Other Epidemics

During the Renaissance period, influenza pandemics recurred frequently enough to be well described by the fifteenth century. At least three influenza epidem­ics were quite severe during the sixteenth century, those of 1510,1557-8, and 1580.

Virulent smallpox, by contrast, may have appeared in Renaissance Europe only in the mid-sixteenth century (Carmichael and Silverstein 1987). Before that time measles and smallpox were described as relatively mild infections of childhood, an observa­tion resting on those of ninth- and tenth-century Muslim physicians, Rhazes and Avicenna. Unless many of the fourteenth- and fifteenth-century epi­demics of plague were in fact mixed epidemics of plague and smallpox, with the latter masked by the horror of the plague, records of epidemics of small­pox were sparse before the 1560s and 1570s. More likely a milder strain of smallpox prevailed before virulent smallpox entered England in the sev­enteenth century. Smallpox has a much more prominent — if not preeminent — place among the dis­eases of the seventeenth and eighteenth centuries and will thus be discussed later in more detail.

The history of other infections transmitted by air­borne droplets is a patchy one during the Renais­sance.

The German physician Daniel Sennert is credited with having written the first unambiguous descrip­tion of scarlet fever. Rheumatic fever, another mani­festation of severe streptococcal infection, was de­scribed well by Baillou in the sixteenth century and by the English physician Thomas Sydenham in the seventeenth century. Epidemic typhus fever seems to have been a new disease in Renaissance and early modern Europe.

One of the great problems facing historians of Renaissance diseases is the difficulty of discerning the precise cause of an epidemic much before 1500. For example, the following account from a Parisian chronicler in 1414 suggests both whooping cough and influenza:

And it pleased God that a foul corrupt air should fall upon the world, an air which reduced more than a hundred thousand people in Paris to such a state that they could neither eat, drink, nor sleep. They had very sharp attacks of fever two or three times each day, especially whenever they ate anything. Everything seemed very bitter to them, very rotten and stinking, and all the time, where ever they were, they shook and trembled. Even worse, besides all this they lost all bodily strength so that no one who had this disease could bear to touch any part of his body, so wretchedly did he feel. It continued without stopping three weeks or more; it had begun in early March of the same year and was called the tac or herion.... As well as all the misery described above, people had with it such a fearful cough, cattarh, and hoarseness that nothing like a high mass could be sung anywhere in Paris.

This vivid description is echoed by a brief mention of a contemporary catarrhal illness in the other urban areas of Europe, suggesting that the disease was influenza. The cough and low case fatality, however, indicate whooping cough (the chronicler is unlikely to have noted the deaths of babies). But if either whooping cough or influenza was a truly new dis­ease in the early fifteenth century, then the implica­tions for changing disease patterns in the later Re­naissance would be considerable. It is more likely that the criteria for diagnosis and the medical theo­ries governing the description of disease changed during the Renaissance, making difficult a retrospec­tive assessment of what was new and different then.

In others words, evidence for the sudden appear­ance of many common diseases in the sixteenth and seventeenth centuries is somewhat artifactual - a “reporting phenomenon.” During the Renaissance, physicians increasingly turned to models of conta­gion to explain (and, hence, control) the spread of plagues and pestilences, and were aided considerably by adoption of ontological theories of disease. That is, physicians crafted new medical definitions of dis­eases, which had long possessed common lay names, describing them as individual entities with unique and distinguishing characteristics.

In the sixteenth and seventeenth centuries, dozens of “new” diseases seemed to demand or defy medical explanation, which resulted in some of the earliest medical descriptions we possess for scurvy, rickets, typhus, syphilis, scarlet fever, the “English sweate” (whatever that was), and even anorexia nervosa. Thus, one of the fundamental problems for historical epidemiologists is determining which of these, if any, were indeed new or newly important during the pe­riod from 1400 to 1800. And by “newly important,” we mean diseases that changed in incidence and preva­lence in a society rather than those that became im­portant to some groups within these societies. For example, was gout “important” to Renaissance and early modem elites because it became a noble form of suffering - in contrast, for example, to the ignominy ofsyphilis - or because meat consumption among the upper classes, together with a heavy consumption of dehydrating alcohol, increased the clinical expres­sion of gout? In many cases we will never know the answer, and thus must make some assumptions based on those data that did not change over the reporting period while considering significant shifts in the crite­ria for definition and diagnosis. In this respect, much scholarly attention has been devoted to smallpox and syphilis, which thus form two illustrative case stud­ies of the problems involved in tracing the history of diseases of early modern Europe.