Disasters in the History of Disease: When Doctors Got It Wrong

The history of disease is not a bestseller with doctors fighting like heroes. It was a trial and error process in which the medics were often too arrogant to admit they didn’t know something. Most of the time, the doctors knew no more than ordinary people who used known healing practices. Yet, they saw themselves as educated men, higher beings than the ignorant common folk. However, when it came to the history of disease, they missed the perpetrator entirely until the end of the 18th century. They knew nothing about microbiology, and they did not discover the principle of infection or disinfection. Only after the first bacteria had been found could medicine move on.

In the History of disease, doctors’ prescriptions went against common sense. But then, we must rethink our idea of common sense. We are evaluating the practices in light of what we know and fail to realize that medieval people were left in complete darkness concerning anatomy and physiology without microscopes and modern lab technology.

One of the most famous goofs in the history of disease is bloodletting. Today we know that sick organisms need to rest to keep all their strength. When patients lose too much blood, they are weak and, in severe cases, can die. The last thing our common sense would advise us is to make them bleed. However, medieval and early modern medics followed different lines of reasoning. They believed that a patient suffering from a fever needs to lose the hot blood and feel relieved. They followed the renowned ancient doctor Galen who advocated harmony among the four humors — blood, phlegm, yellow, and black bile. Fever means too much blood in the body, and if you let some go, you achieve balance, and the body heals. And do not imagine a harmless bloodsucking. The doctors often relieved their patients of at least half a liter of blood (17 ounces) a few times during their illness.

False Views On Human Anatomy in the History of Disease

Until the beginning of the 15th century, the autopsy did not belong in a medic’s curriculum. This led to false conclusions about what the human body looked like. The assumptions made by Galen in the 3rd century CE were not based on the careful study of bodies or corpses. Until the Renaissance came, no correction was made to the authority of Galen.

Medieval images of especially women’s bodies seem almost funny today. Doctors wrote, and clerics read about the female womb traveling through the body as though a being equipped with free will. And this womb was supposed to be obsessed with living up to its purpose — reproduction. It was meant to turn the woman into an insatiable being, always ready to mate, unable to resist the call of her womb. It might sound funny, but the medieval theories about women’s physiology led to the image of a woman as the devil’s seducer and helped to form a misogynistic culture.

When the pestilence came to Europe, people were rightly scared. The death rate was shockingly high, and nobody knew about the bacteria and the fleas that carried it from house to house. This was the saddest goof that caused the death of thousands of otherwise healthy people during the history of disease.

From experience, ordinary people (and doctors) knew that people who lived with sick people also fell ill. Thus, they locked the whole family inside in the quarantine. Eventually, they all fell sick and died inside. It was the proper precaution but it would not prevent the sickness from spreading. Because you cannot lock the rats in quarantine, and you definitely cannot prevent the fleas from moving into another building when all their hosts are dead. And the healthy people, who ran away from the plague town, carried infected fleas in their luggage and clothes.

The plague had a relatively short incubatory period but not all of the germs were so merciful. People cured their symptoms and the symptom-free person was considered healthy. However, experience showed that precautions should be in place when a healthy person was in touch with a sick person. But there are diseases, like smallpox, which can be infectious even before the visible symptoms appear. People were virtually helpless in these cases.

Why Would People Believe in Such Stories?

We must realize one thing. People knew nothing. The key to understanding the processes in the human body lies in the microscopic world. Only under the microscope do we see that the female egg lies patiently waiting for the sperm chasing. People believed in fairies and invisible beings hidden in the forest. They accepted invisible beings as part of the universe. But a world inhabited by life forms so small that they could not be seen was far beyond anybody’s imagination. People were used to things being out of their control and nature having her wayl. Thus, they sought more plausible explanations — some more aligned with their common sense.

Today medicine and science strive to disintegrate the natural world and examine each piece individually. That idea was against common sense for medieval people. The worldview dominated everything. The theory of the four humors defined everything in human physiology — the disease and the cure, happiness and depression, anger and calm, and love and hatred. Within this worldview, there was no place for novelties.

