Diseases of Pre-Modern Europe

By: Kathy Turnbull

Throughout history there have been many maladies caused by microbes.

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Some are minor like a cold or a stomach virus

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but some can have devastating effects like Ebola.

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Some of these diseases have been with us for almost all of recorded history.

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The major diseases of pre-Modern Europe were smallpox,

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tuberculosis,

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measles,

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leprosy,

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syphilis,

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dysentery,

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typhus,

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typhoid fever,

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and the plague.

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To really understand what these diseases

did we need to define some terms.

According to Webster’s New World Dictionary of the American Language; Second College Edition

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endemic means

“restricted to and constantly present in a particular country or

locality: said of a disease” 22,

epidemic means

“prevalent and spreading rapidly among many

individuals in a community at the same time: widespread:

said esp. of human contagious disease”21,

and pandemic means

“prevalent over a whole area, country etc.; universal; general;

specific, epidemic over a large area.”23

The first disease we will talk about is smallpox.

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Smallpox is a virus that only affects humans

and has no animal reservoir 3(9).

It is a member of the Orthopoxvirus genus

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and is composed of a 165-210 kb DNA strand

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surrounded by a capsule.

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Since this disease has no animal reservoir

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it has existed as an endemic within the human population for hundreds of years with occasional epidemic outbreaks.

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Possibly the first known death of smallpox occurred in Egypt in 1157 BCE when Ramses V died 4(37).

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However the first recorded epidemic in history occurred in Athens, Greece in 430 BCE.

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Although it remains uncertain if smallpox was the cause of the “Plague of Athens”, it is probable that it was.

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The “Plague of Athens” killed an estimated 25-35% of the Athenian population.

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This epidemic was significant because it occurred during Athens’ war with Sparta

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and killed one of the great leaders, Pericles.

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This left Athens in a bad position and helped to lead

to the downfall of the Athenian empire 5 (1-3).

The next serious outbreak of smallpox occurred in 165 BCE in the midst of the Roman Empire.

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It is estimated that as many as five million people died during this epidemic,

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and as in the Athenian plague,

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destabilized the country leading to several years of war and instability throughout the Roman Empire 5 (17)..

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More epidemics of smallpox broke out through the world in Japan and the Americas

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but no real smallpox epidemics occurred again in pre-modern Europe

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and instead existed in an endemic stage until the eighteenth century

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when smallpox once again became one of the great epidemics of Europe killing an estimated 400,000 people

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in a European population that numbered less than 200 million 5 (151).

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However smallpox, which may have killed more people throughout history than any other disease,

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was finally eradicated from the general human population in 1979

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and now only frozen virus stocks are left in 2 locations on the planet 3 (76).

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The next great disease of pre-Modern Europe was thought to no longer be a major threat

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but has made a comeback on the danger scale with drug-resistant strains.

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Tuberculosis has been a disease that has affected human cities and villages for millions of years

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and has a close relationship with human populations6.

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Tuberculosis is caused by the bacteria Mycobacterium tuberculosis

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The infection is spread through water droplets from the cough or sneeze of an infected person7.

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The tuberculosis bacteria is in a family of bacteria that often colonize mammals

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and if untreated the bacteria will begin to eat through the tissues of the body.

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Some of the oldest records of tuberculosis in European history

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are in the skeleton of someone in Italy dating from 4000 to 3500 BCE6.

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Although this disease has not had as great an impact on European history in terms of epidemics,

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it has had an impact as an endemic contributing to the affects of malaria on the Roman empire

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and the decline of leprosy during the Middle Ages5 (39).

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This disease can now be fought in modern times with antibiotics,

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however new strains are developing such as multidrug-resistant strains (MDR-TB) and extensively resistant strains (XDR-TB),

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which affect thousands of people and are resistant to most antibiotics affecting global travel6.

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Measles, a “childhood disease”, was also one of the main diseases of pre-modern Europe.

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In many of the early plagues such as the Plague of Athens and the Antonine Plague,

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measles may have been the culprit instead of smallpox5 (18).

http://www.nature.com/news/2008/080620/images/measles.jpg

Measles is caused by the measles virus (MeV) of the Morbillivirus genus,

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and is closely related to the Rinderpast virus (RPV) 8.

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It is associated with a fever, a cough, and a rash similar to smallpox.

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Measles affects approximately 30 million people a year, mostly in developing countries8.

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This disease is similar to smallpox in that it has no animal reservoir;

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however the death rate is about 7% 8.

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Measles was first described accurately in the 9th century by Rhazes.

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Measles didn’t exist so much as an epidemic in pre-Modern European populations,

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but more as an endemic with 90% of all children, by the age of 15, being affected8.

Although there has been a vaccine developed for measles

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there are still occurrences of measles throughout the world

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but especially in developing countries where vaccination is not always as common.

