Five Medieval Illnesses You Probably Don't Have to Worry About

Sorry for the late posting today. A bout of insomnia kept me up too late last night, which meant I was up too late this morning, and the whole day's been a exercise in catching up.

Earlier this week and for a couple of days last week, I was afraid I'd gotten, or was getting, the flu that's going around. This may be the year I get a flu shot; I might do it next week, before I leave for Bouchercon. I've had several conversations with friends and family this week about shots and vaccinations, though, and it made me think about how much we take our immunities for granted. The things that killed our ancestors don't kill us any more, and it's worth taking a minute to remember what those things were.

1. Childbed Fever. Also called puerperal fever or puerperal sepsis, it killed my great-grandmother Molony as recently as 1916. Alarmingly, it occurred most frequently in births in hospitals, or births attended by male doctors or surgeons. Modern medicine believes the most common cause was Group A Streptococcus, the same bacteria that cause strep throat, and that it was passed from woman to woman in hospital wards simply because doctors didn't wash their hands. Puerperal fever still occurs in up to 8% of all deliveries in the United States, and is a specific risk of Caesarian sections; however, it's treatable with antibiotics.

2. Consumption. They called it consumption, we call it tuberculosis. Either way, it's a horrible way to die. You literally waste away, and your lungs break down, try to repair themselves, scar into fibroids and then break down again, continuing the cycle until they cease functioning altogether. The fact that you don't hear about Westerners dying of it any more doesn't mean it's gone; in fact, a third of the world's population has been infected with Mycobacterium tuberculosis, and a growing percentage of those infected have drug-resistant TB. Tuberculosis has also been known, in different forms and at different points in time, as phthisis, scrofula (when it infected the neck glands), the king's evil, and Pott's disease. It too is treatable with antibiotics, although the disease is evolving to be increasingly drug-resistant.

3. Dropsy. You read about dropsy a lot in medieval histories, but there's no way to know exactly what this was. It was an all-purpose term used to describe any unexplained swelling of soft tissues due to the accumulation of excess water. In some cases it might have been kidney disease; in others, it was probably congestive heart failure. Queen Mary I of England died of dropsy, which had earlier made her believe, mistakenly, that she was pregnant. Doctors now see dropsy as a symptom rather than as a disease, and can treat the underlying illness before it becomes something you notice on the street.

4. Dysentery. Also called the flux, or the bloody flux. It killed millions, and the fact that we almost never see it in the developed world is a triumph of public hygiene and modern plumbing. It's not gone altogether; it's still a risk in less-developed countries, and we have outbreaks after any natural disaster that disrupts the supply of clean water. It's another disease that gets passed along easily in settings where people don't or can't wash their hands. It can be caused by either a bacterial or an amoebic infection, and is treated with drugs and rehydration therapy. A handy tip, in case you ever need to know: camel feces and sheep feces contain a natural antibiotic against dysentery.

5. Smallpox. Arguments about public vaccination campaigns must begin and end with the story of smallpox. Caused by the variola virus, it too killed millions of people worldwide, and left millions more permanently disfigured or blind. In the 18th century alone, it killed 400,000 people in Europe every year, and was responsible for a third of all cases of blindness. As recently as 1950, there were approximately 50 million new cases of smallpox every year — but the last reported death from smallpox happened in 1978, and the disease was declared formally extinct in 1979. It is still the only infectious disease ever eliminated by humans.

The question of immunizations is a cost-benefit discussion. Google images of smallpox, and you'll see things you wish you hadn't; it's a disease you wouldn't wish on your worst enemy. Diphtheria, pertussis (whooping cough), tetanus are likewise illnesses that cause horrible suffering before death, and permanent damage among those who survive. Measles can make you blind or sterile, meningitis can leave its survivors brain-damaged or comatose. I've never had to make these decisions, but if I had children, I wouldn't hesitate to vaccinate them against any of these illnesses.