A Short History of Disease

by Sean Martin

  Dengue fever: Known as breakbone fever due to the intense pains it causes in bones and joints, dengue is a mosquito-borne viral disease that also causes a measles-like rash. Has seen a huge increase in cases since the 1960s, and is now endemic in more than 100 countries.

  Diabetes: Known since antiquity as a disease that causes ‘honeytasting’ urine – people were employed as professional tasters – it was known in the seventeenth century as the ‘Pissing Evil’. Caused by irregularities in the pancreas, diabetes has seen an upsurge in the twentieth century, largely due to an increase in obesity. In British India, it was seen as one of the ‘penalties of an advanced civilisation’.

  Diphtheria: A ‘throat distemper’ that causes a hide-like membrane on the tonsils and a ‘bullneck’. Frequently a disease of the poor in the nineteenth century, the first recorded epidemics were in the seventeenth century. The Spanish outbreak of 1613 was known as The Year of Strangulations, a reference to the severe sore throat and breathing difficulties that diphtheria produces.

  Dracunculiasis: Old Testament references to a ‘fiery serpent’ are, it has been suggested, references to the guinea worm, which causes dracunculiasis, a parasitic infection caused by drinking infected water. Egyptian mummies from c. 1450–1500 BC also show evidence of worm infestation, and the Indian Rig Veda offers magical charms against the worm. The female worms move through the person’s subcutaneous tissue, causing intense pain, and eventually emerge through the skin, usually at the feet, producing blisters and ulcers, accompanied by fever, nausea, and vomiting.

  Dropsy: An abnormal accumulation of fluid in the interstitium, between the skin and in the cavities of the body. Galen noted that it was a common condition in ancient Rome. Its principal causes are congestive heart failure, liver failure, kidney failure, and malnutrition.

  Dysentery: A major killer of children in ancient Rome, dysentery (bloody diarrhoea) also saw King John and Henry V of England and Louis IX of France to their graves.

  Ebola: One of the deadliest diseases known, Ebola is an acute viral haemorrhagic fever that first broke out in South Sudan and northern Democratic Republic of Congo in 1976. In the latter case, the mortality rate was 88 per cent. Its animal reservoir is unknown, although bats are strongly suspected. The 2014 outbreak in West Africa was the first time Ebola had reached epidemic proportions, with over 10,000 deaths.

  Elephantiasis: Caused by a parasitic worm, elephantiasis can cause thickening of the skin and horrific swellings of the lower body.

  Encephalitis: A viral swelling of the brain, encephalitis comes in a variety of forms. Many can be fatal. Some survivors can develop parkinsonism.

  English Sweate: A mysterious sweating sickness that first affected England in 1485 after the Battle of Bosworth. Dutch mercenaries fighting for Henry VII were immune. It could kill within 24 hours. German medical historian Justus Hecker attributed the disease to the English weather and habits of the aristocracy – gluttony and heavy drinking in particular. The English Sweate disappeared after 1551, although the equally mysterious Picardy sweat, noted in the C18 and C19, could be a descendant.

  Epilepsy: A neurological disease of ancient pedigree. Ancient Babylonians attributed epilepsy to the touch of a god, or the influence of the star Marduk (Jupiter). Hippocrates believed the disease had a natural explanation, although was not able to identify a cause. The ancient Romans believed fresh human blood could cure epilepsy, and sufferers were allowed into the arena to drink from gladiators’ wounds. In the early modern period, epileptics were frequently confined in mental asylums.

  Ergotism (St Anthony’s Fire): A fungal disease that can cause convulsions and, in its gangrenous form, rashes and hallucinations. An outbreak in 922 of the gangrenous type was said to have killed 40,000 people, while another killed 14,000 in Paris in 1128–9. Ergotism has been proposed as the disease behind the Salem witch trials in 1692, as the accused girls all showed signs of ergot poisoning, including eating bread that was coloured red – a classic indicator of ergot-infested rye.

  Erysipelas: Long confused with ergotism, which also produces rashes on the skin, erysipelas was identified as a separate disease in the nineteenth century. It was noted that erysipelas often happened in conjunction with puerperal or childbed fever, one of the main causes of deaths in childbirth. Puerperal fever was eventually found to be caused by the doctors attending women in labour not washing their hands.