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It is estimated that 1.9% of the 10.8 million infant deaths every year is caused by measles9.

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However there is hope that measles too, can be eradicated like smallpox.

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Leprosy, another epidemic within Europe, is often thought of as a catch-all phrase for any number of different skin diseases.

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Today the disease that is referred to as leprosy is “Hansen’s disease”1 (175).

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The Mycobacterium leprae bacterium causes the disease10.

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The bacterium often causes lesions on the skin

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which can lead to deformations, loss of extremities and bone damage5 (35).

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Almost all forms of leprosy can lead to nerve damage in the arms and legs

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and if untreated permanent damage can be present in the skin nerves, eyes, and limbs10.

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The disease appears to have first appeared in the 6th century AD in Egypt, France, and Britain1 (144-145).

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However it was not widespread until about 1000 AD,

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when leprosy thrived until about 1350 AD.

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Leprosy affected medieval culture and society.

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Leprosaria, institutions where lepers were secluded were created throughout Europe

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and the disease was associated with shunning,

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so much so that now the word leper means “someone who is shunned, especially on moral grounds”5 (35).

However, surprisingly, leprosy suddenly declined after the Black Death1 (175).

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The decline was such that by about 1500, leprosy was scarce in Europe5 (35).

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This may have been due to the rise of tuberculosis,

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which is easier to spread than leprosy, and the lower population1 (176).

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However leprosy is still present today.

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According to the World Health Organization (WHO) at the beginning of 2010 there were 211,903 cases of leprosy in 141

countries.

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75% of all of the cases occur in South American and African countries11.

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Yet efforts are being put into place to lower the incidence of leprosy worldwide.

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Syphilis, a modern scourge, was also present in pre-modern Europe.

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It is caused by a bacterium, Treponema pallidum.

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The symptom of syphilis is generally a sore called a chancre at the site where the bacteria entered the body12.

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Lymph glands may also be swollen and a sore throat, tiredness, and a headache may also occur.

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However, if untreated, syphilis may result in damage to the heart, eyes, brain, nervous system, bones, joints,

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and can result in mental illness, blindness, deafness, memory loss, heart disease, and death12.

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It appears to have first appeared in Europe in July 1495 in troops fighting in northern Italy5 (69).

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It then spread quickly throughout Europe

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as armies carried it with them home and to the places where battles took place.

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The people of Europe were horrified at the disease because pustules formed and then the body seemed to rot5 (69).

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Another reason for the Europeans horror at syphilis was that it was not a respecter of station and affected everyone5 (59-60).

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Although it is not conclusive that this disease was today’s syphilis, it is likely that it was.

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The response to the disease was varied from sweating the disease to isolating those affected5 (73-75).

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Today syphilis can be cured by penicillin

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and is still a pretty common disease with 13,500 cases reported by the US in 200812.

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Another disease common during war was dysentery.

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It is caused by a bacterium, often of the Shigella species,

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or an amoeba, Entamoeba histolytica.

http://upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Entamoeba_histolytica_01.jpg/240px-Entamoeba_histolytica_01.jpg

Dysentery is characterized by bloody diarrhea14.

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Although dysentery generally doesn’t kill unless the patient is severely dehydrated,

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it is the major cause of diarrhea related deaths in developing countries13.

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Major outbreaks of dysentery in pre-Modern Europe occurred in ancient Rome in conjunction with malaria

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and in Germanic areas during the Thirty Years War.

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Both soldiers and civilians were affected by the war and the disease that accompanied the travelling armies.

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Dysentery was present as an epidemic at the time of the Thirty Years War5 (97).

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Another disease, typhus, was present as an epidemic during the Thirty Years War5 (97).

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It is caused by either Rickettsia typhi

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or Rickettsia prowazeki and is transferred by fleas.

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Aches, high fever, and a rash are all common symptoms of typhus

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and may be confused with the symptoms of other diseases.

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In pre-Modern Europe, 10-60% of the people who contracted the disease were likely to die from it

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and during the Thirty Years War many people were infected17.

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It is estimated that in 1620, 20,000 people in the troops were infected

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and in Frankfurt over 1,700 died when the usual death rate was 6005 (97).

http://wikitravel.org/upload/en/thumb/8/88/Frankfurt_Roemer.jpeg/300px-Frankfurt_Roemer.jpeg

The devastation of war and epidemic diseases resulted in an estimated population loss of 15 or 20% in Germanic states5 (97).

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One example of this is the Duchy of Württemberg

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which went from a population of 445,000 in 1622 to a population of 97,000 in 16395 (97).

