In history there have been many accounts of plague, either from disease, famine, or war. When was the first ever plague? I'm writing a paper on the history of medicines and I'm trying to figure out the earliest forms of plague.
It looks like the current champion for first recorded plague or pandemic was an outbreak that hit the Middle East in the time of Pharo Akhenaten (roughly 1600 BCE). There is a lot of argument over what exact disease it was, with bubonic plague, influenza, and polio all being argued for.
Ankh Nfr has a long discourse on the evidence for this plague and what its source may have been at AmarnaLover. If you want details, it may be worth a read.
Note that we believe the most common temperate infectious diseases evolved for human tranmission amongst the densely populated agricultural areas. So it would make sense that such diseases might start appearing alongside the first agricultural socieites. Likely they were occurring far before anyone had invented writing.
Details of First Historically Recorded Plague Pandemic Revealed by Ancient Genomes
Analysis of 8 new plague genomes from the first plague pandemic reveals previously unknown levels of plague diversity, and provides the first genetic evidence of the Justinianic Plague in the British Isles.
An international team of researchers has analyzed human remains from 21 archaeological sites to learn more about the impact and evolution of the plague-causing bacterium Yersinia pestis during the first plague pandemic (541-750 AD). In a study published in PNAS, the researchers reconstructed 8 plague genomes from Britain, Germany, France and Spain and uncovered a previously unknown level of diversity in Y. pestis strains. Additionally, they found the first direct genetic evidence of the Justinianic Plague in the British Isles.
The Justinianic Plague began in 541 in the Eastern Roman Empire, ruled at the time by the Emperor Justinian I, and recurrent outbreaks ravaged Europe and the Mediterranean basin for approximately 200 years. Contemporaneous records describe the extent of the pandemic, estimated to have wiped out up to 25% of the population of the Roman world at the time. Recent genetic studies revealed that the bacterium Yersinia pestis was the cause of the disease, but how it had spread and how the strains that appeared over the course of the pandemic were related to each other was previously unknown.
Map and phylogenetic tree showing the newly published (yellow) and previously published (turquoise) genomes. Shaded areas and dots represent historically recorded outbreaks of the First Pandemic.
In the current study, an international team of researchers led by the Max Planck Institute for the Science of Human History analyzed human remains from 21 sites with multiple burials in Austria, Britain, Germany, France and Spain. They were able to reconstruct 8 new Y. pestis genomes, allowing them to compare these strains to previously published ancient and modern genomes. Additionally, the team found the earliest genetic evidence of plague in Britain, from the Anglo-Saxon site of Edix Hill. By using a combination of archaeological dating and the position of this strain of Y. pestis in its evolutionary tree, the researchers concluded that the genome is likely related to an ambiguously described pestilence in the British Isles in 544 AD.
High diversity of Y. pestis strains during the First Pandemic
The researchers found that there was a previously unknown diversity of strains of Y. pestis circulating in Europe between the 6 th and 8 th centuries AD. The 8 new genomes came from Britain, France, Germany and Spain. “The retrieval of genomes that span a wide geographic and temporal scope gives us the opportunity to assess Y. pestis’ microdiversity present in Europe during the First Pandemic,” explains co-first author Marcel Keller, PhD student at the Max Planck Institute for the Science of Human History, now working at the University of Tartu. The newly discovered genomes revealed that there were multiple, closely related strains of Y. pestis circulating during the 200 years of the First Pandemic, some possibly at the same times and in the same regions.
Sampling of a tooth from a suspected plague burial.
Despite the greatly increased number of genomes now available, the researchers were not able to clarify the onset of the Justinianic Plague. “The lineage likely emerged in Central Asia several hundred years before the First Pandemic, but we interpret the current data as insufficient to resolve the origin of the Justinianic Plague as a human epidemic, before it was first reported in Egypt in 541 AD. However, the fact that all genomes belong to the same lineage is indicative of a persistence of plague in Europe or the Mediterranean basin over this time period, instead of multiple reintroductions.”
Possible evidence of convergent evolution in strains from two independent historical pandemics
Another interesting finding of the study was that plague genomes appearing towards the end of the First Pandemic showed a big deletion in their genetic code that included two virulence factors. Plague genomes from the late stages of the Second Pandemic some 800-1000 years later show a similar deletion covering the same region of the genomes. “This is a possible example of convergent evolution, meaning that these Y. pestis strains independently evolved similar characteristics. Such changes may reflect an adaptation to a distinct ecological niche in Western Eurasia where the plague was circulating during both pandemics,” explains co-first author Maria Spyrou of the Max Planck Institute for the Science of Human History.