However, a group of specialists had a higher success rate than university doctors in healing people. The history of disease does not mention them too often because they did not study at universities and did not write scientific papers. They were called not when the fever struck but when the injury happened. Yet, they found disinfection much sooner, before anybody knew about infection. These people were surgeons.

Surgeons could operate the skull even in ancient times. Surgeons could work miracles on maimed soldiers and even knew about disinfection, unlike doctors who did not connect the dots between hygiene and mortality rates during childbirth or did not even wash their hands when visiting a room with pestilence.

Surgeons did not study theory too much. They learned their skills from practice and passed them on. Experience showed that when the surgical tools were sterilized by fire or alcohol, the patient’s chances for survival grew. Surgeons, of course, knew nothing of germs but did not need to know. But doctors in universities did not respect their skillful colleagues. In medieval and early modern times, a surgeon was counted among craftsmen, while the doctor was a learned person. Only much later did these two professions ally and even merge.

The Origin of Infection: Various Theories in the History of Disease

Doctors rarely cured the sickness. As such, their cure was always symptomatic. That means that they only tried to mitigate the symptoms. Today, we know of such therapies. Especially when the virus causes the disease, we only take vitamins, prescribe calm and warmth, and lower the fever in the patient. But we do cure the cause when we can. We classify the diseases according to the germ that caused them and add the symptoms, like fever, cough, diarrhea, etc., to each. Medieval doctors did not classify diseases; the symptoms were the sickness. They cured the fever; they healed the cough, and so on. Thus, it is challenging for a historian to learn about the history of disease because the sources do not reveal what diseases had struck.

Galen stated that the patient’s inner balance was distorted and must be maintained. But with epidemic diseases, experience shows that the infection goes from person to person. An obvious explanation was a moral and spiritual one. The disease was always handy as God’s punishment for a specific village, place, or world. But more scientific explanation was needed, and the doctors realized they should come up with one.

They devised the “miasma theory,” which said the infection was caused by miasma — bad air — emanating from the rotting matter. It could have been polluted water or rotting bodies of animals and people. Doctors advised moving away from the source of miasma — a plagued village, or a house with a dead body inside. It was better than staying, but it was not the solution, and it also helped the disease to spread to other places.

Girolamo Fracastoro, believed that some particles that cause infection can remain unseen after contact with the sick person. But in 1546, nobody believed his theory. It was later developed by Marcus von Plenciz in 1762. Plenciz even stated that some organisms might dwell inside the infected body and that a different organism caused each disease. Thus, germ theory was born — yet Plenciz could not prove it. And without the proof, the idea of unseen germs killing people in their thousands seemed too unbelievable to be true. And then came Louis Pasteur.

Pasteur did not have the proof but started to experiment with disinfection. He used boric acid in childbirth and significantly lowered the number of women who died postpartum. That was just the beginning. Later, sterilization and disinfection found their way into everyday life. It was Robert Koch who brought the ultimate proof of the germ theory. He found the bacteria causing tuberculosis and cholera under the microscope.

Further Challenges in the History of Disease

Finally, doctors did not stumble in the dark. Yet, the battle was far from over. Discovering bacteria was one thing, but the world waited until the half of the 20th century to find the cure — antibiotics. Furthermore, the first microscopes could not see viruses, and germ theory was doubted again when the scientists looked for the germs causing smallpox or measles. Vaccination for smallpox was in everyday use, even in Pasteur’s time.

Still, developing new vaccines was slow and complicated, and disastrous accidents further undermined people’s trust in vaccination and medicine in general. New mysteries emerged, like why polio killed more children when hygiene improved and not before. Today, we believe that with lousy hygiene, babies were exposed to polio pathogen in the early stages of life, did not fall sick, and developed immunity. When hygiene improved, older children were infected and fell ill. Only vaccination stopped the spread of polio disease.

The history of disease is far from over. With every new pathogen discovered, new challenges occur. With every problem solved, new problems emerge. Yet, doctors today at least have the means to find the villain in their petri dish and are well-armed to fight it.