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Some of the population deficit may be a result of flight or disappearance

http://thefrailestthing.files.wordpress.com/2010/06/an-allegory-of-the-wars-of-religion.jpg

but there is still a large part of the population that died from epidemic diseases such as typhus and war.

http://www.human-healths.com/wp-content/uploads/2011/08/Epidemic-typhus1.jpg

Today typhus is treatable with antibiotics like Doxycycline, Tetracycline, and Chloramphenicol18.

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The spread of typhus occurs worldwide near areas where rats live.

http://www.weirdasianews.com/wp-content/uploads/2010/04/RatInfestationNepal.jpg

However in the US only a few cases are reported and those are generally in people living in Texas and Southern California15.

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Typhoid fever on the other hand is caused by Salmonella typhi

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which can infect people by the food or water they ingest16.

Symptoms include a fever, diarrhea, and abdominal pain19.

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The death rate is estimated at 10% untreated

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and today an estimated 17 million cases occur each year16.

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This disease was another player in the Thirty Year War but was not a large player in pre-Modern Europe.

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However this did become a major endemic problem in America and Europe in the nineteenth century5 (249).

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The last disease we will look at is the plague.

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The plague is caused by the bacteria Yersinia pestis.

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It is endemic in populations of rats but can be spread to people5 (24).

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Although the plague is not nearly as common now, it is still present in Africa, Asia, and South America with rare occurrences in

the US.

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There are three types of plague, bubonic, pneumonic, and septicemic.

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There is a treatment for the plague

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but it requires immediate attention after the first signs or death is likely for the victim.

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Streptomycin, Gentamicin, Doxycycline, and Ciprofloxacin are used to treat the plague

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but other forms of support may still be needed.

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Even so, with treatment the death rate of people infected with plague is 50% 20.

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However, when compared to usual odds without treatment, these odds are great.

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60-90% of all people who contract bubonic plague die without treatment.

http://sfgbritlit2007.pbworks.com/f/1192213951/catA_plagueBubonic1Lg.jpg

Those who confront pneumonic plague almost always die within 2-3 days.

http://www.upmc-biosecurity.org/sebin/v/v/plague_x-ray.jpg

However those who contract septicemic plague are likely to die within hours of contracting it, since this form is universally lethal2

(15-16).

http://static.howstuffworks.com/gif/plague-6.jpg

There were three major plague pandemics and several epidemics throughout Europe.

http://www.xtimeline.com/__UserPic_Large/4754/ELT200802142244179738026.JPG

The first plague pandemic occurred in pre-Modern Europe from 541-747 AD.

http://contagions.files.wordpress.com/2011/05/khaldun_c_sp2plague-bal.jpg

During that time several waves of plague epidemics traveled through the area of Europe.

http://www.thetech.org/genetics/images/ask/plague_spread_europe.jpg

Witnesses to the plague claim that 5,000 to 10,000 people died daily in Constantinople in the years 541-5445 (23).

http://media.photobucket.com/image/plague%20constantinople/mrsamoa1947/Constantinople20CCLXXIIIIr.jpg

Descriptions of cities affected talk of corpses rotting in the streets,

living babies sucking on their dead mother’s breasts,

and the smell of death permeating the cities5 (25).

The next pandemic occurred from 1346-1844 and was popularly called the Black Death.

http://static.howstuffworks.com/gif/black-death-1.jpg

Within Europe only about 3 areas were partly or totally spared by the plague but they were very small in size5 (42).

http://www.trippintheplanet.com/city/Bubonic_plague_map.png

The estimated mortality for Europe is estimated at 60% of the population5 (43).

http://images.nationalgeographic.com/wpf/media-live/photos/000/033/cache/plague-painting_3338_600x450.jpg?01AD=3i0ndabHKA21VtUxl0k2ZzFTHqL0daUBDijYpcidHo55cmbk9yVzT9w&01RI=F82CC368DADBDAC&01NA=

This translates into 50 million Europeans dying in a total population of 80 million people5 (43).

http://images.rxlist.com/images/quiz/std/std-s3.jpg

However after 1353 the plague was not as widespread

but was present in some European location every year between 1347 and 16705 (46).

http://www.historiasiglo20.org/MEC-BC/images/medieval_fair.jpg

During this second pandemic the devastating epidemic in London in 1665 occurred

http://cache2.artprintimages.com/p/LRG/38/3844/LJWYF00Z/art-print/the-great-plague-in-london-1665-illustration-of-men-loading-dead-bodies-onto-a-cart.jpg

where 75,000 to 100,000 died in one city which had an original population of about 460,0005 (119).

http://history.wisc.edu/sommerville/367/367images/london.jpg

The plague had a major impact on European society since the working population was so depleted

http://1.bp.blogspot.com/_ckWrFNiurfA/SebavCrMjmI/AAAAAAAABcA/KaGUCIirfW0/s1600-h/serfs

and caused people to believe that God was angry with them5 (57).

