Long-term Effects: The plague reshaped European society, contributing to the decline of feudalism and the rise of modern labor systems.

Vanitas

• Definition: A genre of still-life painting that emerged in the 16th and 17th centuries, particularly in the Netherlands.

• Theme: Memento Mori (“remember death”)—a reminder of the inevitability of death and the futility of worldly pursuits.

Symbolism:

• Skulls: Represent mortality.

• Time Symbols: Clocks, hourglasses, and watches symbolize the passage of time and the brevity of life.

• Worldly Possessions: Jewelry, globes, and luxury items highlight the transient nature of wealth and status.

• Candles: Often shown extinguished or burning low, symbolizing the fragility of life.

Example:

• “Allegory of Vanity” (1632/1636) by Antonio de Pereda:

• Features a skull surrounded by luxurious items, timekeeping devices, and other symbols of vanity and mortality.

• Reflects the Baroque era’s preoccupation with the fleeting nature of life and the inevitability of death.

Additional Notes

• Epidemics and Art: The bubonic plague and other epidemics influenced artistic movements like Vanitas, as people grappled with themes of mortality and the fragility of life.

• Historical Parallels: The social and cultural responses to epidemics (e.g., scapegoating, artistic expression) often repeat across history, highlighting recurring human behaviors in the face of crisis.

February 12th - Wednesday 

Cultural Significance of the plague examples

• Two published volumes called the “Ars Moriendi” (art of dying), telling people that everyone dies, how to die, and not to be afraid of dying if you do it correctly

• Danse Macabre (genre of art)  - people from diverse backgrounds who may or may not be dancing with music and accompanied by at least 1 skeleton

• Danse Macabre are less serious than vanitas and vanitas were more serious works of art

• Mid 1400’s onward art was very focused on death

Bubonic Plague of late 1340

• Most devastating due to body count

• Waves would occur once per generation 

• Would exert a major check on population numbers well into the 18th century

• Mid 14th century was the worst was but was also a concern thereafter

Regulations and Impact

• Destabilizing impact of the plague, state and civic officials in the late 14 century began to implement regulations

• Like quarantine, travel and trade restrictions, intelligence gathering networks (where the plague would be likely spread, who would spread and where/who to quarantine)

• Rudiments of modern governmental power

• With that power began to mitigate plague and decrease deaths

• Along with that began the threat of coercion

• Soldiers were involved of this

• Sanitary cordon = lines of soldiers/ militarized borders to prohibit travel

• Scaffolds = public hanging and public or where you would be locked up publicly

• Whole idea to show onlookers cost of not listening to authority

• Habsburg empire - modern day austria and hungary

• Habsburn had sanitary cordon from Adriatic Sea to the mountains of romania (covering entire bottom of the border between Hungary and the ottoman empire)

• Habsburgs wanted to keep the ottoman empire

• Also helped with protecting habsburg people from olagues coming from central Asia

• Soldiers could shoot anyone they thought were violating quarantine 

• Naval officers were also involved

• They were concerned the travel and trade restrictions would affect maritime traffic as well

• Beginning in 15th century european ports began building lazarettos

• Lazaretto = quarantine facilities where you get off a ship and quarantine for up to 40 days

• Philadelphia in the US had one as well 

• Barcelona in Spain they decided that pets fault of the plague and they were forced to kill their pets

Printing press

• Helped spur the protestant reformation in the early 16th century 

• Helped Copernicus and Galileo publish their works challenging the views against the church and the earth was the center of the universe 

Chaos of War and Upheaval (1517 - 1648)

• Protestants fighting each others and catholics  

• Era of Witch trials in europe

• American ones happened but later 

• All this religious and sectarian chaos fed into the modern european nation state chaos

• Led to absolutist monarchies where the king or queen had all the levers of state power, no democracy, no checks or balances, and no constitution.’

• Prevailing economic system was all about centralizing wealth in as few hands as possible (usually around the king and his circle)

• Catholics would pray to saints to be protected bt the plague

• Protestants would turn to modern medicine

Yersinia Pestis (Y. Pestis)

• Intestinal bacteria 

• Inhabits non human vectors

• Vector = organisms that carry pathogens like Y. Pestis

• Vectors would include species of rodents 

• In rural areas especially and areas that had a lot of underground living marmats and rodents

• Fleas that live on those rodents 

• Final species = humans, not that important to Y. pestis’ life cycle but primarily affects animals.

• Infects and kills burrowing mammals in large numbers but deaths mostly go unnoticed by humans 

• Y pestis infects fleas by blocking a valve that allows food to go into the fleas stomach

• The hungry flea goes to bite a human or animal to ingest the blood but it’s blocked and hits the wall of Y pestis bacteria that's it the fleas esophagus and gets regurgitated into whatever organism the flea was trying to bite

• Regurgitated blood has bits and pieces of Y. Pestis and spreads to the organism 

• Flea dies of starvation 🙁

• Also can spread by animal carrying Y. pestis by being bit, scratched, or eating an infected animal

• More likely to happen to hunters that hunt highland marmots

• Rats (primarily in urban environments) carried the fleas

• Plague outbreaks were so explosive since all the rats would be infected at once and die at around the same time and all the fleas would jump onto the next warm body as quickly around the same time (sometimes humans)

Pneumonia Plague

• Plague infection in your lungs

• Spread when Y pestis bacteria being spread between human and human via breath droplets (having Y pestis and you cough on someone)

Symptoms

• Reproduces (Y pestis) rapidly in your bloodstream and then your lymphatic system

• As (Y pestis) is filtered by the lymphatic system large painful swellings called buboes (bubonic plague name comes from)

• Buboes accumulate where your lymph nodes are

• Saint Sebastion = prominent church symbol for the plague, thought could protect from plague

• Once lymph nodes becomes overwhelmed, y pestis circulates more freely in the blood

• Uncontrolled blood clotting, tissue death, bleeding, organ failure… (similar to fleas)

• Symptoms: High fever, uncontrollable thirst, if lucky enough to survive bubonic plague (rarely happened) you’d would be left with things like impaired hearing, vision, and memory loss and trauma

• You don’t get immunity if you get it

• Tended to coincide in spring and summer (warm and humid) flea vectors preferred and they would reproduce

Where did plague come from?

• Emerged in europe in mid 14th century 

• Most research says Y pestis came from centraal asian among the Highland marmots and circulated and wrought havoc among poor animals way before it began to infect humans

• First recorded plague was in 541 and wrought havoc in the mediterranean island constantinople and during the byzantine empire 

Second major (late 1340’s) plague 

• After landing in europe and then spread from europe the egypt and then south across africa and was very destructive 

• 14th century was so deadly even more than 541 due to europe during increased population growth - closer density in cities

Little Ice Age

• Period of cooler and wetter weather

• 13th century to 19th century (roughly)

• Was followed by a population and urbanization boom

• When little ice age hit the populations was hit the threat of famine

• Vast disparities (like quality of life) between rich and the poor made it even more difficult during the late medieval period 

• People who grew up during the little ice age there were shortage on food and children were malnourished and become adults with weak immune systems - explains why so many die during the bubonic plague and become less lethal as centuries went on

• Disease become more lethal in the 1340’s and less after that as brown rate took other other rat species in numbers as they were less comfortable with humans 

• Makes plague transmission difficult

• Another reason for decline in plague mortality is advancement in public health infrastructure

• Like quarantine houses, lazarettos, sanitary cordons, public boards of health and they would have dictatorial powers during plague outbreaks and grave digging (getting rid of bodies ASAP), and restrictions on public gathering