Lunel-Viel (Languedoc-Southern France). Victim of the plague thrown into a demolition trench of a Gallo-Roman house end of the 6th-early 7th century.
Credit: 1990 CNRS - Claude Raynaud
The current study offers new insights into the first historically documented plague pandemic, and provides additional clues alongside historical, archaeological, and palaeoepidemiological evidence, helping to answer outstanding questions. “This study shows the potential of palaeogenomic research for understanding historical and modern pandemics by comparing genomes across millennia,” explains senior author Johannes Krause of the Max Planck Institute for the Science of Human History. “With more extensive sampling of possible plague burials, we hope to contribute to the understanding of Y. pestis’ microevolution and its impact on humans during the course of past and present pandemics.”
Plague is one of the oldest identifiable diseases known to man (see References: WHO: Plague manual). Three plague pandemics have been recorded throughout history (see References: WHO 2000), with an estimated 200 million deaths (see References: Perry 1997). Brief descriptions of the three pandemics follow.
- The first pandemic started in Egypt in 542 AD and continued for more than a century. Outbreaks in Europe, Central and Southern Asia, and Africa killed an estimated 100 million people.
- The second pandemic began in Italy in 1347 and rapidly spread throughout Europe over the next several years, killing an estimated one third of the European population. During that time, plague became known as the Black Death. Outbreaks of plague continued to occur sporadically in Europe over the next several centuries.
- The third pandemic began in 1894 in China and spread around the world over a 10-year period, predominantly by infected rats and their fleas aboard steamships. An estimated 12 million deaths occurred, mostly in India.
Although bubonic plague historically has been the most common form of disease, large outbreaks of pneumonic plague (with person-to-person transmission as the primary mode of spread) also have been reported (see References: Kool 2005, Meyer 1961).
Background to site of Edix Hill
The Edix Hill cemetery near Barrington in southern Cambridgeshire was excavated between 1989 and 1991 by Cambridgeshire County Council’s Archaeological Field Unit, revealing part of an inhumation cemetery with 149 individuals buried between c. 500 and 650AD.
Left: Double burial at Edix Hill of an adult woman and a child aged around 10 or 11 when they died of plague in the mid-6th century. Right: Burial from Edix Hill of young man aged around 15 when he died of plague in the mid-6th century. Images: © Cambridgeshire County Council.
According to Craig Cessford of the Department of Archaeology, University of Cambridge, “Although there are some relatively impressive burials, in most respects Edix Hill is broadly typical of inhumation cemeteries of the period from East Anglia . There are no documentary sources that definitely record that the Justinianic Plague of the 540s reached Anglo-Saxon England, so its identification at Edix Hill represents a major discovery.”
“At least four individuals tested positive for Y. pestis, meaning that they almost certainly died of the plague. The total is likely to have been much higher than this, as less than 15% of the skeletons have been tested so far. As the Edix Hill cemetery served a small community or communities of perhaps 50 to 65 people, this must have been a major traumatic event, comparable to the later Black Death . Despite the disastrous circumstances, these individuals were buried with care and respect and are archaeologically indistinguishable from individuals who died of other causes. Some of the plague victims were buried individually, while others were buried in pairs, perhaps when two members of a family succumbed to the plague. All were accompanied with a range of grave goods.”
“It is unlikely that Edix Hill is unusual in being affected by the Justinianic Plague, more probably most, if not all, of Anglo-Saxon England was ravaged by it. This discovery therefore represents a major historical event that previously could only be guessed at, meaning that the story of Early Anglo-Saxon England must be rewritten.”
Skeletons from the cemetery are now being re-studied at the University of Cambridge by researchers on the project ‘After the Plague: Health and History in Medieval Cambridge’, funded by the Wellcome Trust.
Sampling of a tooth from a suspected plague burial. Image credit: Evelyn Guevara
First recorded Great Plague death discovered in parish record
In winter of 1664, a bright comet blazed over London and was the talk of the town.
Our superstitious London ancestors ominously debated what kind of catastrophic event this comet was a harbinger of.
Several months later, the answer would be clear to many - the Great Plague.
The Great Plague of London was the last great outbreak of the Bubonic plague, which had been the terror of Europe since the 1300's. It killed more than 100,000 people, a quarter of London's population.
