Dr. Ian Carr

Professor Emeritus, Faculty of Medicine, University of Manitoba

In the beginning, for millions of years, Man was a hunter, a big meat eater, roaming the land in small hunting bands; infectious disease would not spread readily. Then came the glaciation, and the meat ran low.

There was nothing for man and woman to do but settle down, get a visa, buy a plough, till the land, build villages, domesticate animals, and invent religion, civil servants, income tax, and mortgages. They did not get round fast enough to inventing sewage disposal, and it slopped around their feet and got into the drinking water. Humans had invented diarrhoea; it runs in families and they did. The water had snails, the snails had schistosomes, and they liked the smell of human feet -- schistosomiasis. There was exposure to large ungulate herds and their trypanosomes. Humans cut down the trees; they slashed, they burned, they ruined the drainage and the mosquitoes bred in the pools of water. Malaria. Folk went on pilgrimage -- a religious word for a vacation, and took their diseases with them. Trade developed early; boats from Aden sailed to India 3000BC. The expanding civilizations collided and the pools of disease spread from one civilization to another; the frequent wars helped.

Civilization focussed, trade developed, infections spread.

The ancient and mediaeval worlds were periodically devastated by such plagues, carried by war, or trade, sometimes clearly identifiable in Procopius' description of the Plague of Justinian (542 AD.)

In the Dark Ages, for reasons unknown, major long distance movements of Mongol people started across Central Asia. The most famous outbreak, the Black Death, devastated the known world in the years from 1347 killing about a quarter of the civilized world and half the population of London. At Avignon the Pope consecrated the river so that the bodies could be thrown in and ships with dead crews helplessly drifted seas.

In Italy, a detention period of 40 days was enforced on newly arrived ships - quarantine. Fields were untilled, animals wandered . Civil order broke down, Jews were accused of poisoning the world and burned alive. Preventive measures included fumigating with burning juniper; physicians wore overalls, gloves and a nose bag soaked with cinnamon and herbs.

The plague recrudesced over the years. The "Great Plague" occurred in London in 1665; the congested streets of wooden, rat-infested houses were an ideal place for plague to spread. Infected houses were closed, guarded and marked with a red cross and the inscription "The Lord have mercy on us". Normal life and trade stopped and the dead carts trundled through the streets to the tolling of bells and the call of "bring out your dead". Bodies were burned in shallow mass graves from which arose the stench of corruption. The plague lasted most of the year. Perhaps 100,000 of the half million inhabitants of London died. London itself was cleansed by the Great Fire the next year but the plague persisted in the countryside.

Most doctors fled from London, but the account of Dr. Nathaniel Hodges who stayed is worth reading: Hodges tells us that he rose early, took a dose of antipestilential electuary and then, for two or three hours, saw "crowds of citizens, as in a hospital." Then he breakfasted, and visited the sick at their homes. On the threshold of each dwelling he "immediately had burnt some proper thing upon coals," by way of fumigation. Meanwhile he sucked lozenges containing myrrh, cinnamon, and angelica root, and he took care to recover his breath and coolness before entering the sickroom. On returning home to dinner, he drank a glass of sack before and after the meal. After a further round of visits, "until eight or nine at night," he "concluded the evening at home, by drinking to cheerfulness of my old favourite liquor, which encouraged sleep and an easy breathing through the pores all night." On two occasions he felt ill and feared he might be smitten with plague, but a glass of sack proved a "sure antidote."

But trouble really started, when long distance sailing ships were developed . The Chinese did less harm, but Europeans caused a problem, from 1492.

The Columbian exchange started when Christopher Columbus petitioned Ferdinand and Isabella of Spain for a grant, to explore westward. Everyone knows the name of Columbus -- the upwardly and westwardly mobile Genoese mariner. All accept that he sailed from old Europe to the New World, -- but there is little agreement beyond that -- gold digger, slave master, visionary or all of these. Westering ho with a notion, or with a map, or even only the latest and best known of a long line of explorers , stretching back through Leif the Lucky and St Brendan to some Punic adventurer who settled to build menhirs in the uplands of Vermont. Nothing is certain about this man -- not even his picture. But there is no doubt that his voyages occasioned a century long episode of genocide, even worse than the Jewish holocaust by many millions.

The voyages of Christopher Columbus were shining maritime achievements in themselves. Columbus set sail for the first time from Palos on August 3 1492, leaving a Europe wracked by war, and a Christianity menaced by Islam. The population had been halved a century before by the Black Death, and its shadow still darkened men's memories. The day he left, another ship set out from the same port, carrying the last of the persecuted Jews; the heavy hand of the Inquisition was on the land. Columbus sailed perhaps with a secret map, and certainly in fear of crossing the line into the waters allocated to the Portuguese. Men were killed for betraying navigational secrets in those days.