• These practices expanded form the 14th century onward

• People began understanding the plague better

Alexandre Yersin 

• French swiss pathogen

• Located the source/cause of the plague

• His insights led to the discovery of roles of fleas and than public health authorities could target that cause to fight the plague

February 14th - Friday

Hippocratic Medicine

• Sought to understand the human body as a system that could be managed with therapies

• Worked to tried to understand the human body, medicine and systems separate from religion 

Humoral Theory

• 4 humors:

• Blood

• Yellow bile

• Phlegm

• Black bile

• Needed to stay balanced to stay healthy 

• Humor physician tried to fix people’s humors through things like exercise

• Yellow bile too much = prescribe too much they prescribe you something that makes you throw up

• Black bile makes you too depressed or stressed and they’d blame being too cold and would make you eat warm things and red meat

Claudium Galen

• Scholar of Anatomy

• Introduced bloodletting (opening of vein and let blood let)

• Added environment factors to contribute to humoral theory 

• Miasma = polluted or poisonous air (when the air doesnt smell right)

• Miasma was prevalent during the plague due to things like the dead bodies

• Miasma was blamed for the plague as well as things like butchery and public health officials doubled down on them.

Blood letting

• One of Galen’s innovations

• Opening of the plague 

• Too much hot blood was to blame for the plague

• Would drain out the excess blood

More

• Rats were more of a side effect of miasma than as a cause of spreading as it really was 

• Aromatic herbs were put into the beak of the plague costume ans the rest was to protect the person inside as much as possible

John of Burgundy 

• Physician 

• Has a humor framework

• Says the disease doesn’t hesitate and neither should everyone else and should quickly act with bloodletting

Figures who challenged ancient world theories like the cosmos was earth centered 

• Nicolaus Copemicus

• Galileo Galilei

• Issac Newton 

Christains during the plague

• Thought the plague was a response for their sin

• Would hurt themselves to demonstrate their guilt and repentance 

• One common response was pinning the blame on jews: Punishing them, massacring them, ostracizing them, and kicking them out of areas.

• General sentiment was that Jews were more immune than christians 

• Violence against jews were horrific including being burned 

San Francisco Bubonic Plague Outbreak (1900 - 1904)

• Chinese people were faced with a lot of discrimination

• Were blamed for economic failure and stealing jobs

• Plague was brought to San Francisco from steam boats from hong kong where rats with fleas snuck on

• Once the plague broke out in Chinatown neighborhood, authorities wouldn’t let them leave or flea

1. The agency of non human actors in the history of pandemics

2. How pandemics (and responses to them) have helped give rise to institutions we associate with modernity

3. The importance of considering these processes in historical context

4. How pandemics (and responses to them) have reflected or even reinforced  

February 12th, Wednesday - Bubonic Plague and the Modern State Part 2

Cultural Significance of the Plague: Ars Moriendi (“The Art of Dying”):

• Two published volumes in the 15th century that provided guidance on how to die a “good death.”

• Emphasized acceptance of death, spiritual preparation, and avoiding fear.

• Reflected the pervasive presence of death during the plague era.

Danse Macabre:

• A genre of art and literature depicting people from all walks of life (rich, poor, clergy, peasants) dancing with skeletons.

• Symbolized the universality of death and the equality of all people in the face of mortality.

• Less serious in tone compared to Vanitas art, which focused on the solemnity of death and the futility of worldly pursuits.

• Mid-1400s Art: Death became a central theme in art, reflecting the trauma and omnipresence of mortality during and after the plague.

Bubonic Plague of the Late 1340s Impact:

• Overview: The most devastating pandemic in human history, caused by Yersinia pestis.

• Massive death toll, with waves recurring every generation, suppressing population growth well into the 18th century.

• The mid-14th century outbreak was the deadliest, but the plague remained a concern for centuries.

• Social Collapse: Breakdown of social norms, economic systems, and religious practices due to widespread fear and death.

• Regulations and Impact

State Responses:

• Late 14th-century governments implemented measures to control the plague:

• Quarantine: Isolating infected individuals or communities.

• Travel and Trade Restrictions: Limiting movement to prevent spread.

• Intelligence Networks: Monitoring outbreaks and identifying high-risk areas.

• These measures laid the foundation for modern public health systems.

• Sanitary Cordon: Militarized borders (e.g., Habsburg Empire) to enforce quarantine.

• Soldiers were authorized to shoot violators, reflecting the harsh enforcement of public health measures.

• Lazarettos: Quarantine facilities built in European ports starting in the 15th century.

• Example: Philadelphia and Barcelona had lazarettos to isolate travelers and prevent disease spread.

• Coercion and Public Discipline: Public executions and punishments (e.g., scaffolds) were used to deter non-compliance with health regulations.

• Example: Barcelona officials blamed pets for the plague and ordered their mass killing.

Printing Press and Its Impact

• Protestant Reformation: The printing press enabled the rapid spread of ideas, fueling religious reform in the early 16th century.

• Scientific Revolution: Helped figures like Copernicus and Galileo publish works challenging traditional views (e.g., heliocentrism vs. geocentrism).

• Chaos of War and Upheaval (1517 - 1648)

• Religious Conflicts: Protestants and Catholics fought for dominance, leading to widespread violence and instability.

• Witch Trials: A surge in witch hunts across Europe, fueled by religious and social tensions.

• Rise of Absolutist Monarchies: Centralized power in the hands of kings and queens, with no democracy or checks on authority.

• Economic Centralization: Wealth concentrated among the elite, exacerbating social inequalities.

Yersinia Pestis (Y. Pestis)

• A bacterium that primarily infects rodents and fleas.

• Humans are accidental hosts, not essential to its life cycle.

Transmission:

• Fleas become infected and transmit the bacteria to humans through bites.

• Blocked fleas regurgitate infected blood into hosts, spreading the disease.

• Also spread through contact with infected animals (e.g., hunters handling marmots).

• Urban Outbreaks: Rats in cities carried infected fleas, leading to explosive outbreaks when rat populations died off.

Pneumonic Plague

• Definition: A severe form of plague where Y. pestis infects the lungs.

• Transmission: Spread through respiratory droplets (e.g., coughing), making it highly contagious.

Symptoms of Bubonic Plague

• Buboes: Painful swellings in lymph nodes, the hallmark of bubonic plague.

• Systemic Effects: Uncontrolled blood clotting, tissue death, organ failure, and high fever.

• Long-term Effects: Survivors often suffered from impaired hearing, vision, and memory loss.

• Seasonality: Outbreaks peaked in warm, humid months when fleas were most active.

Origins of the Plague

• Central Asia: Y. pestis likely originated among marmots and rodents in Central Asia.

• First Recorded Outbreak: The Plague of Justinian (541 AD) devastated the Byzantine Empire.

• Second Pandemic: The Black Death (1340s) spread from Europe to Africa, causing unprecedented death tolls.

Little Ice Age

• Timeline: 13th to 19th centuries, marked by cooler and wetter weather.

• Reduced agricultural productivity, leading to famines and weakened immune systems.

• Contributed to the high mortality rates during the plague.

• Advancements in Public Health

• Quarantine Facilities: Lazarettos and sanitary cordons became widespread.

• Public Health Boards: Established to enforce measures like grave digging and restrictions on public gatherings.

• Decline in Plague Mortality: Improved infrastructure and understanding of disease transmission reduced outbreaks over time.