http://sljglobal.wikispaces.com/file/view/medieval_church.jpg/168742453/medieval_church.jpg

Although there are still plague epidemics, today it can be treated.

http://static.howstuffworks.com/gif/plague-8.jpg

The third plague pandemic began in 1894

http://erikaelvander.com/final%20assignment/images/plague-inspectors.jpg

and spread through much of Asia, Africa and then to every continent except Antartica5 (332).

http://0.tqn.com/d/historymedren/1/0/Y/9/msAsiaBDa.gif

These diseases and epidemics provide great examples

http://hsc.sca.nsw.gov.au/__data/assets/image/0019/5851/5_bacteria_variety.JPG

of what a virus or bacteria can do if it is easily transmitted and in a virgin population.

http://www.desktopclass.com/wp-content/uploads/2011/07/antibac_pix_virus_types-300x226.jpg

The epidemics and pandemics of pre-Modern Europe can serve as examples of how a disease can be transferred

http://turkeymacedonia.files.wordpress.com/2010/02/europe.gif

and may help with pandemics that exist today such as AIDs

http://civilrightsandwrongs.files.wordpress.com/2009/12/aids-ribbon.jpg

or the emergence of a new microbe with similar spread patterns as these diseases.

http://www.techvert.com/wp-content/uploads/2010/08/30/oil-eating-microbes-consume-oil-plume/microbes.jpg

CreditsMusic FromSmr00 PlayingAn original piece2PM’s I Hate You

Without UTik- Tok ftr.Yoon Eun Hye

2AM’s I Was WrongCan’t Let You Go Even If I Die

Yiruma PlayingWhen The Love FallsSpring WaltzMy Memory and Only YouLove MeKiss the RainMayTill I Find YouAutume SceneDo YouFarewellThe MomentIf I could See You AgainIts Your DayLove HurtsMoonlightRiver Flows In YouSometimes SomeoneTime Forgets…Wait ThereWhat Beautiful StarsMaybe

Credits Cont.Photos From• http://1.bp.blogspot.com/_9OzC-TEnUA/TCuRqLnbdGI/AAAAAAAAARc/RoHfC60SxJU/s1600/microbe.jpg • http://static.howstuffworks.com/gif/light-virus-1.jpg • http://www.brettrussell.com/effects/ebola.jpg • http://www.compassionatexpression.com/images/handcrafted%20scroll%20collection.gif • http://c0365781.cdn2.cloudfiles.rackspacecloud.com/datas/18426889/original/Smallpox.jpg • http://textbookofbacteriology.net/MTBCDC.jpg • http://saypeople.com/wp-content/uploads/2011/11/Measles_virus.jpg • http://www.stanford.edu/class/humbio103/ParaSites2006/Leprosy/Bacteria_files/image005.jpg • http://www.sciencephoto.com/image/11327/350wm/B2200738-Syphilis_bacteria-SPL.jpg • http://media.eurekalert.org/multimedia_prod/pub/web/23040_web.jpg • http://www.sciencephoto.com/image/11150/530wm/B2200521-Rickettsia_prowasekii_bacteria_causing_typhus-SPL.jpg • http://cdn.physorg.com/newman/gfx/news/2006/salmonella_typhi.jpg • http://4.bp.blogspot.com/_8e89PjfSxgI/TSc8mGiyePI/AAAAAAAACSQ/V7PF1Hwltpo/s1600/plague-bacteria-sc3519-xl.jpg • http://img2.imagesbn.com/images/24410000/24418839.JPG • http://www.mcb.uct.ac.za/tutorial/smallpox-structure-250.jpg • http://www.lpa.ens.fr/spip/IMG/gif/ADN_animation.gif • http://www.nada.kth.se/~asa/bilder/pvirus.jpg • http://saypeople.com/wp-content/uploads/2011/08/animal.jpg • http://maximizetravel.files.wordpress.com/2010/10/people-out-persp.gif • http://www.gorydetails.net/demo_sites/SmallpoxSite/images/ramsesv.jpg • http://www.greece-athens.com/places_images/1.jpg • http://listverse.files.wordpress.com/2009/01/480520436-de3869e875.jpg • http://www.sciencefile.org/system/media/k2/items/cache/82cdc4575b4cb55c0f3c0b126c5d7873_XL.jpg • http://www.kidspast.com/images/sparta-athens-greece.jpg • http://theory369.com/wp-content/uploads/2011/04/Pericles_Pio-Clementino_Inv269_n2.jpg • http://upload.wikimedia.org/wikipedia/commons/0/04/Athenian_empire_atheight_450_shepherd1923.png • http://www.crystalinks.com/romanempiremap.gif • http://www.lewrockwell.com/orig2/smallpox.jpg • http://2.bp.blogspot.com/_2TCYQxSUqGQ/TCSwTxyIsCI/AAAAAAAAI14/OHI1pFgC8CQ/s1600/the+plague+of+Athens.jpg • http://gallery.nen.gov.uk/assets/0910/0000/0241/the_roman_legion.jpg • http://1.bp.blogspot.com/_KLZqJvojvls/S7RXid7pM1I/AAAAAAAAACQ/0LTpBUqTeuc/s1600/When+You+Visit+To+Japan.jpg