The first recorded victim
Our recently released collection of Westminster burials contains what is believed to be the first recorded burial due to this outbreak of the plague:
Images reproduced by courtesy of The Lord Mayor and Citizens of the City of Westminster, London
How do we know what she died of? If we zoom in on her entry, you will notice a tiny indication in the upper right corner of the record, that reads PLA:
Images reproduced by courtesy of The Lord Mayor and Citizens of the City of Westminster, London
The plague had been a common threat in London for centuries, since the first Black Death of 1347. For this reason, the community prepared for outbreaks by appointing someone from each parish to inspect the bodies of the deceased and determine the cause of death.
Learn more about parish records
The plague spreads
Within a few days, the plague had also cropped up in the nearby parish of St. Giles-in-the-Fields. This is where the true outbreak occurred - multiple cases were discovered among the crowded, poor and unsanitary tenement buildings. Though the households were quarantined, the local community broke down the door of the sealed house, releasing the victims into the city.
It's likely the plague would have spread regardless. By the time it was clear a full-on outbreak was on their hands, it was too late for Londoners to do anything other than flee. Many moved to the countryside while those who stayed were ravaged by the disease.
It peaked in September of 1665, killing 30,000 people that month. It finally began to decline during the winter months, with most of the population moving back after December.
Where did it come from?
It's difficult to trace the outbreaks of the Bubonic plague precisely. Most scholars believe this instance of the disease spread from Amsterdam - the Netherlands had a deadly outbreak of the plague that killed 50,000 people in 1664-65, and Dutch trading vessels frequently interacted with London merchants.
Though what came to be known as the Great Plague of London was the last severely deadly outbreak, the plague was really a common feature of 17th century London life: There were only 4 years between 1603 and 1665 without at least one plague death.
Outbreaks also occurred in 1593 (15,000 deaths) 1625 (41,000 deaths) 1640-46 (11,000 deaths) and 1647 (3,600 deaths).
The Black Death
“The Plague” was a global outbreak of bubonic plague that originated in China in 1334, arrived in Europe in 1347, following the Silk Road. Within 50 years of its reign, by 1400,  it reduced the global population from 450 million to below 350 million, possibly below 300 million, with the pandemic killing as many as 150 million. Some estimates claim that the Black Death claimed up to 60% of lives in Europe at that time .
Starting in China, it spread through central Asia and northern India following the established trading route known as the Silk Road. The plague reached Europe in Sicily in 1347. Within 5 years, it had spread to the virtually entire continent, moving onto Russia and the Middle East. In its first wave, it claimed 25 million lives .
The course and symptoms of the bubonic plague were dramatic and terrifying. Boccaccio, one of the many artistic contemporaries of the plague, described it as follows:
In men and women alike it first betrayed itself by the emergence of certain tumours in the groin or armpits, some of which grew as large as a common apple, others as an egg. From the two said parts of the body this deadly gavocciolo soon began to propagate and spread itself in all directions indifferently after which the form of the malady began to change, black spots or livid making their appearance in many cases on the arm or the thigh or elsewhere, now few and large, now minute and numerous. As the gavocciolo had been and still was an infallible token of approaching death, such also were these spots on whomsoever they showed themselves .
Indeed, the mortality of untreated bubonic plague is close to 70%, usually within 8ꃚys, while the mortality of untreated pneumonic plague approaches 95%. Treated with antibiotics, mortality drops to around 11% .
At the time, scientific authorities were at a loss regarding the cause of the affliction. The first official report blamed an alignment of three planets from 1345 for causing a “great pestilence in the air” . It was followed by a more generally accepted miasma theory, an interpretation that blamed bad air. It was not until the late XIX century that the Black Death was understood for what it was – a massive Yersinia Pestis pandemic .
This strain of Yersinia tends to infect and overflow the guts of oriental rat fleas (Xenopsylla cheopis) forcing them to regurgitate concentrated bacteria into the host while feeding. Such infected hosts then transmit the disease further and can infect humans – bubonic plague . Humans can transmit the disease by droplets, leading to pneumonic plague.
The mortality of the Black Death varied between regions, sometimes skipping sparsely populated rural areas, but then exacting its toll from the densely populated urban areas, where population perished in excess of 50, sometimes 60% .