Alexandre Yersin

• Discovery: Identified Yersinia pestis as the cause of the plague in 1894.

• Impact: His work highlighted the role of fleas in transmission, guiding public health responses.

February 14th, Friday - Bubonic Plague and the Modern State Part 3

Hippocratic Medicine

• Focus: Understanding the human body as a system that could be managed through therapies.

• Separation from Religion: Emphasized natural causes of disease rather than divine intervention.

Humoral Theory

• Four Humors: Blood, yellow bile, phlegm, and black bile.

• Balance: Health depended on maintaining a balance of these fluids.

• Treatments: Bloodletting, vomiting, and dietary changes were used to restore balance.

Claudius Galen

• Advanced humoral theory and introduced bloodletting as a treatment.

• Linked disease to environmental factors like miasma (bad air).

• Legacy: His ideas dominated Western medicine for centuries.

• Bloodletting: To remove “excess” blood and restore humoral balance.

• Use During Plague: Believed to treat “hot blood” associated with the disease.

Plague Costumes

• Design: Included aromatic herbs in beak-like masks to protect against miasma.

• Function: Intended to shield wearers from “bad air” and contaminated environments.

John of Burgundy

• Recommendations: Advocated for swift action, including bloodletting, to treat the plague.

Challengers of Ancient Theories

• Copernicus, Galileo, Newton: Challenged geocentrism and laid the groundwork for modern science.

Christian Responses to the Plague

• Sin and Repentance: Many believed the plague was divine punishment for sin.

• Scapegoating: Jews were falsely accused of causing the plague, leading to widespread violence and persecution.

San Francisco Bubonic Plague Outbreak (1900 - 1904)

• Discrimination: Chinese immigrants were blamed and subjected to quarantine in Chinatown.

• Source: Infected rats from Hong Kong brought the plague to San Francisco via steamships.

Agency of Non-Human Actors in Pandemics

• Role of Pathogens: Diseases like Y. pestis have shaped human history and institutions.

• Modernity: Public health measures (e.g., quarantine, sanitation) emerged from responses to pandemics.

• Historical Context: Understanding pandemics requires examining both biological and social factors.

February 17th, Monday - Sex, Gender, and the Pox of Many Names Part 1

Venereal Diseases

• Diseases spread through sexual contact

• “The pox”

• Europeeans brought smallpox and measles that wiped out indigenous people

• Indigenous people brought syphilis to europeans 

• This exchange is called the columbian exchange (exchange of lots of things, plants, people foods, but also pathogens between continents after Columbus)

Syphilis

• Happens when someone transmits Treponema Pallidum through aperture of skin or contact with a mucus membrane (which are in our sexual organs), usually through sexual contact

• They then multiply 

• After a while you than get a chancre ulcer

• You’ll get a fever, headaches, rash,..

• Can be spread through the rash (even as simple as a handshake)

• Easily rash can be mistaken for other things

• Latency period last a long time 

• Latency period = period between infection and the onset of systems

• Congenital = Passed through a pregnant mother to an unborn child - either in the womb or during delivery 

• Syphilis spread from mother to child, child has congenital syphilis

• Syphilis is difficult to retrospectively diagnosis because causes different diseases and they all come from T paledom

• Syphilis victims however, more likely to have skull lesions 

• Indigenous skeletons without skull lesions are usually other diseases also coming from T - pallidum

T - pallidum (Treponema Pallidum Bacteria) same pathogen, different transmissions

• Bejel = spreads

• Yaws = Spreads primarily via skin contact; spreads ore readily in warmer environments

• Morphology = the biological form and the structure of living organisms

• In order for it survive in colder areas, it evolved to transmit through sexual contact

• And thanks to rise of medieval Europe and travel, prisons, public bathhouses, gave Treponema pallidum more opportunities to spread

• Symptoms are very similar between syphilis and the other 2 non venereal diseases (bejel and yaws)

• “The pox” at the time included = syphilis, bejel, yaws, gonorrhea, and leprosy

• As people noticed children didn’t get it

• Leprosaria = places set apart for lepers to live

• Syphilis: term first used in 1530 by Girolamo Fracastoro 

Humoral Theory + Syphilis

• Syphilis: cold + wet qualities, resulting from excess phlegm

• Guaiac wood: warm +dry qualities

• Guaiac wood would make you cough up phlegm

• They would use the shavings of the wood and boil and and as you inhaled the vapor you’d cough up phlegm (which does actually help people feel better by clearing up their lungs and breath easily but wouldn't cure them)

Mercury compounds for treating syphilis

Paracelsus

• Used a lot of mercury in medicine

• Did not like humoral medicine 

• Iatrochemistry: Medical chemistry 

• He was an alchemist

• Alchemy = the transformation or purification of metals

• He preferred chemical treatments rather than plant based remedies 

• Tria Prima: Sulphur (combustible) mercury (liquid), salad (solid)

• Believed nothing was inherently toxic, but toxicity was determined by dose

• Venereal Diseases

• Definition: Diseases spread primarily through sexual contact.

Historical Context

• Often referred to as “the pox” in historical texts.

• Part of the Columbian Exchange: The widespread transfer of plants, animals, people, foods, and pathogens between the Americas, Europe, and Africa after Columbus’s voyages in 1492.

• Europeans brought diseases like smallpox and measles to the Americas, which devastated Indigenous populations.

• Indigenous peoples introduced syphilis to Europeans, which spread rapidly across Europe.

• Syphilis: Caused by the bacterium Treponema pallidum.

Transmission:

• Spread through contact with skin abrasions or mucous membranes, typically during sexual activity.

• Can also spread through non-sexual contact with infectious rashes (e.g., handshakes).

• Congenital Syphilis: Passed from a pregnant mother to her unborn child, either in the womb or during delivery.

Symptoms:

• Primary Stage: A painless chancre ulcer at the site of infection.

• Secondary Stage: Fever, headaches, rash, and flu-like symptoms. The rash can be mistaken for other conditions.

• Latency Period: A long period (years or decades) with no symptoms, during which the disease remains active.

• Tertiary Stage: Severe complications, including damage to the heart, brain, and other organs.

Diagnosis:

• Difficult to retrospectively diagnose due to its varied symptoms and resemblance to other diseases.

• Skull Lesions: A common marker in skeletal remains, though their absence does not rule out syphilis.

• Other diseases caused by T. pallidum (e.g., bejel, yaws) can complicate diagnosis.

Treponema Pallidum (T. Pallidum)

• Pathogen: The bacterium responsible for syphilis and related diseases.

Variants:

• Bejel: Spread through skin contact, common in arid regions.

• Yaws: Spread through skin contact, thrives in warm, humid environments.

• Syphilis: Evolved to spread through sexual contact, likely due to colder climates and social factors (e.g., urbanization, travel, public bathhouses).

• Morphology: The structure and form of T. pallidum adapted to different environments and transmission methods.

• Symptoms: Similar across all variants, making differentiation challenging.

Historical Terminology

• “The Pox”: A catch-all term for diseases like syphilis, bejel, yaws, gonorrhea, and even leprosy.

• Leprosaria: Facilities where lepers were isolated, reflecting the fear and stigma around contagious diseases.

• Syphilis: The term was first used in 1530 by Girolamo Fracastoro, an Italian physician and poet.

• Humoral Theory and Syphilis

• Humoral Explanation: Syphilis was attributed to an imbalance of the four humors, specifically an excess of phlegm, which was considered cold and wet.

