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A discussion based on “History of medicine: A scandalously short introduction” by Jacalyn Duffin Chapter 7 - Plagues and peoples: Epidemic Diseases in History

Posted on 29 November 2014 by Annie Li (Meds 2018), The History of Medicine Club

How do social practices fair in the face of epidemic disease?

Looking into the past, we arrive at The Plague of Athens, where a contagious and fatal disease was rampant. Determining disease etiology was highly important as it provided insight to possible remedies. The clergy believed that the plague was due to divine punishment. Others believed that the attacking Spartans had poisoned their wells. Still others said that the plague was due to the long war and starvation. When the etiology could not be identified, and no remedy effective, social structure broke down – fear, self-preservation and perhaps opportunistic gains took over.

Moving forwards, we arrive at the Black Death – a disease that produced in its victims symptoms of fever, swollen and oozing nodes, dehydration and death. At the time, Black Death was known to be spread by travellers. This caused a heightened sense of them and us. The outcome was such that not only travellers suffered cruelties, but minorities, and village idiots were also targeted. Social construct within the dominant population also broke down; the living wandered the countryside, the sick were shunned, and the dead left unburied. Furthermore, the certain fatality of this disease and the inability of any authority to remedy it shook the foundations of the feudal social system.

Further still, we arrive on North American shores where waves of European immigrants brought with them typhus and cholera. Treatment towards the immigrants was incredibly biased and unjust. Boarders lined with angry and fearful residents. Unfortunately, sick and healthy immigrants were regarded alike and were forcefully isolated and quarantined together. Inevitably, the healthy became sick and the majority of immigrants succumbed to the disease. With imported diseases, social structures dealing with the other are under strenuous stress and courtesy is unlikely to be observed.

Presently during the Ebola epidemic in West Africa, how have we faired? Fear, there is definitely plenty of that – both in Western Africa and in the Americas. In West Africa fear may be gathered from the unburied bodies, street riots and vigilant adherence to rituals. In the Americas fear is seen in futile and exaggerated precautions to this virus. Futility is seen in the implementation of thermal scans at airports, which neither accounts for the incubation period of the disease nor the other more common diseases associated with fevers abroad (e.g. malaria). Exaggerated response is seen in the suspension of basic human rights to a nurse who had returned from West Africa. Ms. Hickox and was forced to live in a tent, in a hospital, without shower and directed to wear paper scrubs. Despite this fear (which spans back to antiquity), I would argue however, that we are learning. Fear is limited by limiting the epidemic. Given our current understanding of science, epidemics are best limited by targeted and vigorous screening, isolation or quarantine and if need be, proper disposition of the body. (These elements may be seen in Nigeria’s successful response to Ebola.)

It is perhaps instinctive that during epidemics (historical or present), fear transcends established social structures. Although it seems circular, one feasible solution preventing the collapse of social constructions during epidemics is to prevent epidemics altogether. Currently, with our investment and knowledge in science, we are in a much better position to prevent epidemics than our historical counter parts.

 

Reference

Duffin, Jacalyn. “Chapter 7: Plagues and Peoples: Epidemic Diseases in History.” History of Medicine, Second Edition: A Scandalously Short Introduction. 2nd ed. Toronto: U of Toronto, 2010. 163-194. Print.

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