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Plague of 1665

Plague of 1665. last English epidemic of this bacterial infection spread to humans by rats’ fleas worst during hot months, when vectors thrived London death rate went from 33 to 1,600 per day first symptom: lymphatic gland enlargement (bubo) other symptoms followed within hours:

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Plague of 1665

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  1. Plague of 1665 last English epidemic of this bacterial infection spread to humans by rats’ fleas worst during hot months, when vectors thrived London death rate went from 33 to 1,600 per day first symptom: lymphatic gland enlargement (bubo) other symptoms followed within hours: chills, pains, fast pulse, fever, vomiting in 70% of cases, death within a few days This account an abbreviation of Defoe’s 1722 text

  2. 18th c. medicine: from revelation to reason animist/mechanistic debates continued industrial revolution expanding affluence rise of middle class & participatory politics end of traditional authority (French Rev’n) Medicine combined ancient knowledge & new science (Boerhaave’s hydraulic model) clinical observation explained via theory

  3. Dr. Boerhaave hydraulic model of bodily function, combining humoral theory with anatomical knowledge

  4. Qualitative disease diagnosis felt pulse smelled & observed body tasted urine listened to breathing • heard patient’s account of disease history & lifestyle • cross examined re regimen, symptoms, course of illness • dr. aimed to diagnose & manage progression of disease Theories of constitution used to explain differential susceptibility to disease disease spread via precipitating & predisposing causes

  5. Changes in medicine, 18th c. • Clinical observations combined with theory • Rise of qualitative measures of disease • thermometer • vital statistics for populations • Disease taxonomies developed (nosologies) • Expansion of hospital care • Medicalization of childbirth • Rise of pathological anatomy (autopsy) Little medical impact on mortality

  6. Yellow fever in Philadelphia, 1793

  7. Protections against yellow fever Recommended by College of Physicians Avoid infected people Use vinegar on handkerchief when visiting sick Avoid fatigue Don’t sit in draft, sun, or evening air Dress appropriately for weather Drink wine, beer & cider sparingly

  8. Public health measures recommended • Mark houses of ill, so others will know • Place patients in airy rooms • Change linens often, remove filth • Build hospital near city for sick poor • Clean streets, butchers’ market stalls & wharves • Burn gunpowder to clear the air • Stop tolling bells for dead • Bury dead privately

  9. Yellow fever in U. S. South “Lucille died at 10:00 Tues night, after such suffering as I hope never again to witness…the poor girl’s screams might be heard for half a square at times and I had to exert my utmost strength to hold her in bed. Jaundice was marked, the skin being a bring yellow hue: tongue and lips dark, cracked and blood oozing from the mouth and nose….to me the most terrifying feature was the black vomit which I never before witnessed. By Tuesday it was black as ink and would be ejected with terrific force. I had my face and hands spattered but had to stand by and hold her. Well, it is too terrible to write any more about it.” (Spielman, 62)

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