Treatment with Guaiac Wood:

• Guaiac wood was believed to have warm and dry qualities, counteracting the cold and wet nature of syphilis.

• Patients inhaled vapors from boiled guaiac wood shavings, which induced coughing and cleared phlegm.

• While this provided temporary relief (e.g., easier breathing), it did not cure syphilis.

Mercury Compounds for Treating Syphilis

• Historical Use: Mercury was a common treatment for syphilis, applied as ointments, inhaled as vapors, or ingested.

• Side Effects: Mercury poisoning caused severe symptoms, including tooth loss, neurological damage, and death.

• Legacy: Despite its toxicity, mercury remained a standard treatment for centuries due to the lack of effective alternatives.

Paracelsus

• Background: A Swiss physician and alchemist (1493–1541) who challenged traditional humoral medicine.

Contributions:

• Iatrochemistry: The use of chemistry in medicine, emphasizing chemical treatments over plant-based remedies.

• Tria Prima: His theory that all matter was composed of three principles—sulphur (combustible), mercury (liquid), and salt (solid).

• Toxicity: Believed that “the dose makes the poison,” arguing that any substance could be toxic or medicinal depending on its quantity.

• Legacy: Pioneered the use of minerals and chemicals in medicine, laying the groundwork for modern pharmacology.

Impact of Syphilis:

• Syphilis had profound social and cultural effects, contributing to stigma, fear, and moral panic.

• Its spread was facilitated by urbanization, travel, and changing social norms.

Public Health:

• The rise of syphilis and other venereal diseases spurred early public health measures, including quarantine and treatment protocols.

Modern Understanding:

• Syphilis is now treatable with antibiotics, but it remains a public health concern, particularly in cases of congenital syphilis.

February 19th, Wednesday - Sex, Gender, and the Pox of Many Names Part 2

Allegorical Paintings - Art During Syphilis

• Allegory: A form of art or storytelling where elements (e.g., characters, objects, or events) have hidden meanings, often moral, political, or symbolic.

• During the syphilis epidemic, artists used allegory to comment on the disease’s social and moral implications.

• Paintings often depicted themes of sin, punishment, and the consequences of immoral behavior, reflecting the belief that syphilis was a divine retribution for sexual promiscuity.

• Works from the Renaissance and Baroque periods often included symbolic elements like decaying fruit, wilting flowers, or skulls to represent the consequences of syphilis.

Girolamo Fracastoro (1476 - 1553)

• Background: An Italian physician, poet, and scholar.

Contributions:

• Syphilis Naming: Coined the term “syphilis” in his 1530 poem Syphilis sive Morbus Gallicus (“Syphilis or the French Disease”).

• Medical Theory: Proposed that diseases could be caused by “seeds of contagion,” foreshadowing the modern understanding of germs.

• Cultural Impact: His work helped shape the perception of syphilis as both a medical and moral issue.

Cultural Impact of Syphilis

• Perception: Syphilis was not seen as deadly as the plague but was highly stigmatized due to its association with sexual behavior.

• It was often referred to as the “French Disease” or “Great Pox,” reflecting national prejudices and blame-shifting.

Gender Roles and Sexual Norms:

• Men: Expected to be sexually experienced before marriage, often leading to premarital encounters with sex workers.

• Women: Expected to remain sexually pure until marriage, creating a double standard.

• Marriage: Married women were obligated to fulfill their husbands’ sexual demands, even if the husband showed symptoms of syphilis (e.g., open sores).

Social Stigma:

• Visible symptoms like sores and scars were deeply shameful, leading to efforts to conceal them.

Covering Up Sores and Scars

• Beauty Marks and Patches:

• Les Mouches: French term for small black beauty marks or patches worn on the face.

• Originally fashionable, they were also used to hide syphilitic sores or scars.

• Symbolism: These patches sometimes carried hidden meanings, with their placement conveying messages (e.g., near the mouth for flirtation).

• Perfume: Used to mask the foul odor of syphilitic sores.

• Makeup: Heavy makeup and powders were applied to conceal skin lesions and blemishes.

• Powdered Wigs: Popular among both men and women to cover hair loss caused by syphilis or its treatments (e.g., mercury poisoning).

Additional Notes

• Artistic Depictions:

• Artists like Albrecht Dürer and Lucas Cranach the Elder created works addressing syphilis, often blending medical and moral commentary.

• These works reflected societal anxieties about sexuality, morality, and disease.

Legacy:

• The syphilis epidemic influenced fashion, art, and social norms, leaving a lasting cultural imprint.

• Efforts to conceal the disease highlight the tension between public perception and private suffering.

February 21rst, Friday - Sex, Gender, and the Pox of Many Names Part

Protestant Reformation and Sex Work

• Despite the prevalence of sex work, it was heavily condemned, especially among certain social circles.

• The Protestant Reformation, led by figures like Martin Luther in the early 16th century, emphasized moral purity and condemned sexual immorality.

Impact on Sex Work:

• Many brothels were closed as part of the Reformation’s push for moral reform.

• Sex workers were forced onto the streets, making their activities more visible and further stigmatized.

• This increased visibility led to greater societal condemnation and harsh treatment of sex workers.

Densely Populated Cities and Syphilis

• Urbanization: The rise of densely populated cities, especially busy port cities, increased the demand for prostitution.

• This contributed to the widespread transmission of syphilis across Europe.

• By the late 19th century, an estimated 10% of Europeans were infected with syphilis.

• Neurosyphilis (late-stage syphilis affecting the brain) was a leading cause of admission to insane asylums.

Regulation of Sex Work:

• Calls for government regulation of sex work emerged as a public health measure to control the spread of venereal diseases.

• However, these measures often targeted women disproportionately, reinforcing gender inequalities.

Gender Disparities and Stigma

• Women bore the brunt of syphilis’s social and medical consequences, while men were often portrayed as “victims” in art and literature.

• This double standard persisted well into the mid-20th century.

Lock Hospitals:

• Poor individuals with syphilis or other venereal diseases were confined to lock hospitals—effectively prisons with physicians.

• Patients were often treated without dignity, and many were not allowed to leave until deemed “cured.”

Workhouses:

• Workhouses were filthy, disease-ridden, and sex-segregated institutions designed to punish rather than rehabilitate.

• Women, especially unwed mothers and suspected sex workers, faced extreme cruelty.

• Sex workers were forced to wear red dresses, and unwed mothers had to wear yellow dresses, marking them as social outcasts.

Contagious Disease Acts (1864 - 1886)

• These acts allowed authorities to forcibly examine women suspected of sex work for venereal diseases.

• A single accusation was enough to subject a woman to invasive examinations.

Procedures:

• Women were arrested and examined by male physicians using intrusive devices like speculums.

• The process was humiliating and traumatic, with no regard for the women’s consent or dignity.

Impact:

• The acts reinforced gender inequality and stigmatized women, particularly those from lower socioeconomic backgrounds.

Wet Nursing and Mercury Poisoning

• Poor women often worked as wet nurses, caring for abandoned or orphaned babies.

• Many babies died due to malnutrition or disease, as wet nurses could not produce enough milk for all the infants in their care.

Mercury Poisoning:

• Wet nurses were unknowingly dosed with mercury to treat syphilis in the babies they nursed.

• This led to widespread mercury poisoning, killing both women and infants.

• Wealthy parents with syphilis often sent their children to wet nurses to avoid congenital transmission, further exploiting poor women.