In the vacuum of a reasonable explanation for a catastrophe of such proportions, people turned to religion, invoking patron saints, the Virgin Mary, or joining the processions of flagellants whipping themselves with nail embedded scourges and incanting hymns and prayers as they passed from town to town . The general interpretation in predominantly Catholic Europe, as in the case of Justinian plague, centered on the divine “punishment for sins.” It then sought to identify those individuals and groups who were the “gravest sinners against God,” frequently singling out minorities or women. Jews in Europe were commonly targeted, accused of “poisoning the wells” and entire communities persecuted and killed. Non-Catholic Christians (e.g., Cathars) were also blamed as “heretics” and experienced a similar fate . In other, non-Christian parts of the world affected by the plague, a similar sentiment prevailed. In Cairo, the sultan put in place a law prohibiting women from making public appearances as they may tempt men into sin .
For bewildered and terrified societies, the only remedies were inhalation of aromatic vapors from flowers or camphor. Soon, there was a shortage of doctors which led to a proliferation of quacks selling useless cures and amulets and other adornments that claimed to offer magical protection .
Entire neighborhoods, sometimes entire towns, were wiped out or settlements abandoned. Crops could not be harvested, traveling and trade became curtailed, and food and manufactured goods became short. The plague broke down the normal divisions between the upper and lower classes and led to the emergence of a new middle class. The shortage of labor in the long run encouraged innovation of labor-saving technologies, leading to higher productivity .
The effects of such a large-scale shared experience on the population of Europe influenced all forms of art throughout the period, as evidenced by works by renowned artists, such as Chaucer, Boccaccio, or Petrarch. The deep, lingering wake of the plague is evidenced in the rise of Danse Macabre (Dance of the death) in visual arts and religious scripts , its horrors perhaps most chillingly depicted by paintings titled the Triumph of Death (Fig. 2.2 ) .
The Triumph of Death (Trionfo Della Morte), fresco, author unknown, cca. 1446, on display at Palazzo Abatellis, Palermo, Italy
True or False? The Influenza Epidemic of 1918 killed more people than died in World War One.
World War I claimed an estimated 16 million lives. The influenza epidemic that swept the world in 1918 killed an estimated 50 million people. One fifth of the world's population was attacked by this deadly virus. Within months, it had killed more people than any other illness in recorded history.
The plague emerged in two phases. In late spring of 1918, the first phase, known as the "three-day fever," appeared without warning. Few deaths were reported. Victims recovered after a few days. When the disease surfaced again that fall, it was far more severe. Scientists, doctors, and health officials could not identify this disease which was striking so fast and so viciously, eluding treatment and defying control. Some victims died within hours of their first symptoms. Others succumbed after a few days their lungs filled with fluid and they suffocated to death.
The plague did not discriminate. It was rampant in urban and rural areas, from the densely populated East coast to the remotest parts of Alaska. Young adults, usually unaffected by these types of infectious diseases, were among the hardest hit groups along with the elderly and young children. The flu afflicted over 25 percent of the U.S. population. In one year, the average life expectancy in the United States dropped by 12 years.
It is an oddity of history that the influenza epidemic of 1918 has been overlooked in the teaching of American history. Documentation of the disease is ample, as shown in the records selected from the holdings of the National Archives regional archives. Exhibiting these documents helps the epidemic take its rightful place as a major disaster in world history.
It is recorded that by 1331 The Black Death was ravaging its way through central Asia. It was for a l ong time a mystery as to how exactly this plague managed to make its way to the shores of Europe but by reading ancient texts historians and biologists think they have traced its advancement to the city of Kaffa in Crimea and the first ever recorded use of biological warfare.
As the plague killed half the population of China and made its way through India and Persia somehow trade managed to continue. It’s of no surprise then that plague infested rats climbed aboard trading vessels and found their way into Southern Russia around 1345.
This was land known as the ‘Golden Horde’ and it was Mongol ruled territory. The plague spread rapidly through this area and made its way to Crimea.
In the city of Kaffa a group of merchants from Genoa were allowed by the Mongols to control the seaport on the Crimean peninsula. The Mongols allowed this as it was highly advantageous to them but tensions often ran high between the Catholic Italians and the Muslim Mongols. As things often do, violence eventually broke out, in a small town called Tana, between the Genoans and the local people, subsequently a Muslim man was found dead.
Although not a picture of The siege of Kaffa, this is a Mongol style siege.
