Show Notes: Catherine Abou-Nemeh - Pandemics Through History


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Show Summary:

Catherine Abou-Nemeh is an academic historian of early modern science, technology, and medicine, first at Princeton and now Victoria University. She’s currently working on a biography of Dutch lens-maker and natural philosopher Nicolaas Hartsoeker.

What we’re diving into today, is what it was like to experience an epidemic in early modern times – which is the period from 1500-1800 AD, just after the medieval period. We’re also exploring how early modern scientists thought and wrote about epidemics — and how much power they had to influence government responses.

Show Notes:

  • [0:48] How did the average citizen in the early modern period (roughly 1500–1800) experience an epidemic?
  • [4:04] The origin of the word “quarantine”
  • [5:19] In what ways did public health measures evolve during the early modern period?
  • [10:44] How was the public health response different from place to place during early epidemics?
  • [12:27] What was the level of knowledge about public health in the general population during the early modern era?
  • [13:24] Catherine breaks down the history of “quack” doctors
  • [18:10] What was the role of doctors in the early modern age?
  • [20:35] The impact of being a “specialist” at any point in history
  • [25:53] Is there anything from the early modern age that we’ve lost in our contemporary world-- that we should be doing but we’re not?

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Jimmy Catherine Abou-Nemeh is an academic historian of early modern science, technology and medicine, first at Princeton and now Victoria University. She's currently working on a biography of Dutch lens maker and natural philosopher Nicholas Hudsucker. But what we're diving into today is what it was like to experience an epidemic and early modern times, which is the period from about 1500 to 1800 AD, just after the medieval period. We're also exploring how early modern scientists thought and wrote about epidemics, and how much power they had to influence government responses. Catherine, thanks for coming on.

Thanks, Jimmy. Happy to be here.

Jimmy 8
So very different environment in the 16th century to the 21st. How did the average person, the average citizen in the early modern period, generally experience an epidemic? Did it look fairly similar to what we’re going through now? Or was it just a completely different experience?

Well, there’s definitely some overlap between how we’re currently experiencing lockdown or quarantines how patients with the disease are being sequestered away from family. So back in mediaeval and also early modern Europe, as cities set up special hospitals to tend to the sick, especially during times of epidemics and mass outbreaks. There were changes in how families interacted with each other. There were stories, unfortunately of abandonment, so parents abandoning their sick children, fearing being essentially being infected as well. And, and vice versa. So relatives kind of, we do kind of get the sense of kind of public turmoil and social social anxieties around disease. Obviously cities rallied and started to set up public health boards. We have good documentation, especially around the Mediterranean. So in places like Venice, Milan, Ragusa, which is present day to Dubrovnik, in Croatia, where people kind of collectively organise various public health measures to do with streets, sanitation and cleaning projects, the specific kind of rituals around burials changing so you of course still had the involvement of medical personnel like physicians and nurses and various charity workers like in this period, it was also sisters working out of monasteries, for example, or monks who tended to the sick as well who engaged and tended to the sick priests still made their visits to try and administer the fun the last office or the last sacrament before people died often they would you know, Boccaccio, kind of early humanist author from Florence, he would recount how often the priests and his entourage wouldn’t make it in time people would have been dead. Often it wasn’t just one person, but a whole family that would have they succumb to the two mass outbreak of the bubonic plague, for example. So we get the sense from historical documents of this kind of public upheaval and also, sharp measures being put into place quite early on actually, so already around the Black Death, so 1348 in Europe, taking measures to do these sort of larger scale sanitation, I guess projects and the building of specific hospitals. This idea and concept of quarantine as well being of Italian origin, meaning 40 days, quaranta from the Italian word for 40. And this, essentially, no one knew how to deal with pandemics. And so the best way was to remove yourself and those who could the wealthiest members of society would usually retreat to their estates in the countryside, or go and stay with relatives. men often send their families away for protection. So again to in the countryside. And yeah, people retreated from city life. Cities felt very empty as they do for us today. You know, during lockdown, we kind of early moderns also had to get used to the new found silence And, you know, people heard only the tolling of vowels which would announce burials of the dead. And they yeah, they would sort of notice some of the similar things we notice, like nature sounds and cities and general silence and quiet and only those who couldn’t retrieve anywhere which, who were often the poor and the destitute, those would still be in the streets.