Advances in Treatment

• Wasserman Test (1906): A blood test that detected antibodies for Treponema pallidum, enabling earlier diagnosis of syphilis.

• Salvarsan (1909): An arsenic-based drug developed by Paul Ehrlich, the first effective treatment for syphilis.

• Sulfa Drugs (1935): Synthetic antibiotics that provided another treatment option for bacterial infections.

Penicillin (1928/1941):

• Discovered by Alexander Fleming, penicillin became the most effective treatment for syphilis and other bacterial infections.

Julius Wagner-Jauregg (1857 - 1940):

• Pioneered malariotherapy, using malaria-induced fevers to treat neurosyphilis. This earned him the 1927 Nobel Prize in Physiology or Medicine.

Unethical Human Experiments: Tuskegee Syphilis Experiment (1932 - 1972):

• Conducted by the U.S. Public Health Service on 600 Black men in Alabama, 399 of whom had syphilis.

• Participants were lied to, told they were being treated for “bad blood,” and denied effective treatment even after penicillin became available.

• Outcome: 128 men died, 40 wives were infected, and 19 children were born with congenital syphilis.

• The study was widely condemned as state-sponsored murder and a violation of medical ethics.

J. Marion Sims (1813 - 1883):

• Known as the “father of modern gynecology,” Sims performed experimental surgeries on enslaved Black women without anesthesia.

• His work laid the foundation for gynecological medicine but came at the cost of immense suffering.

Guatemala Syphilis Experiments (1946 - 1948):

• Led by John Cutler, U.S. researchers intentionally infected Guatemalan prisoners, sex workers, and soldiers with syphilis, gonorrhea, and chancroid.

• The experiments were conducted without informed consent and caused widespread harm.

Doctors’ Trial (1946):

• Part of the Nuremberg Trials, where Nazi physicians were prosecuted for unethical human experiments during World War II.

Nuremberg Code (1947):

• Established ethical guidelines for medical research, emphasizing informed consent and the prohibition of coercion.

• Laid the foundation for modern medical ethics and human rights in research.

Modern Implications:

• The legacy of unethical experiments like Tuskegee and Guatemala continues to fuel mistrust in medical institutions, particularly among marginalized communities.

• Efforts to address these injustices include increased oversight, ethical training, and community engagement in research.

Cultural Impact:

• The history of syphilis and its treatment reflects broader societal issues, including gender inequality, class disparities, and racial injustice.

February 24th, Monday - Smallpox & American Catastrophe Part 1 

Smallpox

• Smallpox, caused by the Variola major virus, was one of the deadliest diseases in human history, killing hundreds of millions of people.

• By the late 18th century, as plague pandemics waned, smallpox became the most feared disease in Europe.

Virus vs. Bacteria:

• Unlike bacteria, which are living organisms capable of metabolizing and reproducing, viruses are much smaller and consist of genetic material enclosed in a protein sheath

• Viruses cannot reproduce on their own; they invade living cells and hijack their machinery to replicate.

Transmission:

• Spread through respiratory droplets (e.g., coughing, sneezing).

• Can also spread through fomites (objects or materials that carry infectious agents, such as clothing or bedding).

• Congenital transmission: Rarely, smallpox could be passed from mother to child during pregnancy.

• The virus can survive on surfaces for weeks under the right conditions.

• Symptoms and Progression

• Incubation Period:

• After exposure, the virus incubates for about 12 days before symptoms appear.

• Initial Symptoms:

• High fever, nausea, and sometimes convulsions.

• In severe cases, blood vessels can burst, causing sudden death.

Rash and Pustules:

• After 2-4 days, a rash develops, starting in the mouth and spreading to the rest of the body.

• The rash turns into pustules (fluid-filled blisters), which can appear in the mouth, trachea, eyes, nose, and lungs.

• The pustule stage lasts about 5 days and is extremely painful.

• Neurological and psychological damage: Survivors often experienced long-term effects.

• Pregnancy: Pregnant women frequently miscarried.

• Blindness: Pustules in the eyes could lead to permanent blindness.

• Difficulty eating and breathing: Pustules in the mouth and respiratory tract made eating, drinking, and breathing painful and sometimes fatal.

• Secondary infections: Scratching the pustules could lead to bacterial infections.

Smallpox in the Americas: Virgin Soil Epidemic:

• Indigenous populations in the Americas had no prior exposure to smallpox, making them highly susceptible.

• Mortality rates: While Europeans had some immunity, Indigenous populations faced mortality rates of 50-90%.

• Smallpox devastated Indigenous communities, contributing to the collapse of entire civilizations.

• The disease played a significant role in the European conquest of the Americas.

• Theories on Indigenous Mortality

• Divine Providence Hypothesis:

• Some Europeans interpreted the mass deaths of Indigenous peoples as an extension of God’s will, justifying colonization and conversion efforts.

Evolutionary Hypothesis:

• Popularized by Charles Darwin’s Origin of Species (1859), this theory framed the devastation as a result of natural selection and “survival of the fittest.”

• This perspective absolved Europeans of moral responsibility for the deaths of Indigenous peoples.

Pequot Massacre (1637)

• English settlers, allied with Mohegan and Narragansett warriors, launched a brutal attack on the Pequot tribe.

• Settlers burned Pequot villages, destroyed crops, and raided other settlements.

• Hundreds of Pequot men, women, and children were murdered.

• The massacre marked a turning point in the colonization of North America, demonstrating the settlers’ willingness to use extreme violence against Indigenous peoples.

Residential Schools

• Established in the 19th and 20th centuries, residential schools were part of a systematic effort to assimilate Indigenous children into Euro-American culture.

• “Kill the Indian in him, and save the man”: This infamous statement by Richard Henry Pratt (1892) encapsulates the schools’ mission to erase Indigenous identity.

• Children were forcibly removed from their families and communities.

• They were forbidden to speak their native languages or practice their cultures.

• Many children suffered physical, emotional, and sexual abuse

• The residential school system caused intergenerational trauma and contributed to the erosion of Indigenous cultures and communities.

Smallpox Vaccination:

• The development of the smallpox vaccine by Edward Jenner in 1796 marked a turning point in the fight against the disease.

• Vaccination campaigns eventually led to the eradication of smallpox in 1980, making it the first disease to be eradicated by human effort.

Modern Implications:

• The history of smallpox in the Americas highlights the devastating consequences of disease introduction during colonization.

• The legacy of violence and cultural destruction, including the residential school system, continues to affect Indigenous communities today.

February 26th, Wednesday - Smallpox & American Catastrophe Part 2

Colonial Violence and Smallpox

• Smallpox and colonial violence worked hand in hand to devastate Indigenous populations in the Americas.

• The introduction of smallpox, combined with military conquest, led to the collapse of many Indigenous societies.

Variola Major

• Origins: The oldest remains with traces of the smallpox virus date back to the 17th century.

• Unlike bacteria, viruses like Variola major leave fewer traces in historical and archaeological records.

Hypothesis on Arrival in Europe:

• One theory suggests smallpox was introduced to Europe during the Crusades (1095-1291).

• Over time, Europeans developed herd immunity, as many survived smallpox in childhood.

• Symptoms of smallpox at certain stages could be mistaken for syphilis, complicating diagnosis.

Fall of Tenochtitlan (1521)

• Aztec Empire: The Aztec capital, Tenochtitlan, was a highly militarized and centralized empire with a system of writing.

• Despite their advanced society, the Aztecs lacked immunity to European pathogens.