He landed perhaps on Watling Island on Friday October 12, 1492, and early wrote back to Ferdinand and Isabella how docile the natives were and how very unskilled in arms. "They could all be subjected and made to do as one wishes", said Bartolome las Casas. He soon after landed on Hispaniola, and enslaved its inhabitants. From the beginning the Europeans were hardly kind to the indigenous peoples. Within a year or so they had enslaved most of the people of Hispaniola, (Haiti and the Dominican Republic); in 1493 500 Arawak people were shipped back to Spain as slaves. Five shivering captives actually reached the streets of Barcelona.

Natives were grossly maltreated, often in the name of religion; "they were hanged in groups of 13, in memory of our Redeemer and his apostles." There was considerable papal thought before they were declared to be human. Of 500 hapless Arawaks taken back to Spain as slaves, only seven survived.

In succeeding voyages Columbus explored the West Indies, and reached the mainland coast of South America. After Columbus returned to Spain, and as he travelled to Cadiz in 1492 two small boys may have huzza-ed his passage -- Cortes and Pizarro. Their ambition must have been fired, and the conquest of Meso-America was triggered.

By 1522, much of Yucatan, Mexico and Peru was under the Spanish heel. It was December 1518 when the smallpox began in Santo Domingo, and soon spread to Yucatan, Mexico, and less immediately Peru. The disease had a 12 day incubation period, and started with a rash, fever and vomiting. It did not at first cross the Atlantic because the voyage took more than the natural life history of the disease, but the protection was only temporary, since the virus was buried in the scabs. The attack rate in a virgin population was nearly 100% and the mortality rate over 50%. "Viruelas" the Spaniards called it; it was unmistakeable, but was accompanied by measles, typhus, and later yellow fever, so not all the epidemics were pure, single diseases; and it had vicious respiratory complications. So it was not always the virus which killed.

The population of Hispaniola was exterminated, and there was a massive die-off in the rest of Meso-America. Estimates vary from 50% to 90%; certainly more than 20 million people died. The leaders were killed off. Cortes won Tenochtitlan as much by the virus as the sword.

Before the arrival of the Spaniards these societies had been prosperous, and healthy. After the conquest of Yucatan a Mayan wrote:

There was then no sickness; they had no aching bones; they had then no high fever; they had then no smallpox; they had then no abdominal pain; they had then no consumption; they had then no headache. At that time the course of humanity was orderly. The foreigners made it otherwise when they arrived here. (Chronicle of Chilam Bayam)

Golden Ages are in the past; what followed was dreadful:

It was the month of Tepeilhuitl when it began and it spread over the people as great destruction. Some it quite covered with pustules on all parts -- their faces, their heads, their breasts, etc. There was a great havoc. Very many died of it. They could not walk; they only lay in their resting places and beds. They could not move ; they could not stir; they could not change positions , nor lie in one side; nor face down , nor on their backs. And if they stirred, much did they cry out. Great was its (smallpox) destruction. Covered , mantled with pustules, many people died of them. (Bernardino de Sahagún's Florentine Codex)

Similarly Cakchiquel Mayan annals recorded:

Great was the stench of the dead. After our fathers and grandfathers succumbed, half of the people fled to the fields. The dogs and vultures devoured the bodies. The mortality was terrible. Your grandfathers died, and with them died the son of the king, and his brothers and kinsmen. So it was that we became orphans, oh my sons. So we became when we were young. All of were thus. We were born to die!"

The people died, the leaders died, the agriculture was crippled, and famine followed pestilence; they could not defend themselves, they couuld not feed themselves. The Horsemen of the Apocalypse had come to Meso-America. It was only five hundred years ago, not quite beyond folk memory.

Similar things happened a little later further north; in 1622 around Boston Bay the Indians "died on heapes, as they lay in their houses; and the living, that were able to shift for themselves, would runne away and let them dy, and let their Carkases ly above the ground without burial....And the bones and skulls upon the severall places of their habitations made such a spectacle after my coming into these partes, that as I travailed in the Forrest nere the Massachusetts, it seemed to me a new found Golgotha." Similar things happened in Western Canada even more recently.

Disease also went back eastward with Columbus -- the Columbian exchange. The tale of syphilis is picturesque, and probably but not certainly true, since it is not absolutely certain whether syphilis existed in Europe before 1490.