And so you talked early there about people coming together collectively organising public health measures. So, by this point, public health measures were fairly well understood. That sounds like innovation in that early modern period of how things were treated? Did it evolve during that period? Or were they already knowledgeable enough to do the basics and, you know, basically treat it the same way they had, for example, the Black Death?

It’s a good question. A lot of medical historians or medical histories basically see To suggest that with pandemics or with the bubonic plague and virulent pestilence outbreaks, it was mostly a triumph of administrative efforts. So these kinds of public health measures that I just talked about, rather than any kind of medical innovations, so we do have to cast our minds back to an earlier time when even doctors were seen as not not having the answers and there wasn’t really such a thing as biologists or epidemiologists investigating under a microscope, the causes of diseases. There was still so much room for speculation to do, what the medical side of why these outbreaks happened, what the causative vectors of disease might be, you know, is that rats, is it fleas. Those were later ideas And germ theory didn’t come about. So this idea that diseases spread through germs that we pick up on our hands and you know, in other ways like eating either rotting food or contaminated things, is more a 19th century idea. So even though there were earlier speculations happening in the medical world, like including by the figure I studied Nicholas Hartz, Sucre, for instance, in the early 18th century argued, and even earlier argued that plagues and pests happen through insects, so tiny, tiny insects, we can even see under the microscope, who must be carrying the germs of disease, and then kind of end up on or in our bodies. And that’s how we become ill. Other people well into the early 18th century speculated that germs of disease are not necessarily causative of disease themselves, they must be mixed with different like invisible particles within our bodies. So they thought that it had to be a kind of concoction or a meeting of the germs of disease with the germs that we carry within us and various kind of dusts creating a poison that then kills us. So this area of, I guess, causation of disease, and understanding were quite speculative for a long time and the measures that seemed to work best were sequestration of the sick end of the healthy quarantine waiting things out for 40 days and seeing you know, who survives basically and try to stave off contamination. People in London who were sick were told to carry you a wand or a stick in In order to make sure that passers by wouldn’t touch them or wouldn’t come close and therefore catch it, and regular people believe that, you know, the germs of disease or whatever kind of caused causative agent must reside also in the things owned by people who were sick, so in their clothes or in the objects that they touched, so there was a kind of idea that if things become tainted, you know, but people didn’t quite know why. So, in terms of rooms for innovation, room for innovation, I think it was more about the public health measures in fact, and social distancing, and less so about finding a cure because no one did find a cure. So for other diseases like yellow fever or malaria later on in history, people did start getting some success with either using the Peruvian bark or quinine against malaria, or mercury treatments, for example, for syphilis, or the so called great pox, which also kind of made a lot of people sick very quickly and to grave effects and many died. So there was some, some medical innovations, but not for the bubonic plague.

And was the response evenly or unevenly distributed? So we have records of cities, communities, states nations responding to these early epidemics. Was it similar today in that some places were doing really well, some places were chaotic, some places seem to not care. Was there that difference and were people aware of that difference?

And definitely, there were differences. So, for instance, with the after the bubonic plague, which by had two waves, so 1348 and then again in the 1360s, it came back and ravaged various European nations as well. So, yeah, a place a town like Bologna, for instance, was very successful at instituting public measures and saving its city or preserving it as best as it could. Whereas other cities suffered. And as you say, you know, there was more chaos, more deaths. Some places like even the thriving maritime power of Genoa so another maritime power compared to just like, like Venice, and it’s, I mean, Venice and Genoa were rivals economic rivals, but Genoa, for instance, recovered much more slowly than Venice did. It took almost 100 years for Genoa to recover its economic strength after the Black Death. Compared to a place like Venice, for instance.

So in the, the experience out on the street, you talked about the the sticks, keeping people away, which I think I’ve seen some photos and people doing that even now, but on the streets, Daniel Defoe wrote in a journal of the plague year, he wrote with a lot of let’s call it scepticism about what he felt like were quack quack remedies being offered out on the street for people who were who were scared essentially. And was there much of a sense of knowledge or level of knowledge in the general population? Or was the knowledge or or speculate speculative knowledge even held in only the scientific class?