Hernán Cortés (1485-1547):

• Led a small army with limited firearms but had the advantage of pathogenic immunity.

• Exploited existing tensions between the Aztecs and their enemies to conquer Tenochtitlan.

Montezuma (1466-1520):

• The Aztec emperor’s demand for human sacrifices alienated many Indigenous groups, which Cortés used to his advantage.

Measles (Rubeola Virus)

• Impact: Measles weakens the immune system, making individuals more susceptible to other infections like bacterial pneumonia.

• While most people survived measles, many suffered lasting neurological damage.

• Symptoms included small, flat rashes across the body.

• The introduction of measles and other diseases, alongside smallpox, devastated Indigenous populations.

• Loss of elders meant the loss of oral traditions and cultural knowledge.

Trail of Tears (1830-1850)

• Under President Andrew Jackson, approximately 100,000 Indigenous people were forcibly removed from their homes.

• The affected tribes included the Seminole, Chickasaw, Choctaw, Cherokee, and Muscogee.

Impact:

• Forced marches to present-day Oklahoma exposed Indigenous people to pathogens like smallpox.

• Small reserves in Oklahoma facilitated the rapid spread of diseases.

• Dysentery, measles, whooping cough, malaria, and cholera further compounded the suffering.

Smallpox Blankets: Bioterrorism

• Fort Pitt (1763):

• During the Seven Years’ War, British forces gave smallpox-infected blankets to the Delaware/Lenape tribe.

• This act of bioterrorism aimed to weaken Indigenous resistance.

• February 28th, Friday - Smallpox Treatments and Eradication

Smallpox in Japan

• Cultural Beliefs:

• Smallpox was thought to be caused by a demon afraid of the color red.

• “Red Treatment”: Patients were surrounded by red objects to ward off the demon.

Influence of Humoral Theory:

• The red treatment spread via the Silk Road and was later integrated into European humoral medicine.

Cherokee Medicine

• Illness was often attributed to offended spirits.

• Smallpox was associated with thunder or fire spirits.

• Submerging patients in water to counteract the “fire” of smallpox.

• Using aromatic fires to appeal to benevolent spirits for healing.

Variolation

• The intentional infection with smallpox to induce a milder form of the disease and confer lifelong immunity.

• Scabs or pus from smallpox victims were introduced into healthy individuals.

• Mortality Rate: 1-2%, compared to 30% for natural smallpox.

Ancient Chinese Practice:

• Small amounts of smallpox material were blown into the nose to induce immunity.

• Edward Jenner observed that milkmaids who contracted cowpox (a milder disease) were immune to smallpox.

• In 1796, Jenner inoculated James Phipps, the 8-year-old son of his gardener, with cowpox material.

• The experiment was successful, leading to the development of vaccination.

Vaccination Process:

• Cowpox material was spread from person to person to induce immunity.

• Criticism: Early vaccination efforts faced skepticism and logistical challenges, such as the transmission of other pathogens.

• Global Eradication of Smallpox

Bifurcated Needle:

• A tool used to deliver freeze-dried vaccine material efficiently.

UNICEF (1946):

• Played a key role in global vaccination campaigns.

• Smallpox was declared eradicated in 1980, thanks to coordinated international efforts.

Factors contributing to eradication:

• Smallpox only infected humans (no animal reservoir).

• Effective vaccination programs and public health measures.

Resistance to Vaccination

• Some Christians viewed vaccination as “playing God.”

• The British press spread fears about vaccination, hindering its acceptance.

Medical Miracle Period:

• The eradication of smallpox marked a turning point in public health, demonstrating the power of vaccination and international cooperation.

• The history of smallpox highlights the intersection of disease, colonialism, and cultural beliefs.

March 3rd, Monday - Yellow Fever, Race & the Era of Revolution, part 1

Yellow Fever: Overview

• Vector-Borne Illness: Yellow fever is transmitted by insects that feed on human blood. The primary vector for yellow fever is the Aedes Aegypti mosquito.

• Virus Group: Yellow fever is part of the Flavivirus group, which includes other diseases like Dengue fever, Zika virus, and West Nile virus.

• Transmission: The disease is spread when an infected mosquito bites a human, injecting the virus into the bloodstream.

Optimal Habitat for Aedes Aegypti Mosquitoes

• Climate: Warm temperatures are ideal for mosquito breeding and survival.

• Standing Water: Mosquitoes lay their eggs in standing water, which is essential for their lifecycle.

• Primate Populations: High densities of primates (including humans, monkeys, and apes) provide a ready source of blood for female mosquitoes.

• Sweet Liquids: Male mosquitoes feed on sweet liquids like nectar and honey, which are crucial for their survival (males do not drink blood).

• Rainfall/Drought Extremes: Both heavy rainfall and drought conditions can create environments conducive to mosquito breeding.

Symptoms of Yellow Fever

• First Stage: Symptoms include nausea, fatigue, and joint pain. 

• Many patients experience a temporary recovery after this stage.

• Second Stage (15% of cases): Liver inflammation and jaundice occur as bile ducts become blocked, causing bile to enter the bloodstream.

• The liver fails to filter toxins, leading to neurological issues.

• Third Stage: Blood vessels constrict and may burst, particularly in mucus membranes.

• Symptoms include bleeding from the rectum or uterus.

• Fourth Stage: Black vomit (a mixture of blood and stomach acid) appears.

• Widespread organ failure occurs as the body begins to digest its own organs.

• Mortality Rate: Among the 15% who reach this stage, there is a 50% chance of survival.

Plantation Modernity

• Export-Oriented Monocultures: Plantations were not focused on subsistence farming but rather on producing large quantities of a single crop (e.g., sugarcane) for export.

• Global Scale: These plantations were part of a transoceanic or global economic system, often financed by shareholders through joint-stock enterprises.

• Unsustainable Agriculture: This form of agriculture relied on exploiting enslaved labor and was not self-sustaining.

Plantation Complexes

• Climate: Warm temperatures were ideal for both sugarcane cultivation and mosquito breeding.

• Sugarcane Juices: The sweet juices from sugarcane attracted mosquitoes, creating a perfect environment for the spread of yellow fever.

• Enslaved Labor: Enslaved Africans were forced to work under brutal conditions, often suffering from diseases like yellow fever.

The East India Company (1600 - 1874)

• Role in Global Trade: The East India Company was a major player in the global trade of goods, including sugar, tea, and spices.

• Dehumanizing Conditions: Enslaved Africans were transported in horrific conditions on ships like the Brookes, where they were packed tightly into cramped spaces (men given 6 feet by 16 inches, women 5 feet by inches, and children even less).

Modern Chattel Slavery

• Historical Context: Unlike earlier forms of slavery in Arabic and Ancient Greek societies, modern chattel slavery was race-based and hereditary.

• Arabic Slavery: Slaves in Arabic societies could sometimes gain freedom by changing their religion or paying a commission to their owners. They often performed skilled labor.

• Race-Based Slavery: In the Americas, slavery became tied to skin color, and enslaved people were treated as property with no rights or opportunities for freedom.

Harewood House, Yorkshire (1759 - 1761)

• Built by Edwin Lascelles: This grand estate was constructed using wealth generated from the exploitation of enslaved labor in the Caribbean sugar plantations.

Darien Scheme (1698 - 1700)

• Scottish Colonial Ambitions: Scottish investors attempted to replicate the success of the East India Company by establishing a colony in Panama, Central America.