Credits Cont.Photos From• http://globaltwilight.edublogs.org/files/2011/04/middle_ages-vhfayu.jpg • http://www.liv.ac.uk/arts_ses_images/18cworlds/Zoffany_-_Young_I.jpg • http://katiephd.com/wp-content/uploads/2011/06/inoculation.jpg • http://i.telegraph.co.uk/multimedia/archive/01506/population-article_1506492c.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/9/92/Smallpox_virus_virions_TEM_PHIL_1849.JPG/220px-Smallpox_virus_virions_TEM_PHIL_1849.JPG • http://upload.wikimedia.org/wikipedia/commons/thumb/b/b8/Smallpox_vaccine_injection.jpg/220px-Smallpox_vaccine_injection.jpg • http://www.arcatoglobal.com/images/ag_cdc.jpg • http://www.thejoyofshards.co.uk/history/byzantine_4516.jpg • http://www.antibioticsandalcohol.org/wp-content/uploads/2011/02/antibiotics-and-alcohol-drugs.jpg • http://c0365781.cdn2.cloudfiles.rackspacecloud.com/datas/2804/original/tuberculosis.jpg • https://s3.amazonaws.com/lessonplanet-files/public/uploaded_images/3517/human_population_lesson_plans_medium.jpg • http://textbookofbacteriology.net/MTBCDC.jpg • http://www.firehow.com/images/stories/users/80/cough.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Mammal_Diversity_2011.png/275px-Mammal_Diversity_2011.png • http://nursingcrib.com/wp-content/uploads/tissue-types-picture.jpg?9d7bd4 • http://masterghistory.com/images/europe.gif • http://images.starfishred.multiply.com/image/1/photos/upload/300x300/SM-jzQoKCtUAADp0VBQ1/45023209-skeleton226.jpg?et=joQnAtv%2BNlZDye5cYlWUuQ&nmid=0 • http://www.semp.us/_images/securitas/novdecS4photoD.jpg • http://www.rainforesteducation.com/terrors/malaria/Anopheles_stephensi.jpg • http://www2.kenyon.edu/projects/margin/leper3.jpg • http://education.technyou.edu.au/sites/default/files/images/bio/antibiotics.jpg • http://www.stonybrook.edu/commcms/icbdd/images/infectious2.jpg • http://travelersbackpack.com/wp-content/uploads/2010/02/global_travel.jpg • http://missinglink.ucsf.edu/lm/IDS_105_skinILM/measles_files/image002.jpg • http://www.toptenz.net/wp-content/uploads/2009/05/antonine-plague-300x216.jpg • http://www.nature.com/news/2008/080620/images/measles.jpg • http://rybicki.files.wordpress.com/2010/11/para-3.gif • http://upload.wikimedia.org/wikipedia/commons/5/5b/Rinderpest_Virus.JPG • http://www.babble.com/CS/blogs/strollerderby/2008/01/08-15/chillow_kid_fever.jpg • http://www.thecommonwealth.org/Shared_ASP_Files/GFSR.asp?NodeID=210085&AttributeName=FileName • http://www.allaboutwildlife.com/wp-content/uploads/2011/05/tiger.jpg • http://ingenre.com/wp-content/uploads/2010/08/death.jpg • http://www.lsg.sch.ae/departments/history/arabic_medicine_web/images/Past/rhazes.jpg • http://anders.com/lectures/lars_brownworth/12_byzantine_rulers/images/christ_mosaic.jpg • http://deskofbrian.com/wp-content/uploads/New-measles-vaccine.jpg • http://www.scientificamerican.com/media/inline/3E0F9160-E7F2-99DF-358998AA3C1A910F_1.jpg • http://zunia.org/uploads/pics/41444-Niger-vaccination33.jpg