  Fatal familial insomnia: A very rare neurological disease caused by prions, fatal familial insomnia produces progressively worsening insomnia, leading to hallucinations, delirium, and confusional states like that of dementia. It is usually fatal within 18 months of onset.

  Gerstmann–Sträussler–Scheinker syndrome: A very rare neurodegenerative disease caused by prions. Initial symptoms include difficulty speaking and unsteadiness, followed by worsening dementia.

  Gout: A disease that causes the joints, particularly the knee and ankles, to swell due to the formation of crystals as a result of higher levels of uric acid in the blood. 90 per cent of the sufferers are male. Long associated with fine living and overindulgence, its nickname ‘the Disease of Kings’ reflects the fact that the well-to-do were often its victims. The poor had to make do with pellagra.

  Haemorrhagic fevers: Viral diseases characterised by a high fever, bleeding from all orifices, shock and high mortality rates. Yellow fever is one of the oldest known, characterised by jaundice and the production of black vomit, while Ebola is the most well-known of the newer haemorrhagic fevers. The group also includes Marburg virus, Lassa fever, and Crimean-Congo haemorrhagic fever, which all originated in Africa and Asia. A South American group includes Argentine, Bolivian, Brazilian and Venezuelan haemorrhagic fevers.

  Halfdead disease: A condition known to the Anglo-Saxons, who referred to it as seo healfdeade adl, which was probably hemiplegia, a form of partial paralysis often caused by a stroke.

  Heart disease: The heart attack is a particularly twentieth century phenomenon. Although demographer John Graunt (1620–74) recorded people dying ‘suddenly’, which could be heart-related, the term was not coined until 1912. Like diabetes, heart disease has seen a rise of cases in the twentieth century, and is now the biggest killer.

  Hepatitis: Producing inflammation of the liver, often leading to jaundice, hepatitis exists in a number of different forms. It can be caused by excess consumption of alcohol or drugs, autoimmune deficiencies, and can be sexually transmitted.

  HIV: Human immunodeficiency virus, the virus that causes AIDS. HIV has been one of the worst pandemics in history, infecting around 65 million people and killing around 25 million. Half of all HIV deaths have occurred in Africa.

  Huntington’s chorea: Neurodegenerative disorder than can lead to erratic movements and mental impairment. It has been suggested as a cause of dancing mania and St Vitus Dance.

  Influenza: Also known as flu, influenza is a disease of humans, pigs, horses, and several other species of mammal and birds. In humans it is a very contagious respiratory disease characterised by sudden onset and symptoms of sore throat, cough, runny nose, fever, chills, headache, weakness, muscle and joint pain. The first recorded epidemics were in the sixteenth century, and an eighteenth century epidemic gave the disease its name, from the Italian for ‘influence’ (meaning the influence of the stars, which were thought to be responsible for so apparently universal an affliction.) A particularly virulent strain was responsible for the Spanish Flu pandemic in 1918–19.

  Kuru: A degenerative neurological disease endemic among the Fore people of Papua New Guinea. It is similar to variant CJD. In the case of the Fore, it is usually caused by their practice of funerary cannibalism.

  Lassa fever: An acute viral haemorrhagic fever first reported in Nigeria in 1969. Symptoms include high fever, lethargy, muscle and joint pains, sore throat, back pain, nausea, liver failure, and bleeding. Lassa can simulate the appearance of other endemic African diseases such as malaria, yellow fever and typhoid. Lassa is a Risk Group 4 pathogen
, meaning it’s one of the deadliest diseases known.

  Legionnaires’ disease: First breaking out at a convention of the American Legion in a Philadelphia hotel in 1976, Legionnaires’ is a sudden form of pneumonia caused by a previously unknown bacterium, legionella. An airborne infection, the disease is frequently spread by air conditioning, cooling towers and condensers.

  Leprosy: Along with plague, leprosy is perhaps the most feared disease in history. There are numerous references to leprosy in the Bible, although these could be any number of skin conditions. Leprosy reached epidemic proportions in Europe in the late Dark Ages through to the High Middle Ages. It declined after the fourteenth century, possibly being replaced by tuberculosis. Frequently seen in the Middle Ages as a disease caused by sin, lust in particular. Lepers were given bells and clappers to warn of their approach. The medical cause of the disease was finally identified in 1880 and it is now known as Hansen’s Disease.