Fearing execution by the Mongols the Genoans fled for their lives back to the main city of Kaffa. They were given sanctuary and the pursuing Mongols were refused entry. Incensed by this action the Mongols laid siege to the city but it wasn’t long before in turn The Black Death caught up with them. It is here we have a first-hand account of events by Gabriele de’ Mussi “whereupon the Tartars (Mongols) worn out by this pestilential disease and falling on all sides as thunderstruck, and seeing that they were perishing slowly, ordered the corpses to be thrown upon their engines and thrown into the city of Kaffa. Accordingly were the bodies of the dead hurled over the walls, so that the Christians were unable to hide or protect themselves from this danger, although they carried away as many as possible and threw them into the sea”
A map showing the progression of the plague from 1346 to 1350
Of course it cannot be proven as to whether it was the bodies that then infected those within the walls of the city or that the rats carrying the disease made their way inside. Either way it was the death knell for many of those holed up inside. In 1347 the Italians finally fled Kaffa and headed for their ships. On their way back to Italy they stopped at Constantinople and infected the city. Thousands upon thousands were killed as it spread its way through Asia Minor and eventually on to infect the Genoans homeland of Italy and the rest of Western Europe.
8 Natural Disasters of Ancient Times
Natural disasters are something that humanity has had to deal with since its inception. They have the capability to wipe out significant amounts of the human and wildlife populations where they strike. In fact, it is possible that a natural disaster will be the cause of the end of the world, whenever that inevitably happens. They could be avoided, to some extent, by removing the human population from areas where natural disasters are known to strike. However, looking back on natural disasters in the past, we see that people were just as prone to exposing themselves to the risk of natural disasters as they are today.
The Damghan Earthquake was an earthquake of magnitude 7.9, that struck a 200-mile (320 km) stretch of Iran on 22 December, 856 A.D. The earthquake&rsquos epicenter was said to be directly below the city of Damghan, which was then the capital of Iran. It caused approximately 200,000 deaths, making it the fifth deadliest earthquake in recorded history. The earthquake was caused by the Alpide earthquake belt, a name for the geologic force that created a mountain range named the Alpide belt, which is among the most seismically active areas on earth. [Source]
In late May, 526 AD, an earthquake struck in Syria and Antioch, which were then part of the Byzantine empire. The death toll was a massive 250,000. The quake caused the port of Seleucia Pieria to rise up by nearly one meter, resulting in the silting of the harbor. It was the 3rd deadliest earthquake of all time. The quake is estimated to have been over 7 on the Richter scale (VIII on the Mercalli scale). After the earthquake a fire broke out which razed all buildings that had not already been destroyed.
The Antonine Plague is named after one of its possible victims, Marcus Aurelius Antoninus, the Emperor of Rome. It is otherwise known as the plague of Galen. Galen was a Greek physician who documented the plague. Judging by his description, historians believe that the Antonine Plague was caused by smallpox or measles. We can call this plague a natural disaster because it was caused by a naturally occurring disease and it killed a significant number of people.
The Antonine Plague is thought to have come from Roman soldiers returning from battle in the east. Over time, it spread throughout the Roman Empire and some of the tribes to the north. An estimated 5 million people were killed by the Antonine plague. During a second outbreak, a Roman historian named Dio Cassius wrote that 2,000 people were dying each day in Rome. That&rsquos roughly one quarter of those who were infected.
On July 21, 365 AD, an earthquake occurred under the Mediterranean Sea. It is thought that the earthquake was centered near the Greek island of Crete, and that it was a magnitude eight or greater. It destroyed nearly all of the towns on the island. It would have also caused damage in other areas of Greece, Libya, Cyprus and Sicily.
After the earthquake, a tsunami caused significant damage in Alexandria, Egypt and other areas. It was documented best in Alexandria. Writings from the time tell us that ships were carried as far as two miles inland by the wave. A description by Ammianus Marcellinus describes the effect of the earthquake and the resulting tsunami in detail. He wrote of how the earth shook and then the ocean receded in Alexandria and how a great wave inundated the city with seawater. It is estimated that thousands of people were killed.
The 79 AD eruption of Mount Vesuvius, and the subsequent destruction of Pompeii and Herculaneum, reminds us of the awesome power of this active volcano. In fact, Vesuvius may be the most dangerous volcano on Earth. There are more people living in its vicinity than any other active volcano. Furthermore, it is most certainly going to erupt again.
