Читать книгу The Greatest Benefit to Mankind: A Medical History of Humanity - Roy Porter - Страница 55

European expansion produced the ‘Columbian exchange’, a highly unequal disease trade-off in which Columbus may have brought one killer disease back from the Americas: syphilis. This broke out in 1493–4 during a war between Spain and France being waged in Italy. When Naples fell to the French, the conquerors indulged in the usual orgy of rape and pillage, and the troops and their camp-followers then scattered throughout Europe. Soon, a terrible venereal epidemic was raging. It began with genital sores, progressing to a general rash, to ulceration, and to revolting abscesses eating into bones and destroying the nose, lips and genitals, and often proving fatal.

Initially, it was called the ‘disease of Naples’, but rapidly became the ‘French Pox’ and other terms accusing this or that nation: the Spanish disease in Holland, the Polish disease in Russia, the Russian disease in Siberia, the Christian disease in Turkey and the Portuguese disease in India and Japan. For their part, the Portuguese called it the Castilian disease, and a couple of centuries later Captain Cook (1728–79), exploring the Pacific, rued that the Tahitians ‘call the venereal disease Apa no Britannia – the British disease’ (he thought they’d caught it from the French).

That some of the Spaniards at the siege of Naples had accompanied Columbus suggested an American origin for the pox (or ‘great pox’, to distinguish it from smallpox). It certainly behaved in Europe like a new disease, spreading like wildfire for a couple of decades. ‘In recent times’, reflected one sufferer, Joseph Gruenpeck (c. 1473–c. 1532):

I have seen scourges, horrible sicknesses and many infirmities affect mankind from all corners of the earth. Amongst them has crept in, from the western shores of Gaul, a disease which is so cruel, so distressing, so appalling that until now nothing so horrifying, nothing more terrible or disgusting, has ever been known on this earth.

Syphilis, we now know, is one of several diseases caused by members of the Treponema group of spirochetes, a corkscrew-shaped bacterium.^* There are four clinically distinct human treponematoses (the others are pinta, yaws and bejel) and their causative organisms are virtually identical, suggesting all are descendants of an ancestral spirochete which adapted to different climates and human behaviours.

What caused this terrible outbreak? Many epidemiological possibilities have been mooted. It is feasible that some American treponemal infection merged with a similar European one to become syphilis, with both initial infections subsequently disappearing. Others maintain that venereal infections had long been present in Europe but never properly distinguished from leprosy; treponemal infections (pinta, yaws, endemic and venereal syphilis) had, it is suggested, initially presented as mild childhood illnesses, spread by casual contact and producing a measure of immunity. With improved European living standards, treponemes dependent on skin contact had become disadvantaged, being replaced by hardier, sexually transmitted strains. Thus an initially mild disorder grew more serious. A related theory holds that the spirochete had long been present in both the Old World and the New; what would explain the sixteenth-century explosion were the social disruptions of the time, especially warfare.

Like the pox itself, the debate raged – and remains unresolved to this day. But whatever the precise epidemiology, syphilis, like typhus, should be regarded as typical of the new plagues of an age of conquest and turbulence, one spread by international warfare, rising population density, changed lifestyles and sexual behaviour, the migrations of soldiers and traders, and the ebb and flow of refugees and peasants. While Europeans were establishing their empires and exporting death to aboriginal peoples, they were caught in microbial civil wars at home. Bubonic plague bounced from the Balkans to Britain, malaria was on the increase, smallpox grew more virulent, while typhus and the ‘bloody flux’ (dysentery) became camp-followers of every army. Influenza epidemics raged, especially lethal being the ‘English sweat’ (sudor Anglicus) which struck in 1485 (delaying Henry VII’s coronation), 1507, 1528, 1551 and 1578, and was described by Polydore Vergil, an Italian diplomat in London, as ‘a pestilence horrible indeed, and before which no age could endure’. John Caius’s (1510–73) A Boke of Conseill against the Disease Commonly Called the Sweat or Sweating Sickness (1552) noted the copious sweating, shivering, fever, nausea, headache, cramps, back pain, delirium and stupor. It came to crisis within twenty-four hours, with very high mortality. It was thought even worse than the plague, for plague:

commonly giveth three or four, often seven, sometimes nine … sometimes eleven, and sometimes fourteen days’ respect to whom it vexeth. But that [the sweating sickness] immediately killed some in opening their windows, some in playing with children in their street doors, some in one hour, many in two it destroyed, and at the longest, to they that merrily dined, it gave a sorrowful supper.

The ‘English sweat’ remains a riddle. Such calamities form a doleful backdrop to the Renaissance.