Credits Cont.Photos From• http://www.the-parenting-magazine.com/wp-content/uploads/2011/05/nursery-rhymes-41.jpg • http://www.about-child.com/wp-content/uploads/2011/07/Symptoms-Of-Measles-In-Children-1.jpg • http://www.indchurch.org/indchurch_files/leprosy-hands.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/2/26/Leprosy.jpg/230px-Leprosy.jpg • http://www.human-healths.com/wp-content/uploads/2011/08/Mycobacterium-leprae3.jpg • http://2.bp.blogspot.com/-38pWUWuKM4Y/Te4m0oz3WpI/AAAAAAAABJw/KFxf2QdIngg/s1600/Leprosy.jpg • http://www.sciencemuseum.org.uk/hommedia.ashx?id=9238&size=Small • http://www.mcvitamins.com/images/neurop2.gif • http://www.indchurch.org/indchurch_files/MLS-leprosy%2011.jpg • http://1.bp.blogspot.com/_GmSJ6PSNQ1c/Swz4B3JjxuI/AAAAAAAAADM/bopgDOLJSBk/s1600/glastonbury-tor.jpg • http://www.clemson.edu/caah/history/FacultyPages/PamMack/lec124/viking.jpg • http://cbertel.files.wordpress.com/2009/09/medieval-medicine-leprosy.jpg • http://www.stanford.edu/class/humbio103/ParaSites2006/Leprosy/Historical_files/image008.jpg • http://www.fotothing.com/photos/47d/47d4a74cea29f16f218adaf30fd458db.jpg • http://bulk2.destructoid.com/ul/149595-pspgo.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/9/96/Holbein-death.png/220px-Holbein-death.png • http://www.sciencephoto.com/image/300589/530wm/N5240001-Woodcut_of_leprosy_in_medieval_times-SPL.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/9/9c/Tuberculosis-x-ray-1.jpg/230px-Tuberculosis-x-ray-1.jpg • http://wwwimage.cbsnews.com/images/2007/08/29/image3216569.jpg • http://www.damienfoundation.org/the_diseases_we_tackle/images/lepra-vandaag.jpg • http://www.medicaidcoverage.com/wp-content/uploads/2010/01/World-Health-Organization.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/5/54/South_America_-_Blue_Marble_orthographic.jpg/220px-South_America_-_Blue_Marble_orthographic.jpg • http://www.scientificamerican.com/media/inline/3E0F9160-E7F2-99DF-358998AA3C1A910F_1.jpg • http://www.stdinfo.org/wp-content/uploads/2011/10/what-is-syphilis.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/2/29/Treponema_pallidum.jpg/200px-Treponema_pallidum.jpg • https://online.epocrates.com/data_dx/reg/50/img/50-1-hlight.jpg • http://microbiology2009.wikispaces.com/file/view/LYmp_nodes/71787523/LYmp_nodes • http://www.buzzle.com/images/diagrams/nervous-system/labeled-nervous-system-diagram.jpg • http://scienceblogs.com/thoughtfulanimal/2010/11/05/mentalillness.jpg • http://cache2.asset-cache.net/xc/2695264.jpg?v=1&c=IWSAsset&k=2&d=45B0EB3381F7834DBF12693B2AEEAEEBD30C82DDEB9501F4E23FEF406871B787 • http://www.smoothhound.co.uk/images/europe.gif • http://thiswritelife.files.wordpress.com/2011/04/800px-french_troops_and_artillery_entering_naples_1495.jpg • http://3.bp.blogspot.com/_7mgRdSFz1-c/TScUSBYrthI/AAAAAAAABz0/jza5Wxi1pcM/s1600/pustule.jpg • http://4.bp.blogspot.com/_6-97fCRS_-M/S-N1JwwzEHI/AAAAAAAAAPo/G3lwrFZNYVw/s1600/Tournament_bavarian_engraving.png • http://www.sciencephoto.com/image/11327/350wm/B2200738-Syphilis_bacteria-SPL.jpg • http://condor.wesleyan.edu/courses/2007f/engl205/01/comedies/graphics/sweatingtub.jpg