So at this stage, because no one knew for a fact what would work for besides, again, social distancing measures and personal hygiene. So people also were told to wash their hands frequently. This is happening in their early modern world as it is happening today. It’s hard to say or it’s hard to draw firm lines around learned medicine in this period. And you know, the knowledge of the elites and vernacular ways of knowing about medicine because there has always been kind of a quote, a quack quote unquote, quack marketplace, medical marketplace. And any age there were people who were trying to practice without a licence, and often because they kind of they couldn’t get a licence in other ways. So this also applied to women and, and kind of the herb women or you know, the wise women of a village who throughout human history, we’re able to come up with remedies for various illnesses, but the plague baffled both the learned physician as well as quack doctors. And of course, quack doctors are easy kind of targets of public ridicule. And someone like Defoe, you know, it makes sense that he sort of let kind of put his teeth into them, but at the same time, quack doctors in an era of chaos and general social anxieties around a cure or alleviating certain certain aspects or symptoms of the plague such as you know, nosebleeds or these reducing the swelling of the buboes. So the kind of lymphatic swellings happening and armpits or groin, so if people could alleviate those things, would seek out certain quack doctors and, and so in the 17th century, in particular, the kind of wild, practical medicine preached by some, some people outside of the academy had already gained some strength as well, because they tended to focus on the practical kind of utilitarian sides of how can I alleviate or assuage this patient’s pain without necessarily focusing on, you know, an curable or a panacea for for this So, and so people, even scientists, we hold up as kind of geniuses of science today like Robert Boyle, or at least in the popular media realm, or Robert Hooke, who were both fellows of the Royal Society of London in the 17th century. Even they held ideas that we would dismiss as quackery. So both, for example, believed that amulets containing certain Herbes or containing certain potions would be cured could be curative. So this belief and the potential of certain remedies without knowing exactly without the certainty of, of their curative potential is something we may be struggle with today, but was very much part and parcel of daily medicine for them. And the fact that really, across the 16th and 17th centuries, families were the first port of call for curing diseases so often you wealthy as well as less wealthy families would have would rely on family recipes that were trusted and trusted and true. And they these contained recipes for how to concoct your own remedies for various ailments from like eye diseases, to bruising to what have you including you know what to do in the case of an epidemic, or how to relieve the fever resulting of, of the plague, for instance, or some other pestilence. So, we see that doctors were not necessarily the only ones who knew something, the realm of knowledge of medical knowing in particular, kind of was diffused across society. And of course, those with more money and more resources could afford the more exotic kind of pharmacopoeia that would, for example, need to rely on Peruvian bark imported from New Spain from sorry, from the Inca Empire, for example, taken over by by the Spanish in this period, but other there’s a stratification in the pharmacological remedies as well right that reflected the social stratification of cross social classes, right. So you know, poor baker, for example, would seek a different cure or would be given another kind of equivalent drug for the same ailment, for instance.

That touches on something really interesting is that we’ve talked mostly about scientists, but doctors? What was the role of doctors at this point? Did it look pretty similar to what we have today? You know, where they are hospitals where there are a bunch of doctors working, could you go to the local GP and have your checkup? Did they make house calls? Or was it a completely different model? Or was it just not established yet?

Well, interestingly, a lot of doctors would see to their patients via via letter correspondence. So you would write to your, to your doctor to your physician, and then depending on what was wrong with you, you he might come for a visit. So there was that model. And this was, you know, quite common, for instance, 17th century Britain. But there, the idea of going to hospital was mostly for those for which for whom there was no help. So I spoke a little bit about the kind of hospitals being set up in times of plague. These were called incurables. So these were basically for incurable people with incurable diseases, and they tended to skew poor as well. So they tended to be for the lower social classes, those who needed public outreach because most wealthy patients would suffer their pain at home so the doctors would come to see them personally. But there were also you know, town doctors who would make calls and visit patients. They tended to, I mean, just like now we’re seeing headlines of doctors succumbing to COVID-19. So too back then when doctors and priests in particular administering the last sacrament with would basically lose their lives eventually over, or would be overrepresented and mortality statistics in this period.

And we talked a little bit before about scientists, even famous row society scientists having beliefs that we would not consider quackery. Were scientists taken seriously at that point, and during that period, was it you know, whether that’s by governments or the wider community, or was it still a bit of a lonely career and you were off to the side a bit following your weird, weird science stuff?

