The plague doctor

Plague and pandemics have been with us for as long as humans have been on the earth. Ralph Tapping looks at some historic examples and how the current pandemic fits into the picture

The images of health workers around the world dressed in protective coveralls and face masks, trying to prevent the spread of the Covid-19 corona virus reminds us of previous pandemics experienced throughout world history.

The most deadly of these was the bubonic plague, which was estimated to have killed more than 100 million people over three centuries. While this disease has pretty well disappeared, it caused 200 deaths in Madagascar as recently as 2017!

In the 16th century the plague swept through Europe and was thought to have killed over a third of the population of Venice alone, where it accounted for more than 50,000 deaths. Various health measures were instituted in 1575 that included quarantine on two islands in the Venetian Lagoon.

In those times infections were thought to be caused by “miasma”—the bad smells emanating from swamps, sewers and decaying organic matter. The “plague doctors” of the time wore a protective suit designed to protect the wearer, consisting of a long ankle-length, usually black tunic made of linen or waxed cloth, leather gloves, boots, bonnet, spectacles and a wide-brimmed black hat.

The face was covered by a strange-looking mask in the shape of a large bird-like beak which contained a variety of aromatic herbs and dried flowers such as lavender, designed to protect the wearer against infection and the foul smells of the sick.

The “doctor” also carried a wooden cane which allowed them to touch the patient without getting too close. The cane enabled them to remove clothing and reportedly even check the pulse! It must have been terrifying to those dying, to see this fearful figure entering their house and only murmur “bless you” before walking out.

Scientific breakthroughs

It was the mid-1860s before Louis Pasteur proposed the germ theory that suggested that pathogens were responsible for communicable diseases. This theory was followed up by Robert Koch in the 1880s, resulting in the miasma theory being largely debunked.

The plague probably originated in ancient China and spread throughout Europe along the trade routes. It is due to a bacterium called Yersinia pestis and its vector was a tiny flea that hitched a ride on the back of the black rat, Rattus rattus, that was prevalent throughout the world, having stowed away on various forms of transport.

The disease eventually killed the rat and with no fresh blood for the flea to suck, it would jump off onto something tasty like a human being or a dog. The hapless human would often be bitten on the leg and in no time large swellings would appear in the groin. These were called buboes, thus the term ‘bubonic plague’.

A few people survived this form of the disease, however, usually the bacteria spread to the lungs causing fever, coughing and sneezing, leading to pneumonic plague which was always fatal within a few days. The terminal stage involved septicaemia that caused internal bleeding, resulting in black and blue blotches on the skin before the inevitable demise: hence the name ‘Black Death’.

“Bring out your dead”

In the English summer of 1665, 15% of the population of London was said to have died from the black plague. Incubation took a mere 4 to 6 days and when the plague appeared in a household, the house was sealed and a red cross painted on the door. At night a cart was dragged through the streets with the cry “Bring out your dead” and corpses loaded to be taken away to the plague pits outside the city walls for mass burial.

King Henry VIII of England reportedly avoided the plague by isolating himself in his palace. How he managed to keep the rats and fleas away remains a mystery.

In 1666 the Great Fire of London, combined with an extreme cold snap, helped to kill the rats and bring about a virtual end to the outbreak.

In more recent times, the so called ‘Spanish Flu’ in 1918-20 resulted in nearly 50 million deaths world-wide—more than the total number of fatalities from World War 1. Being a viral infection, it was similar to the current Covid-19 corona virus that originated from a live animal market in China. The human immune system does not recognise this new virus because of this.

Somehow the virus mutated, which made it highly contagious to humans, who have no natural immunity. Our only defence has been social distancing, even isolation, to avoid break-outs. People of all ages have been susceptible, although the elderly have been particularly vulnerable.

Eventually a vaccine should become available, but until then we need to take extreme precautions.

Pestilence is something that the world has endured regularly during past centuries and inevitably will reoccur in the future.

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