When Mount Vesuvius erupted in 79 AD, it warned the people with an earthquake, which was ignored. The earthquake was later followed by the expulsion of volcanic debris and the appearance of an ominous cloud over the mountain. Pompeii was only 5 miles from the volcano Herculaneum was even closer. The people of these towns died as one might expect victims of a volcano to die they choked, burned and were subsequently covered in volcanic debris and run off. What makes this ancient natural disaster so interesting is the evidence we have of it.
For more than 1500 years, Pompeii lay buried in Italy. It was found when residents were cleaning up after another major eruption, in 1631 AD. It was not completely uncovered until the 20th century. Then, people learned all to well the horrible fate that had befallen its ancient residents. The agony of their deaths has been immortalized in plaster. Because their bodies rotted away long ago, while entombed in volcanic rock, cavities, like those found in fossils, were left behind. These were filled with plaster and what came out were near-perfect statues of the people who died in Pompeii, as they had died. There were thousands of victims. Today, there could be millions.
Sometime around 1645 BC, a volcano erupted on the island of Santorini. The massive eruption caused widespread damage on both Santorini and the nearby island of Crete. At the time, the Minoans occupied both islands. The town on Santorini was not rediscovered until modern times.
Interestingly, there is reason to believe that this natural disaster inspired Plato&rsquos tale of Atlantis. However, this is, and will likely remain, purely speculation. It is assumed that the ancient inhabitants of these islands picked up warnings that the volcano was going to erupt, and heeded them. No victims of the eruption, if there were any, have been found. Furthermore, it appears as if all transportable, valuable items were removed prior to the eruption. Nonetheless, archaeologists have discovered buildings and large belongings remained.
Helike was submerged in the Gulf of Corinth by an earthquake and a tsunami in 373 BC. It remains submerged to this day. Ancient writers commented on the destruction and some mentioned that you could see the ruins beneath the water for hundreds of years after the disaster. It is assumed that a number of people lost their lives, but how many is uncertain.
The search for Helike did not begin until the end of the past century. Since then, relics of Helike and, interestingly, other towns have been found. Walls, walkways, coins and more have been viewed and photographed. This is yet another possible scene of Atlantis, according to some. However, the destruction of Helike happened in Plato&rsquos lifetime. He wrote that it happened 9,000 years before his time. It could have been inspiration for fiction, though.
A number of other, smaller, natural disasters occurred throughout ancient times. People were subject to them then as much as we are today. It makes you wonder how many civilizations were destroyed by natural disaster that we have no knowledge of, as of yet.
The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire (Byzantine Empire), including its capital Constantinople, in the years 541&ndash542 AD. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing, or for contributing to, the Black Death of the 14th century. The plagues&rsquo social and cultural impact during this period is comparable to that of the Black Death. In the views of 6th century Western historians, it was nearly worldwide in scope, striking central and south Asia, North Africa and Arabia, and Europe as far north as Denmark and as far west as Ireland. Until about 750, the plague would return with each generation throughout the Mediterranean basin. The wave of disease would also have a major impact on the future course of European history. Modern historians named this plague incident after the Eastern Roman Emperor Justinian I, who was in power at the time. He contracted the disease, but was one of a limited number of survivors. The death toll from this series of plagues was an unbelievable 40 to 100 million. [Source]
America's Devastating First Plague and the Birth of Epidemiology
T he terror that is gripping Americans due to the coronavirus would be familiar to America&rsquos founding generation. As Noah Webster, then the editor of New York City&rsquos first daily newspaper, wrote to a friend in the fall of 1793, &ldquoThe melancholy accounts received from you and others of the progress of a fatal disease&hellipexcite commiseration in every breast. An alarm is spread over the country.&rdquo
The disease was the yellow fever, a virus that attacked the liver and kidneys. This American plague, which got its name because its victims became jaundiced, swept through the nation&rsquos biggest cities a few times between 1793 to 1798. The first outbreak occurred in August of 1793 in Philadelphia, which served as the nation&rsquos capitol from 1790 to 1800. By the middle of that November, the yellow fever would decimate the city, wiping out 5,000 of its 50,000 residents and forcing President Washington and his cabinet to flee to neighboring Germantown. Cool fall temperatures then suddenly stopped this wave of the disease, which, as scientists would determine a century later, was transmitted by mosquitos.