  Lupus vulgaris: A form of tuberculosis that attacks the skin, mainly around the face and neck. The name means ‘common wolf’.

  Lyme disease: First reported in Lyme, Connecticut, in 1975, Lyme is a tick-borne disease that can cause fever, headache, fatigue, and a distinctive skin rash called erythema migrans. If left untreated, infection can spread to the joints, the heart, and the nervous system.

  Malaria: One of the oldest known diseases, malaria has probably killed more human beings than any other. Caused by the bacteria Plasmodium falciparum, it is transmitted to humans by the bite of the female Anopheles mosquito.

  Marburg fever: Lethal viral haemorrhagic fever first reported in 1967, when it affected laboratory workers in Marburg and Frankfurt, Germany, and Belgrade, Yugoslavia. The outbreak was traced to monkeys from Uganda. It can have a fatality rate of 90 per cent, and is one of the World Health Organization’s Risk Group 4 pathogens, meaning it’s one of the deadliest diseases known.

  Measles: Now one of the diseases of childhood, measles is a viral disease that causes a distinctive red rash. Measles is what is known as a crowd disease, meaning it needs a certain number of susceptibles to remain active. In prehistory, communities were not thought to be of sufficient size to sustain measles. The disease was initially far more virulent, and has been proposed as the cause of the Antonine Plague of AD 165–190, and the Plague of Cyprian, 251–70.

  Meningitis: An acute inflammation of the meninges, the membranes that cover the brain and spinal cord. Usually the result of bacterial infection, but can also be caused by fungi and viruses.

  MRSA: Known as a ‘superbug’ for its resistance to antibiotics, methicillin resistant Staphylococcus aureus first broke out in an English hospital in 1963, but became headline news in the 1990s as a disease increasingly prevalent in hospitals and other healthcare facilities. MRSA is a bacterium that can live on any surface, including the nostrils and skin, and can cause life-threatening infections such as blood poisoning, heart problems, pneumonia, urinary tract infection, septic arthritis, osteomyelitis and septic bursitis. MRSA can also cause toxic shock syndrome.

  Mosquitoes: Along with bats and ticks, perhaps the most common disease vector. The most significant mosquito-borne disease is malaria. Others include yellow fever, dengue fever and West Nile virus.

  Nipah: A zoonosis that sprang to bats to humans via pigs. The first outbreak occurred in Malaysian piggeries in 1999. Initially causing fever, vomiting and flu-like symptoms, Nipah then attacks the nervous system, and can cause brain damage and hallucinations before death occurs. It caused 100 human fatalities, and the culling of over one million pigs.

  Obesity: A condition of the body, rather than a disease, obesity has nevertheless been linked to growing incidences of heart disease and diabetes. Increasingly sedentary western lifestyles, together with processed food, are largely responsible.

  Omsk haemorrhagic fever: A highly contagious viral disease discovered in Western Siberia, it is transmitted to humans via contaminated water, an infected tick or rat, or by drinking the milk of an infected sheep or goat.

  Pellagra: Dubbed ‘land scurvy’ for its similarities to the disease that afflicted sailors, pellagra is caused most often by a deficiency of vitamin B3. Characteristic symptoms include the ‘Three Ds’: diarrhoea, dementia and dermatitis.

  Phthisis: One of the old Greek names for tuberculosis.

  Pinta: a skin disease endemic to Central and South America caused by the spirochete, Treponema pallidum carateum, which is highly similar to the organism that causes syphilis.

  Plague: Arguably the most notorious disease in history. Caused by the bacterium Yersinia pestis, plague is a rodent disease endemic in many parts of the world that is spread to humans by the rodent’s fleas, or by eating infected rodent meat. There are three principal forms: bubonic, which settles in the lymphatic system and produces the black tumours or ‘buboes’ that give the disease its name; pneumonic, which attacks the lungs, and causes respiratory problems and the vomiting of blood; and septicaemic, which poisons the blood stream. Bubonic, although the most famous form, is the least lethal, with mortality rates anywhere between 30 to 60 per cent. Untreated pneumonic and septicaemic plague have death rates of almost 100 per cent. There have been three pandemics: the Plague of Justinian (542–c.750), the second (c.1330–1771), whose most notorious phase (c.1330–c.1350) was known as the Black Death, and a third pandemic that began in China in 1855, reached its apogee in the 1890s, when a vaccine for plague was developed, and was considered over by 1959. The Black Death is the most devastating pandemic in history, killing approximately one in three people across Asia, Europe, North Africa and the Middle East in less than twenty years. It did most of its work in Europe, the Middle East and North Africa in less than three (1347–50).