• Failure: The scheme failed due to yellow fever, other diseases, and hostile Spanish forces. 80% of the settlers died, highlighting the dangers of colonial ventures in tropical regions.

Saint-Domingue (Hispaniola)

• Sugar Production: Saint-Domingue (modern-day Haiti) was a major producer of sugar, supplying half of Europe's sugar in the 18th century.

• Enslaved Labor: The colony's economy was built on the backs of enslaved Africans, who endured horrific conditions and were exposed to diseases like yellow fever and malaria.

• Sickle Cell Gene Mutation: Some enslaved Africans had a genetic mutation that provided partial immunity to malaria, but they were still vulnerable to yellow fever.

• Justification for Enslavement: European colonizers justified the use of African labor by claiming that Africans were "immune" to tropical diseases, despite the high mortality rates among enslaved populations.

Key Themes

• Yellow Fever as a Colonial Weapon: The disease disproportionately affected European colonizers, while enslaved Africans had some resistance due to prior exposure.

• Race and Exploitation: The transatlantic slave trade and plantation economies were deeply intertwined with racial hierarchies and the exploitation of African labor.

• Global Interconnectedness: The spread of yellow fever and the success of plantation economies were part of a larger global system of trade, colonization, and exploitation.

• This lecture highlights the intersection of disease, race, and economics during the era of revolution, showing how yellow fever shaped colonial ventures and the lives of enslaved Africans.

March 5th, Wednesday - Yellow Fever, Race & the Era of Revolution, Part 2

French Revolution (1789 - 1799)

• "Universal Rights of Man": A central idea of the French Revolution, but it excluded women and enslaved people, revealing the contradictions in revolutionary ideals.

• Haitian Revolution (1791-1804): Led by Francois-Dominique Toussaint L’Ouverture (1743-1803), a formerly enslaved man who became a skilled military leader.

Success Factors:

• Yellow Fever: British forces arrived during the peak of the Aedes Aegypti mosquito population, which carried yellow fever. Haitian revolutionaries had immunity, while the British did not.

• Rainy Season: L’Ouverture used the rainy season to his advantage, concentrating British forces in port cities where mosquitoes thrived.

• Leadership: L’Ouverture’s strategic brilliance and ability to unite formerly enslaved people were key to the revolution’s success.

• French Motives: The French granted rights to enslaved people as a self-serving move to weaken British forces, not out of moral conviction.

Napoleon’s Attempt to Reclaim Haiti

• Napoleon’s Goals: After the Haitian Revolution, Napoleon sought to reassert control over Saint-Domingue (Haiti) to reinstate slavery and profit from the island’s sugar and coffee production.

• Polish Support: Polish soldiers, recently conquered by Napoleon, refused to reinstate slavery and instead joined the Haitian revolutionaries.

• Haitian Victory: Haiti became the first nation to gain independence through a large-scale revolution led by enslaved people. This victory forced Napoleon to abandon his ambitions in the Americas and sell the Louisiana Territory to the United States in 1803.

Economic Impact of Haitian Independence

• Loss of Revenue: The French lost a significant source of wealth from Haiti’s sugar and coffee exports.

• Haiti’s Economic Struggles: Despite independence, Haiti faced constant economic exploitation and tribute demands from foreign powers, preventing true economic freedom.

Great Dismal Swamp

• Refuge for Marginalized Groups: The swamp was a haven for Native Americans and maroons (escaped enslaved people) due to its inhospitable terrain for settlers.

• Self-Sufficient Communities: The interior of the swamp had independent governments and economies, free from European control.

• Threat to Plantation Owners: Plantation owners feared the swamp’s role in aiding enslaved uprisings. Efforts to drain the swamp, including by George Washington, failed due to high costs.

• Yellow Fever and Malaria: The swamp had seasonal outbreaks, but its inhabitants developed immunity over time.

Yellow Fever Outbreak in Philadelphia (1793)

• Haitian Refugees: Refugees fleeing the Haitian Revolution brought yellow fever to Philadelphia.

• Benjamin Rush (1745-1813): A leading physician and founding father, Rush incorrectly attributed yellow fever to miasma (bad air) and advocated for treatments like bloodletting, emetics, and laxatives.

• Symptoms: Yellow fever caused bleeding, jaundice, and black vomit, which Rush linked to the four humors theory.

• Actual Cause: The outbreak was caused by Aedes Aegypti mosquitoes, not miasma.

March 7th, Friday - Yellow Fever, Race & the Era of Revolution, Part 3

Quaker Perspective on Yellow Fever

• Moral Failings: Quakers blamed yellow fever on moral failings like slavery and sexual sins.

• Racialized Beliefs: Some believed enslaved people had immunity to yellow fever, a misconception that reinforced racial hierarchies.

Yellow Jack (Yellow Fever)

• Transportation and Transmission: The growth of international trade, railroads, and steamships facilitated the spread of yellow fever by transporting infected mosquitoes.

• Public Health Measures: Quarantines and Lazarettos (quarantine stations) were ineffective because they didn’t address mosquito vectors.

Stubbins Ffirth (1784-1820)

• Self-Experimentation: Ffirth attempted to prove yellow fever was not contagious by exposing himself to black vomit, blood, and other fluids from victims. He never contracted the disease, but his experiments were flawed because he used late-stage samples, which were less infectious.

Tropical Medicine

• Patrick Manson: Known as the founder of tropical medicine, Manson studied vector-borne diseases like lymphatic filariasis (caused by mosquito-borne parasites).

• Walter Reed (1851-1902): Led the Yellow Fever Commission in 1900, proving that mosquitoes transmitted yellow fever. His work led to public health measures like eliminating standing water and using window screens.

• Rockefeller Institute: Discovered the yellow fever virus in 1927 and developed the first vaccine in 1937. However, postcolonial distrust of Western medicine and the virus’s non-human reservoirs complicate eradication efforts.

March 10th, Monday - Cholera & the Industrial City, Part 1

Cholera Origins

• Pathogen: Vibrio Cholerae, a bacterium that thrives in water, especially in estuaries where saltwater and freshwater mix.

• Transmission: Cholera spreads through contaminated water. It attaches to the intestinal lining, releasing toxins that cause severe dehydration.

Stages of Cholera Infection

• Ingestion: Vibrio Cholerae survives the stomach and reaches the small intestine.

• Toxin Release: Immune cells attack the bacteria, releasing toxins that cause plasma to leak into the intestine.

• Dehydration: Victims lose up to a liter of fluid per hour, leading to life-threatening dehydration, muscle spasms, and organ failure.

• Complications: Uremia (kidney failure) and gangrene (tissue death) can occur in severe cases.

Treatments

• Humoral Methods: Bloodletting, laxatives, and emetics were ineffective.

• Rehydration: Early attempts to pump water into veins often caused heart failure. Leonard Rogers developed the cholera bed and a saline drip, which significantly reduced mortality rates.

March 12th, Wednesday - Cholera & the Industrial City, Part 2

Industrialization and Cholera

• Urbanization: The Industrial Revolution displaced rural populations into overcrowded cities with poor sanitation.

• Water Pollution: The River Thames in London became heavily polluted with industrial and domestic waste, creating ideal conditions for cholera.

William Farr (1807-1883)

• Miasma Theory: Farr believed cholera was caused by miasmas (bad air) from decaying organic matter. He used elevation data to link cholera mortality to low-lying areas near the Thames.

• Limitations: Farr’s focus on miasma and hygiene ignored the role of contaminated water.