About two years later, New York City was hit particularly hard. Its first recorded patient was Thomas Foster, who sought medical attention from Dr. Malachi Treat, the health officer at the city&rsquos port, on July 6, 1795. As a colleague of Dr. Treat later wrote, Foster&rsquos yellow skin was &ldquocovered with purple spots, his mind deranged, his tongue covered with a dry back sordes.&rdquo Foster died three days later, and Treat himself was soon gone. By mid-August, two New Yorkers a day were dying, and all afflicted patients were quarantined at Bellevue Hospital. As Webster&rsquos New York neighbor, Dr. Elihu Smith, noted in his diary in September, &ldquoThe whole city, is in a violent state of alarm on account of the fever. It is the subject of every conversation, at every hour, and in every company.&rdquo By late November when this outbreak petered out, 730 New Yorkers had died&mdashthe equivalent of about 200,000 today, as the city then had a population of about 40,000
That fall, Webster, who is best known to us today for his monumental dictionary of American English published in 1828, sprang into action. In late October, he published a circular in his paper, The American Minerva, addressed to the physicians in the cities most affected by the fever over the past three years&mdashPhiladelphia, New York, Baltimore, Norfolk and New Haven&mdashwhich asked them to pass on whatever information that they had gathered from their own practices.
This circular served as the basis for the world&rsquos first scientific survey. As Webster argued, given that &ldquowe want evidence of facts,&rdquo medical professionals needed to work together to understand this public health problem. About a year later, Webster published his findings in a 250-page book, A Collection of Papers on the Subject of the Bilious Fevers, prevalent in the United States for a Few Years Past, which featured eight chapters authored by experts scattered across the country such as Dr. Elihu Smith. Unfortunately, their accounts were short of hard data. Noting that poor immigrants constituted a large percentage of the dead, Smith, hypothesized that &ldquothe sudden intermingling of people of various and discordant habits [was] a circumstance favoring the production of the disease.&rdquo In contrast, Webster assumed that the cause had something to do with urban grime, arguing that Americans should &ldquopay a double regard to the duties of order, temperance and cleanliness.&rdquo But given his empirical leanings, Webster acknowledged that he still needed to gather more data to reach a definitive conclusion.
Partisanship was as pervasive then as it is now, and Webster&rsquos political opponents ridiculed his efforts. Webster&rsquos paper supported the Federalist party of President Washington and Benjamin Franklin Bache, a grandson of Benjamin Franklin, who edited Philadelphia&rsquos Republican paper, attacked his counterpart for self-serving behavior, writing that Webster merely sought for himself &ldquothe honor and the glory to triumph over a malady.&rdquo In a cruel irony, just three years later, Bache died from the disease at the age of twenty-nine.
In the summer of 1798, the fever came back with a vengeance. As Webster, who had recently moved to New Haven, wrote in his diary, &ldquoThe disease assumes this year in Philadelphia and New York more of the characteristics of the plague, is contagious and fatal beyond what has been known in America for a century.&rdquo By the time frost in early November ended this round of devastation, another 3,400 had died in Philadelphia, 2,000 in New York and 200 in Boston. Included in these totals was New York&rsquos Dr. Elihu Smith, who was just twenty-seven. The fever would return periodically throughout the 19th century, but never again with the same lethal intensity.
At the end of 1798, Webster published a follow-up book, A Brief History of Epidemic and Pestilential Diseases with the Principal Phenomena of the Physical World Which Precede Them and Accompany Them and Observations Deduced from the Facts Stated. The title was a misnomer, as this two-volume treatise clocked in at over 700 pages. Tracing the history of epidemics from biblical accounts to the present, Webster was again forced to conclude that he could not be sure what caused them, observing, &ldquoMore materials are necessary to enable us to erect a theory of epidemics which shall deserve full confidence. Despite his lack of solid empirical findings, Webster had put the new field of public health on a scientific footing. He had set up a protocol that future medical professionals could follow, which involved gathering as much evidence as possible by pooling together the efforts of numerous experts on the front-lines. As Dr. William Osler, a giant of late 19th century medicine, observed, Webster&rsquos book was &ldquothe most important medical work written in this country by a layman.&rdquo
As we now hunker down to wait out the current epidemic, we might keep in mind Webster&rsquos observation that deadly diseases induce more than just terror and confusion. &ldquoThe natural evils that surround us,&rdquo Webster wrote in his 1798 treatise, &ldquo[also] lay the foundation for the finest feelings of the human heart, compassion and benevolence.&rdquo