  Pneumonia: An acute inflammatory condition of the lung tissue caused by numerous infectious agents and toxins. The name derives from the Greek for ‘condition of the lung’. Symptoms include fever, cough, chest pain, and difficulty in breathing. Untreated, it can have a mortality rate of up to 30 per cent. Pneumonia can also be the result of another disease, such as AIDS, plague or Legionnaires’ disease.

  Polio: An acute disease caused by inflammation and destruction of motor neurons after infection by a poliovirus. Frequently asymptomatic, only a small number of those infected go on to develop full-blown polio. Symptoms can include fever, infection of the central nervous system, meningitis, paresis or paralysis. When the muscles of respiration are affected, death can occur. Although possibly known to the ancient Egyptians, polio suddenly became an epidemic disease in the nineteenth and twentieth centuries.

  Pott’s disease: A form of tuberculosis that attacks the spine, causing deformity. Thought to be depicted in funerary stelae from ancient Egypt.

  Psoriasis: A disease of the skin that can cause rashes, scabs and irritation. Its cause is still not fully understood. It may have been taken for a form of leprosy in the past.

  Puerperal fever: Also known as childbed fever, this was a major cause of mothers dying in childbirth, until it was suggested in the mid nineteenth century that mortality could be reduced by the doctor or midwife washing their hands. Doctors who had performed autopsies immediately prior to working in the delivery room were found to be inadvertently transmitting bacteria to the mother-to-be.

  Pyorrhea: A dental disease that causes gradual loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth.

  Rabies: First recorded in a Babylonian legal tablet from c. 2300 BC, rabies is one of the oldest known diseases, and also one of the deadliest. Usually transmitted to humans via the bite of a rabid dog, it is impossible to survive without urgent treatment. A vaccine was developed by Louis Pasteur in 1885.

  Relapsing fever: The endemic form of relapsing fever is transmitted to humans by ticks and rodents; the epidemic form by a spirochete, transmitted by human head and body lice. Often confused with malaria and typhus, due to the similarity of its symptoms.

  Rickets: Mainly ca
used by a lack of vitamin D, rickets can cause various abnormalities of the bone, muscle weakness and dental problems.

  Rinderpest (cattle plague): Although it does not affect humans, cattle plague has a long history of creating devastation in human communities, causing loss of livelihood, famine and the diseases that follow in its wake, such as typhus.

  Ringworm: Skin condition caused by a fungal infection.

  Risk Group 4 pathogens: The World Health Organization’s highest hazard level classification for diseases. Group 4 pathogens are the deadliest diseases known to humanity, and include Ebola, Marburg, Lassa, Kyasanur Forest Virus, Machupo, Crimean Congo haemorrhagic fever and Nipah virus.

  Salmonella: Infection with salmonella, known as salmonellosis, can cause diarrhoea, fever, and abdominal pain. Usually lasts up to a week, and most individuals recover without treatment. In rare cases, the infection can spread to the bloodstream, which can prove fatal unless treated.

  SARS: Sudden Acute Respiratory Syndrome was the first pandemic of the twenty first century. Breaking out in China in November 2002, it spread to 32 countries over the coming months, with 8,000 cases and 900 deaths. It is thought to have originated in bats, and spread to humans via meat sold in Chinese markets.

  Scabies: From the Latin word ‘to scratch’, scabies is a contagious skin disease caused by the mite Sarcoptes scabiei. The mite burrows under the skin and can cause intense itching.

  Scarlet fever (scarlatina): A disease usually associated with childhood, scarlet fever causes a sore throat with difficulty swallowing, chills, vomiting and pain in the abdomen. After a couple of days, a distinctive red rash appears, giving the disease its name.

  Schistosomiasis: Also known as bilharzia, schistosomiasis is a disease caused by the eggs of parasitic worms. The disease is transmitted by contact with freshwater, in which the snails that carry the worms live. Symptoms include a rash, itchy skin, fever, chills, cough, and muscle aches. Repeated infection can cause anaemia, malnutrition, and learning difficulties.