In 1495 when Charles VIII of France led an army of 50, 000 to besiege Naples; after he took the city, Ferdinand and Isabella sent an army of Spaniards. A new disease developed. The new disease was said to have been brought from America by Columbus' sailors, or more likely by the Indian captives. The French called it Neapolitan disease and the Spaniards called it the French disease. Charles disbanded his army in Lyons in December 1495, and they spread over Europe, selling their mercenary swords.

Remember that five shivering Indians had survived the first trip, and reached Barcelona. There was a severe outbreak of contagious disease with widespread skin eruptions. John de Vigo wrote of syphilis:

"In the yeare of our Loard, 1494, in ye monethe of December when Charles ye Frenche kynge toke hys iorney into the partes of Ytaly, to recouer the kyngdome of Naples, there appered a certayne dysease through out al Ytaly of an unknowen nature, whych sondrye nations hath called by sondry names. The Frenche men call it the dysease of Naples, bycause the souldyours brought it from thence, into Fraunce. The Neapolitanes, call it ye Frenche dysease, for it appered fyrste when they came to Naples, and so other languages call it by other names, whereupon we nede not greatlye to passe, but rather what the nature and cure therof is. Thys dysease is contagious, chiefly yf it chaunce through copulation of a man wyth an unclene woman, for the begynnynge therof was in the secret members of men and women, with lytle pushes of blewe colour, otherwhyles of blacke, sometyme of whytyshe, wyth a certayn hardnes aboute the same, whych pustules could not be healed by medicine applyed with in or wythout, but that they wold enbrace the hole bodye, wyth ulceration of the genetall partes, euer returnyng agayne after they were healed, chiefly in the ioyntes, in the armes, under the knees, & in the foreheade, and welnye spredde through all the body, & yet at thys tyme they begyn euen so, but it is not so contagious as it was at the begynnyng."

How good is the evidence that syphilis came with Columbus from America in 1493? True in 1493 Villalobos descibed an outbreak of a venereal disease, las buvas, in Salamanca, a town some way from the ports. But the best historical record is probably that of Bartholome las Casas, whose father and uncle sailed on Columbus second voyage. Casas was in Seville around the time, and had questioned natives of Hispaniola, and established to his satisfaction that there was a syphilis like disease there, before Columbus arrival, although a mild one. He did not write of it till 1530 in his Apologetica Historica. Oviedo, the other reputable historian shared his view.

Moreover syphilitic bone lesions appeared in many Meso-American burials, and were rare unknown in Europe.

Ruy Dias de Isla (1539) wrote that he had treated men with syphilis in Barcelona, shortly after Columbus return. While there are reports that a syphilis like illness had come back from Africa earlier, these are less well founded. It seems almost certain that syphilis came back with Columbus.

It was shortly named syphilis by Fracastorius, a student of Copernicus. He wrote in verse the tale of a mythical shepherd called Syphilos. "He first wore bubos dreadful to the sight. First felt strange pains and sleepless passed the night. From him the malady received its name, the neighbouring shepherds caught the spreading flame." Presumably the shepherdesses as well.

Battle, rape, slaughter, famine -- the conditions for the spread of a new infection in a virgin population, and spread it did, as at first an acute lethal disease. It spread like wild fire around Europe reaching the Shetland Islands in the far north of Scotland by 1510, and Canton by 1505.

In Scotland an edict of the Town Council of Aberdeen dated 21, April 1497 refers to syphilis. It was "statuted and ordained by the Aldermen and Council that all the light women of the town should desist from their sins of venery." The disease had fairly high initial mortality and was highly contagious and not merely venereal. It was treated with mercury and with infusions of a bark obtained from an island of the West Indies. Syphilis was one of the scourges of society for the next four hundred years - with several names, notably the "Great Pox". True it quietened down over the centuries into a slower but no less certain killer.

One may conclude: severe, often catastrophic epidemic disease strikes when a more urban and sophisticated society meets a society which is less so. The effects may be so great that, with few exceptions there is historical justification for remembering events, rather than celebrating them. If human infections have spread from an old world to a new in the past, then we must be a little careful not to repeat the mistake on an inter-planetary scale.

Crosby, Alfred W. The Columbian Exchange Biological and Cultural Consequences of 1492. Westport, CN: Greenwood Press, 1972.

Crosby, Alfred W. Ecological Imperialism The Biological Expansion of Europe, 900-1900. Cambridge: Cambridge University Press, 1986.

Dyson, John. Columbus for Gold, God & Glory. Toronto: Penguin Books, 1991.

Morison, Samuel Eliot. Christopher Columbus, Mariner. Boston: Little Brown, 1942, 1955.

McNeill, William Hardy. Plagues and Peoples. New York: Anchor Books, 1976.