John Snow (1813-1858)

• Waterborne Theory: Snow proposed that cholera was spread through contaminated water, not air. His investigation of the Broad Street Pump outbreak in 1854 proved his theory.

• Legacy: Snow’s work laid the foundation for modern epidemiology.

Advances in Microbiology

• Louis Pasteur (1822-1895): Developed pasteurization and attenuated vaccines.

• Robert Koch (1843-1910): Proved that specific microbes cause specific diseases, including cholera. His work challenged terrain theory and advanced germ theory.

Cholera in Egypt

• Suez Canal: Completed in 1869, the canal became a focal point for cholera outbreaks. British authorities blamed the Egyptian environment, while French and German scientists focused on microbiology.

• Koch’s Discovery: Koch traced cholera to a pond near Calcutta, disproving environmental theories and highlighting the role of British imports in spreading the disease.

March 14th, Friday - Cholera & the Industrial City, Part 3

Hamburg

• Independent city within Prussia with inferior water + sewer infrastructure 

• Cholera outbreak of 1892, enables Prussians to take over Hamburg water supply and implement other health measures 

• Episodes becomes example of elite corruption + need for social welfare policies 

India High Mortality Rate

• 23 million die from cholera 1865 - 1947

• Warm and wet climate

• British irrigation duchess from export oriented agriculture 

• Shift to monocrop farming in large scale famine

• Famine refugee camps breeding grounds for pathogens (including cholera)

Gava Cholera Crisis

• Typhoid cholera outbreak 

• 2023 - present: military occupation + destruction of water + sanitary and (including water purification tablets)

Diseases and Pathogens

Bubonic Plague

Disease: Yersinia pestis

Disease Type: Bacterial infection

Vector: Fleas (primarily Xenopsylla cheopis) carried by rodents (e.g., rats).

Short Description: A highly contagious and deadly disease that caused the Black Death in the 14th century. Symptoms include painful buboes (swollen lymph nodes), fever, and organ failure. It devastated Europe and other regions, killing millions and reshaping societies.

Syphilis

Disease: Treponema pallidum

Disease Type: Bacterial infection

Vector: Human-to-human transmission through sexual contact or congenital transmission.

Short Description: A sexually transmitted infection that causes chancres, rashes, and severe long-term complications like neurological damage if untreated. It was stigmatized and often associated with moral failings in historical contexts.

Smallpox

Disease: Variola major

Disease Type: Viral infection

Vector: Human-to-human transmission through respiratory droplets or contact with contaminated objects.

Short Description: A highly contagious and deadly disease characterized by fever, pustular rash, and high mortality rates. It devastated Indigenous populations in the Americas and was eradicated globally in 1980 through vaccination efforts.

Cholera

Disease: Vibrio cholerae

Disease Type: Bacterial infection

Vector: Contaminated water or food.

Short Description: A diarrheal disease causing severe dehydration, muscle spasms, and organ failure. It thrived in unsanitary urban environments during the Industrial Revolution and remains a public health concern in areas with poor water sanitation.

Yellow Fever

Disease Type: Viral infection (Flavivirus)

Vector: Aedes aegypti mosquitoes.

Short Description: A mosquito-borne disease causing fever, jaundice, and hemorrhagic symptoms. It played a significant role in colonial history, particularly in the Caribbean and Americas, where it affected enslaved populations and European colonizers differently.

Measles

Disease: Rubeola Virus

Disease Type: Viral infection

Vector: Human-to-human transmission through respiratory droplets.

Short Description: A highly contagious disease causing fever, rash, and potential neurological damage. It weakened immune systems, making individuals susceptible to secondary infections like pneumonia, and contributed to the devastation of Indigenous populations in the Americas.

Malaria

Disease Type: Parasitic infection (Plasmodium species)

Vector: Anopheles mosquitoes.

Short Description: A mosquito-borne disease causing fever, chills, and anemia. It has historically been a major cause of death in tropical regions and was a significant factor in the transatlantic slave trade due to partial immunity among African populations.

Bejel

Disease Type: Bacterial infection (Treponema pallidum subspecies endemicum)

Vector: Skin-to-skin contact.

Short Description: A non-venereal form of treponemal disease causing skin lesions and bone deformities. It is endemic in arid regions and often confused with syphilis.

Yaws

Disease Type: Bacterial infection (Treponema pallidum subspecies pertenue)

Vector: Skin-to-skin contact.

Short Description: A tropical disease causing skin ulcers and bone deformities. It is closely related to syphilis but transmitted non-sexually, primarily in warm, humid climates.

Guinea Worm Disease

Disease Type: Parasitic infection (Dracunculus medinensis)

Vector: Water fleas (copepods) in contaminated water.

Short Description: A painful disease caused by the Guinea worm, which emerges through the skin. It is preventable through improved water sanitation and has been nearly eradicated through public health efforts.

Sleeping Sickness (Trypanosomiasis)

Disease Type: Parasitic infection (Trypanosoma brucei)

Vector: Tsetse flies.

Short Description: A disease causing fever, neurological damage, and coma if untreated. It is endemic in sub-Saharan Africa and has historically impacted colonial ventures and local populations.

Typhoid Fever

Disease Type: Bacterial infection (Salmonella typhi)

Vector: Contaminated food or water.

Short Description: A systemic infection causing high fever, abdominal pain, and diarrhea. It was a major public health issue in overcrowded, unsanitary urban areas during the Industrial Revolution.

Dysentery

Disease Type: Bacterial (Shigella) or parasitic (Entamoeba histolytica) infection

Vector: Contaminated food or water.

Short Description: An inflammatory disease of the intestines causing severe diarrhea, often with blood. It was a common cause of death in crowded, unsanitary conditions, such as during the Trail of Tears.

Tuberculosis

Disease Type: Bacterial infection (Mycobacterium tuberculosis)

Vector: Airborne transmission through respiratory droplets.

Short Description: A chronic disease affecting the lungs, causing coughing, weight loss, and death if untreated. It was a major public health issue in industrialized cities with poor living conditions.

Leprosy (Hansen’s Disease)

Disease Type: Bacterial infection (Mycobacterium leprae)

Vector: Prolonged close contact with an infected person.

Short Description: A chronic disease causing skin lesions, nerve damage, and disfigurement. Historically, leprosy patients were stigmatized and isolated in leprosaria.

Anthrax

Disease Type: Bacterial infection (Bacillus anthracis)

Vector: Contact with infected animals or contaminated animal products.

Short Description: A disease causing skin ulcers, respiratory failure, or gastrointestinal issues. It was one of the first diseases linked to a specific microbe by Robert Koch and has been used as a biological weapon.

Rabies

Disease Type: Viral infection (Lyssavirus)

Vector: Infected animal bites (e.g., dogs, bats).

Short Description: A fatal disease causing neurological symptoms, including aggression and paralysis. Louis Pasteur developed the first vaccine for rabies in 1885.

Cowpox

Disease Type: Viral infection (Orthopoxvirus)

Vector: Contact with infected cows or contaminated materials.

Short Description: A mild disease causing pustules on the skin. Edward Jenner discovered that cowpox infection provided immunity to smallpox, leading to the development of the first vaccine.

Plague (General)

Disease: Yersinia pestis

Disease Type: Bacterial infection

Vector: Fleas carried by rodents (e.g., rats).

Short Description: The plague manifests in three forms: bubonic (lymphatic system), pneumonic (lungs), and septicemic (bloodstream). It caused multiple pandemics, including the Black Death, and remains endemic in some regions.