DECEASED DISEASES* by DAVID RIESMAN, M.D., SC.D
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DECEASED DISEASES* By DAVID RIESMAN, M.D., SC.D. PHILADELPHIA ISEASES, at least many of conditions, but war may revive them. them, are like human be- Of the diseases that have died be- ings. They are born, they cause their causal agent has become flourish and they die. Some spontaneously extinct, the sweating may be eternal or at least coevalsickness with is one of the most interesting Dthe race, but seeing how many have examples. As far as we know this disease disappeared or are in the process of dis- has disappeared utterly. Also known as appearing, it would hardly be a wise the English sweat, it was a devastating prophecy to predict eternity for any of pestilence, of whose symptomatology, them. however, we have little knowledge. One Diseases may die from a variety of of the best descriptive accounts is by causes—thus the agent causing them Dr. John Caius or Kaye. Nor have we may disappear, as in the case of the any ideas as to its etiology. Some have sweating sickness of the Middle Ages. identified it with influenza, but I be- Some have become rare or nearly ex- lieve on insufficient grounds. On the tinct through efficient sanitary meas- Continent, especially in France, the dis- ures of various kinds, as is true of lep- ease was accompanied by an eruption, rosy. In some cases the disappearance is hence the names suer miliaire, suette only apparent, having been brought migliare. about through a change in name. Oth- The sweating sickness appeared first ers have disappeared because they were in England after the battle of Bosworth, really not diseases at all but symptoms August 22, 1485. After a short rigor the wrongly interpreted as clinical entities. body’s powers were prostrated as with a This has been a rather frequent cause blow. Headache, stupor and epigastric of disappearance. Some were entirely pain were present and the whole body fanciful and had to give way before in- was suffused with a fetid perspiration. creasing technical knowledge, and some All this took place in the course of a few have disappeared as the result of a gen- hours and the crisis was over within the eral enlightenment of the people. space of a day or a night. The people The greatest triumphs have un- were seized with consternation when doubtedly been achieved in the infec- they saw that scarcely one in a hundred tious diseases. Theoretically these are escaped. Many who had been in perfect all conquerable and we may hope to health at night were on the following banish most of them in time. Leprosy morning numbered among the dead. and plague, yellow fever and cholera, The physicians could do little or noth- have lost their terrors; typhus fever, re- ing for the people in their extremity. lapsing fever, smallpox are now rare Several epidemics swept over Eng- in civilized countries under civilized land, one in the reign of Henry vm, * Read at the meeting of the History Section of the American Medical Association, At lantic City, N. J., June 13, 1935. when Cardinal Wolsey had the disease. see the disease one has to go to outlying Erasmus, then a resident of England, places in the world, particularly to also seems to have passed through an China, where in the province of Kwang- attack. tung there are from 50,000 to 100,000 It was remarkable that the disease did lepers. Only rarely does an accidental not spread to Scotland, Ireland, or circumstance bring a case to our doors. Calais, which then belonged to Britain. While the disappearance of leprosy Hamburg was visited by the sweating is largely due to the strict isolation prac- sickness in 1529. Within the space of ticed in the Middle Ages and later twenty-two days 1100 inhabitants died times, it must be remembered that the “for such was the number of coffins word leprosy in all probability desig- ■which were at this time manufactured nated a variety of unrelated diseases— by the undertaker.” In Augsburg syphilis in its destructive forms being within six days 1500 inhabitants were one of them. The extensive use of mer- attacked of whom about 800 died. Co- cury is therefore another factor in the logne, Strassburg, Frankfurt had simi- disappearance of what was called lep- lar experiences. rosy. As I have said nothing is known of The plague, both bubonic and pneu- the cause of the malady and the specu- monic, is a disease with which only lations of contemporary writers are of physicians in certain areas in Asia have no value. any real acquaintance, although a spo- The petechial fever of Italy is an- radic case may from time to time be other curious disease about which little seen in other parts of the world. For all is known. It is described by Fracastoro practical purposes plague is one of the as the first plague of the kind to occur deceased diseases, yet at one time it was in his country. It was not a very con- the greatest scourge of mankind, killing tagious disease and did not seem to be during one of its visits to Europe, one- carried by fomites. The sick “lay upon quarter of the population. Hardly any- their backs with an oppressed brain, thing has happened in the world that blunted senses, delirious, with blood- has made an equally profound change shot eyes.” The urine, clear and copi- in the general social structure. In Eng- ous at the beginning, became red and land in the fourteenth century through turbid or resembled pomegranate wine. the death of the majority of teachers, The pulse was small and on the fourth who were largely French, the French or seventh day red and purple spots like language, until then widely spoken, flea bites or larger, resembling lentils died out and gave place to English. (lenticula—which also became a name In an indirect way the plague was of the disorder) broke out. also a factor in the creation of Italian Of the diseases that have yielded to as a spoken language. It happened in improvement in sanitation the best ex- this way. When the plague broke out in ample is leprosy. This disease, terrible Florence, Boccaccio fled with his hu- in its social implications and its destruc- manistic friends and in his voluntary tive effects, has disappeared from the exile wrote the famous “Decameron,” civilized world. At one time there were which soon acquired an extraordinary in France and Germany nearly 10,000 popularity. Being widely read by all leper houses or leprosaria, and in France classes of people, it helped to fix the alone 20,000 lepers. Now in order to Italian language which has undergone less change in six hundred years than their nakedness. They love to be tossed to any other European tongue. Petrarch and again into the air. There are some with his sonnets and Dante with his that will roll themselves in the dirt like “Vita nuova” also had a share in popu- swine. Others again you cannot please un- larizing the lingua volgare. less they be soundly drubbed on the Plague was practically the first dis- breech, heels, feet, back, etc. There are some that take a great pleasure in running. ease recognized as infectious, and for the first time in history methods of iso- That the tarantula itself does dance lation and disinfection were employed at the sound of music is what some have by the public authorities. At Ragusa on believed. A wasp being stung by the the Dalmatian coast, ships and travelers tarantula fell into dancing with it and were detained for forty days (quaranta- a cock happening to be in the way was giorni), whence our word quarantine. by the same means brought in for com- A different group of diseases is repre- pany. With regard to the dancing of the sented by tarantism and the dancing tarantula Baglivi is willing to believe manias of the Middle Ages. it, only he thinks “the matter needs a Tarantism got its name from Taren- little further proof.” tum, the town in Apulia where the Professor Sigerist has advanced the malady had its chief center, and from interesting suggestion that tarantism which the spider, the Tarantula, also de- was a revival of the Dionysiac cult of rives its name. Baglivi1 writes of the Magna Graecia. disease as follows: The best treatment in the popular The tarantula attacks persons asleep as mind was music, a special melody for well as awake without any provocation as special cases or special spiders. Hecker well as when ’tis irritated and in both in his book on “The Epidemics of the cases its bites are venomous. A few hours Middle Ages” gives some of these tunes. after the bite the patient is seized with The Italians even today apply the word great difficulty of breathing, a heavy an- Tarantella to a special dance and to the guish of heart, a prodigious sadness, his music of this dance. voice is sorrowful and querulous, his eyes There is no evidence that tarantism disturbed. The symptoms vary, however, was ever caused by the bite of the different tarantulas producing different tarantula. This spider is no more poi- symptoms. After the violent symptoms of sonous than any other spider.2 the first days are over the disease ends in A convulsive disease also appeared in a peculiar kind of melancholy which con- Scotland. It was noticed first in Forfar- tinually hangs upon the sick person until shire. It was called leaping ague and by dancing or singing or change of air bore so close an analogy to the original those violent impressions are quite ex- St.