I think across history, I don’t think we just need to stick to mediaeval and early modern Europe, but I believe that across human history, science or being able to well be having knowledge on a particular topic, so being a specialist of some kind, has held a lot of sway. So reaching back to ancient Alexandria and the rule of the ptolemies, who sort of patronised the work of anatomists and experimentalists like Herophilus and Erasistratus, so they were some of the earliest scientists to look into the human body and dissect human cadavers which had, up until that point been seen as a black box and therefore taboo, so you wouldn’t touch a dead body and try to dissect it and went against various moral and social ideas about human dignity. It’s sometimes contravened religious beliefs and for instance, you know, the Christian idea that on the day of the Last Judgement, Christians would need their physical bodies whole and preserved as they had been at the time of death rather than kind of chopped up and quartered, thanks to an anatomist wanting to look more deeply into the nature of things. So I mean, that research against stretches millennia, and it was true of various patrons across the world. So we see examples in the sort of opposite Empire, modern day Iraq and Iran. I mean, there was science scientific research being supported and sponsored by the ruler, the rulers of the time and same in Europe. So throughout Europe’s history, various individual scientists or groups of scientists doing either medical or technological or other work would find employment at these courts and would be trusted to either build machines or come up with cures for if the king was sick, for example. So we see, obviously, I mean, if someone failed or was a poor physician, they would lose their job. But this idea in trusting an expert, someone who knows how to do things or how to get them done was certainly not unique in the 17th century. However, what was different by the time we get to the 17th century is the institutional organisation of the study of nature, all of a sudden, towards the later 17th century, you know, 1660 we have the beginnings of the Royal Society of London where various gentlemen across England and further afield start to organise themselves under the under a royal charter. And though they have had no funding their membership, they had to pay their membership fees themselves in order to create resources for running experiments and buying artefacts and things for study. They nevertheless had public and Royal approval for their activities. And they then you know, with the Great Fire of London, for instance, which came right after the great plague. So the fire in 1666, you know, many members of many fellows of the Royal Society were seen to and in efforts to rebuild the city of London so Christopher Wren and john eaglin. And Robert Hooke who, who was mentioned just before they were engaged and designing the buildings, the kind of that might function not only as a cathedral, for example, or a public square, but also potentially as sites for doing more science which is something that Lisa Jordan has explored and Genius pursuits which I highly recommend, it’s a great read. So there was a level of trust and scientists or people who could build things to apply to rulers of the time and basically peddle their knowledge and hopefully compete and hopefully win the competition right for various public works or solutions to a public problem. So that was happening, you know, from the Renaissance onwards. But again, the institutional nature of science developed in the late 17th century, with also the French following on quickly from the British and establishing the French Academy of Science, the Royal Academy of Sciences in Paris from 1665 onward, and recruiting an international coterie of engineers and botanist and naturalist and atomists and you name it, each working within their specific group of experts.

And you mentioned prizes, just at the end there. And I wonder if there’s anything from back in this period that we’ve lost? Is there anything you look back on and think we should be doing this now and we’re not have we gone backwards in any way?

I think one thing this is more on a personal note, I think like one thing that I find so fun about studying this 17th century and earlier centuries is that there was a sense of enchantment with the study of nature and what nature is all entailed so kind of sense of wonder even in the writings of famous scientists, there’s a kind of respect for it, I guess even though there was a lot of discussion to to about subduing nature and about it kind of make me just changing nature for profit sake. So there’s of course competing narratives. But one thing that I find so fascinating is a kind of imagining of limitless possibility. I think, and I don’t know if we’ve necessarily lost that. I think that would mean that we’ve lost our humanity. And I don’t think that’s true. I think there’s so we still come to things with ingenuity and creativity, but a kind of sense of wonder, which I think is perhaps only possible at a time when you really don’t know that much about the world and things Seat still seemed very possible from a lot of different corners. So this kind of suspension of certainty I admire in the seventh in the 17th and early 18th century, and the fact that actually we are moving away from the knowledge of the ancients, which had been for so long for centuries held up as an authority on everything. And that was in part why a lot of doctors during plague years for instance, were skeptical or were quite cautious about proposing a new disease because they often had to work backwards and had to, they couldn’t cope. Or they found that difficult coping with the disease they could name or for which there was no precedent. So that’s also I mean, what makes this period so interesting, but this is kind of slavery or slavish reliance on antiquity and ancient authorities starts to wane. And that’s fascinating to watch. How you kind of destabilise that and all of a sudden, people look around and begin trusting their own judgement, even if it’s wrong. It’s sort of a wonderful thing to watch.

And we can probably take something from that, I think with the abandonment of self certainty and an attitude of learning and questioning and wonder about the world.

Yeah, I think so.

Well, thank you, Catherine. That was Catherine Abou-Nemeh, a historian at Victoria University, talking to us about the experience of epidemics in the early modern period. Thanks for joining us, Catherine.

Thank you.

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