Credits Cont.Photos From• http://2.bp.blogspot.com/__8fOJ3wuIcs/TSSj2u_By4I/AAAAAAAAANE/J7D1F4tBdSc/s1600/penicillin.gif • http://upload.wikimedia.org/wikipedia/commons/thumb/2/29/Treponema_pallidum.jpg/200px-Treponema_pallidum.jpg • http://www.netterimages.com/images/vpv/000/000/002/2161-0550x0475.jpg • http://www.human-healths.com/wp-content/uploads/2011/08/Shigellosis-Bacillary-dysentery-1.jpg • http://upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Entamoeba_histolytica_01.jpg/240px-Entamoeba_histolytica_01.jpg • http://4.bp.blogspot.com/-Ip5KATbDM4s/TmhQfcvYekI/AAAAAAAAEpw/xGSgHCN3H5E/s320/dysentery.jpg • http://farm1.static.flickr.com/145/380088194_c28ca7a031.jpg • http://www.latimes.com/media/photo/2011-03/359681640-22120228.jpg • http://clarosci.com/wp-content/uploads/2011/04/Malaria_red-295x300.jpg • http://www.fortunecity.com/victorian/riley/787/30/30.jpg • http://www.granger.com/pix/WOH/GER/0103431_T.JPG • http://anubisstudios.files.wordpress.com/2009/04/a003056.jpg • http://www.sciencephoto.com/image/11150/530wm/B2200521-Rickettsia_prowasekii_bacteria_causing_typhus-SPL.jpg • http://www.health-healths.com/wp-content/uploads/2011/08/Rickettsia-Typh-1.jpg • http://www.health-healths.com/wp-content/uploads/2011/07/Rickettsia-Prowazekii.jpg • http://www.lifemartini.com/wp-content/uploads/2011/11/symptoms-of-typhus1.jpg • http://www.tenniselbowtips.com/blog/wp-content/uploads/2010/11/elbow-aches-and-pains.jpg • http://www.damninteresting.net/content/Woodcut.JPG • http://hss.state.ak.us/gcdse/history/Images/section%2002%20-%20dark%20ages/2c-london-map.jpg • http://www.military-art.com/mall/images/dhm1096.jpg • http://wikitravel.org/upload/en/thumb/8/88/Frankfurt_Roemer.jpeg/300px-Frankfurt_Roemer.jpeg • http://e-gen.info/wordpress/wp-content/uploads/2011/07/germany-map.jpg • http://upload.wikimedia.org/wikipedia/commons/f/fe/W%C3%BCrttemberg_1495.gif • http://upload.wikimedia.org/wikipedia/commons/thumb/0/00/Tuebingen_Neckarfront.jpg/265px-Tuebingen_Neckarfront.jpg • http://thefrailestthing.files.wordpress.com/2010/06/an-allegory-of-the-wars-of-religion.jpg • http://www.human-healths.com/wp-content/uploads/2011/08/Epidemic-typhus1.jpg • http://www.drsfostersmith.com/images/Categoryimages/normal/p-50356-45451-tetracycline.jpg • http://www.weirdasianews.com/wp-content/uploads/2010/04/RatInfestationNepal.jpg • http://home.freiepresse.de/uwdel/umonu21.jpg • http://cdn.physorg.com/newman/gfx/news/2006/salmonella_typhi.jpg • http://www.nlm.nih.gov/medlineplus/images/stomacheache.jpg • http://ingenre.com/wp-content/uploads/2010/08/death.jpg • http://tcktcktck.org/wp-content/uploads/2011/09/climate-march-tck_mini.jpg • http://www.mpiwg-berlin.mpg.de/features/feature22/img.jpg • http://sueyounghistories.com/wp-content/uploads/2010/06/flu-epidemic-beds.jpg • http://1.bp.blogspot.com/_2TCYQxSUqGQ/TC4CGkhO5fI/AAAAAAAAJLA/9wnqhVTqbyM/s1600/Plague+skeletons.jpg • http://4.bp.blogspot.com/_8e89PjfSxgI/TSc8mGiyePI/AAAAAAAACSQ/V7PF1Hwltpo/s1600/plague-bacteria-sc3519-xl.jpg

Credits Cont.Photos From• http://cache.gawkerassets.com/assets/images/8/2010/11/rats-lots.jpg • http://www.cdc.gov/ncidod/dvbid/images/world98_sm.gif • http://sanctuary.prelucid.com/images/128045672748.jpg • http://scrapetv.com/News/News%20Pages/Science/images-4/black-plague-death.jpg • http://3.bp.blogspot.com/_XAWRh-cWdds/SXSJYRfXIdI/AAAAAAAAA6M/06F4XLzWs18/s400/aaa+plague.jpg • http://www.mims.com/resources/drugs/Indonesia/pic/Streptomycin%20Sulphate%20Meiji%20powd%20for%20inj_7234.gif • http://medicineworld.org/images/blogs/3-2009/intravenous-treatment-6901.jpg • http://4.bp.blogspot.com/_M02XK00Y0kY/S811LNIsptI/AAAAAAAAANI/WwrPTEj4efk/s400/1574+Siege+of+Leiden.jpg • http://images2.layoutsparks.com/1/196872/wet-dice-black-red.jpg • http://sfgbritlit2007.pbworks.com/f/1192213951/catA_plagueBubonic1Lg.jpg • http://www.upmc-biosecurity.org/sebin/v/v/plague_x-ray.jpg • http://static.howstuffworks.com/gif/plague-6.jpg • http://www.xtimeline.com/__UserPic_Large/4754/ELT200802142244179738026.JPG • http://contagions.files.wordpress.com/2011/05/khaldun_c_sp2plague-bal.jpg • http://www.thetech.org/genetics/images/ask/plague_spread_europe.jpg • http://media.photobucket.com/image/plague%20constantinople/mrsamoa1947/Constantinople20CCLXXIIIIr.jpg • http://static.howstuffworks.com/gif/black-death-1.jpg • http://www.trippintheplanet.com/city/Bubonic_plague_map.png • http://images.nationalgeographic.com/wpf/media-live/photos/000/033/cache/plague-painting_3338_600x450.jpg?

