By Anna Riordan
It may seem that our response to and experiences in the COVID-19 pandemic has nothing in common with pandemics of the past, due to modern technology and our advanced knowledge of microbiology and viruses. However, according to Epidemics before microbiology: stories from the plague in 1711 and cholera in 1853 in Copenhagen, despite modern medical knowledge, our pandemic has a lot in common with epidemics of the past. Studying past epidemics may offer us valuable insight when today’s technology alone is not enough.
Epidemics tend to unfold in narratives of 3 “acts.” First, there is a stage of progressive revelation, in which subtle signs that something is wrong appear, but often these are ignored. As the disease spreads, the public grows worried, but often action is stalled to try and maintain social and economic stability. Second, explanations are demanded and offered as infections and deaths accumulate and accelerate. Reasons are provided, “motivated by a desire to control randomness, to assign blame and fault, and find courses of action” (Bencard 2021), triggering various public responses. In the third stage, the epidemic subsides, and society adapts to a new normal. “The rituals invoked, the societal actions taken, the cultural beliefs stirred up, the lessons learned, all have to be reckoned with and their trailing effects understood” (Bencard 2021).
What did people think causes diseases and epidepics before they knew about microbiology or germ theory? Religious or moral reasons were the dominant explanation for plagues and illnesses, due to the sudden and random nature of epidemics. Other common explanations were social or cultural—certain groups of people or social classes were seen as more susceptible to disease. This article provides two particular epidemics as examples to demonstrate this three-stage narrative and how people understood these epidemics before the study of microbiology.
The first example is the Black Plague in Copenhagen, Denmark, from 1711-1712. In 1708 reports arrived of outbreaks in nearby major trading hubs. In preparation for the epidemic, city officials restricted travel and trade, and warehouses were built outside the city to serve as quarantine housing. Citizens were required to carry paperwork certifying they had not been in contact with any person or building infected within the past six weeks. Copenhagen was the center of power and influence, which provided power and stability but also left the heart of the country vulnerable to infection. People believed the plague was a punishment from God, so clergy and citizens prayed, fasted, and gave penance to try and stop the spread.
Theories of medicine at the time were antiquated and inaccurate, making it difficult to manage the outbreak. For instance, the widely believed humoral theory proposed disease is caused by an imbalance of bodily fluids. The most common disease theory was the miasma theory: that diseases were caused by rotten organic material creating “bad air.” Doctors thought the plague came from cesspools, corpses, “rotten” water, or open sewage, so they tried to clear the air by burning sulfur and juniper berries in the streets. In contrast to humoral and miasmic theory, contagion theory – that disease was spread through material objects – arose because the plague seemed to spread between people.
In 1711 Copenhagen was shut down to try and avoid the plague from entering the city. Soldiers at the city border were ordered to shoot anyone who tried to leave, however, the plague still got into the city in July 1711. The king and wealthy citizens fled, and the plague spread uncontrolled through the city, killing 20,000 people, almost a third of the population.In Northern Italy, the response to the plague was quarantining, the burial of the dead, separation of the sick from the healthy, and the government providing food and water. This provided the foundations of modern healthcare systems.
The other example discussed in the article was cholera in Copenhagen in 1853. The unhygienic, crowded conditions of the city promoted the spread of cholera. Contaigists believed the best approaches to disease management were quarantines, isolation of the infected, and public hygiene.Those who believed in miasma believed disease could be created under certain sanitary or atmospheric conditions, so they emphasized lifestyle, diet, and hygiene. 4,373 people of the population of 130,000 died due to cholera and 6-7% of the population was infected. The cholera outbreak occurred in one of the sunniest, airiest, parts of the city, contradicting miasma theory. Cholera seemed to be caused neither by miasma nor contagion, greatly confusing doctors about previously held disease theories. Despite not knowing what caused cholera, the city prepared by constructing a medical infrastructure. They built cholera wards and offices to report cases. The board of health improved city hygiene by improving safe water supply and sewage systems.
Stories of epidemics are not just about pathogens, but also about “how societies are structured, how political power is wielded, how disease is understood, and how personal and existential anxieties and loss are culturally and socially framed” (Bencard 2021). An epidemic can never fully be understood by a strictly medical or scientific perspective, as epidemics affect many aspects of life, culture, and society. Patterns of the past offer invaluable insight to our present situation. I think we’re in the second or third act of the pandemic, as we are getting vaccines and wearing masks to stop the spread and adapting to our new normal of college in a pandemic.
Citation:
Bencard, A. (2021). Epidemics before microbiology: Stories from the plague in 1711 and cholera in 1853 in Copenhagen. APMIS.