01AD=3i0ndabHKA21VtUxl0k2ZzFTHqL0daUBDijYpcidHo55cmbk9yVzT9w&01RI=F82CC368DADBDAC&01NA= • http://images.rxlist.com/images/quiz/std/std-s3.jpg • http://www.historiasiglo20.org/MEC-BC/images/medieval_fair.jpg • http://cache2.artprintimages.com/p/LRG/38/3844/LJWYF00Z/art-print/the-great-plague-in-london-1665-illustration-of-men-loading-dead-bodies-onto-a-cart.jpg • http://history.wisc.edu/sommerville/367/367images/london.jpg • http://1.bp.blogspot.com/_ckWrFNiurfA/SebavCrMjmI/AAAAAAAABcA/KaGUCIirfW0/s1600-h/serfs • http://sljglobal.wikispaces.com/file/view/medieval_church.jpg/168742453/medieval_church.jpg • http://static.howstuffworks.com/gif/plague-8.jpg • http://erikaelvander.com/final%20assignment/images/plague-inspectors.jpg • http://0.tqn.com/d/historymedren/1/0/Y/9/msAsiaBDa.gif • http://hsc.sca.nsw.gov.au/__data/assets/image/0019/5851/5_bacteria_variety.JPG • http://www.desktopclass.com/wp-content/uploads/2011/07/antibac_pix_virus_types-300x226.jpg • http://turkeymacedonia.files.wordpress.com/2010/02/europe.gif • http://civilrightsandwrongs.files.wordpress.com/2009/12/aids-ribbon.jpg • http://www.techvert.com/wp-content/uploads/2010/08/30/oil-eating-microbes-consume-oil-plume/microbes.jpg • Some Photos Courtesy of my mother

Credits Cont.Works Cited• 1McNeill, William H. “Plagues and Peoples” Garden City, Anchor Press. 1917• 2Aberth, John. “The First Horseman; Disease in Human History” Upper Saddle River, Pearson; Prentice Hall. 2007• 3Finer, Kim R. “Smallpox; Deadly Diseases and Epidemics” Philadelphia, Chelsea House Publishers. 2004• 4Henderson, D. A., MD. “Smallpox; The Death of a Disease” Amherst, Prometheus Books. 2009• 5Hays, J. N. “Epidemics and Pandemics; Their Impacts on Human History” Santa Barbara, ABC CLIO. 2005• 6Wingerson, Lois. "Dark History Of The White Death." Archaeology 62.5 (2009): 43. MasterFILE Premier. Web. 29 Nov. 2011.• 7"Pulmonary Tuberculosis - PubMed Health." Pub Med Health. U. S. National Library of Medicine, 7 Dec. 2010. Web. 29 Nov. 2011.

<http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001141/>.• 8Furuse, Yuki, Akira Suzuki, and Hitoshi Oshitani. "Origin Of Measles Virus: Divergence From Rinderpest Virus Between The 11Th And 12Th Centuries." Virology Journal 7.(2010): 52-55.

Academic Search Premier. Web. 29 Nov. 2011.• 9Salama, Peter, Jeff McFarland, and Kim Mulholland. "Reaching The Unreached With Measles Vaccination." Lancet 366.9488 (2005): 787-788. Academic Search Premier. Web. 29 Nov. 2011.• 10"What Is Leprosy?" National Institute of Allergy and Infectious Diseases Home Page. U. S. Department of Health and Human Services, 25 Apr. 2011. Web. 29 Nov. 2011.

<http://www.niaid.nih.gov/topics/leprosy/Understanding/Pages/whatis.aspx>.• 11"Leprosy Today." National Institute of Allergy and Infectious Diseases Home Page. U. S. Department of Health and Human Services, 8 Feb. 2011. Web. 29 Nov. 2011.

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<http://www.niaid.nih.gov/topics/syphilis/understanding/Pages/symptoms.aspx>.• 13Nicolas, X., H. Granier, and P. Le Guen. "Shigellosis or Bacillary Dysentery." PubMed Health. 30 Mar. 2007. Web. 29 Nov. 2011. <http://www.ncbi.nlm.nih.gov/pubmed/17399943>.• 14"WHO | Dysentery." Health Topics: Dysentery. WHO. Web. 29 Nov. 2011. <http://www.who.int/topics/dysentery/en/>.• 15"Endemic Typhus Fever (flea-borne)." Virginia Department of Health. Virginia Department of Health, 30 July 2011. Web. 29 Nov. 2011.

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