Germs, Genes, & Civilization: How Epidemics Shaped Who We Are Today

by David P. Clark

  By the fourth century A.D., Christianity was spreading vigorously. It was especially popular among women, often those from the upper classes. Fabiola, a widow from a distinguished Roman family, founded the world’s first free public hospital in Ostia, the port city that serves Rome. Fabiola originally went to the Holy Land, to join the Christian scholar Jerome who was translating the Bible into Latin with the help of several rich female religious activists. However, the Huns burst into the Middle East, and Jerome and his clique fled to Rome. After returning, Fabiola organized other rich women into founding a hospital. They not only contributed money, but also took part themselves in doctoring and nursing. Fabiola personally collected poor patients off the streets. This was no task for the squeamish. According to Jerome, “They have leprous arms, swollen bellies, shrunken thighs, dropsical legs…their flesh gnawed and rotten and squirming with little worms….”

  Fabiola died in 399 A.D. and was later made a saint. When you consider the positive contributions and personal bravery of these Christian women, it is not surprising that early Christianity gained respect. Both the increased survival of the ordinary Christians and the sincerity of those who died while nursing others must have greatly raised Christianity in the public esteem. Few of us really want to die, even those who believe in an afterlife. Whether the cures were miraculous was not the point—they were attributed to Christianity.

  Coptic Christianity and malaria

  The Copts were a Christian sect centered in North Africa. They wrote their earliest religious texts in Coptic, a language derived from ancient Egyptian. Later, the Copts also wrote in Greek. Although modern-day Christianity dislikes admitting it, these early Christians practiced what can only be described as a form of magic. Spells were written on papyrus sheets, which were then folded into long strips and worn as amulets. Many of these were designed to protect their wearers against disease, and they invoke not only Jesus Christ, but also a mixture of saints and often also Jewish demons.

  Here is part of a fifth-century spell, originally written in Greek on an amulet (Oxyrhynchus 1151) and designed to protect a woman named Joannia from fever (undoubtedly, malaria):

  Flee, hateful spirit! Christ pursues you; the son of God and the Holy Spirit have overtaken you. O God of the sheep-pool, deliver from all evil your handmaid Joannia, whom Anastasia, also called Euphemia, bore. … O Lord, Christ, son and Word of the living god, who heals every disease and every infirmity, also heal and watch over your handmaid Joannia, whom Anastasia, also called Euphemia, bore, and chase away and banish from her every fever and every sort of chill—quotidian, tertian, quartan—and every evil.

  Similar spells were found down to the eleventh century, often containing magical formulas from the medieval Jewish cabala, mixed with more orthodox Christian terminology. These spells illustrate the great importance of both malaria and magic among the Christians of North Africa. They also confirm that early Christianity was in many ways a healing cult.

  Messianic Taoism during the collapse of Han China

  During the early centuries of the Christian era, when successive epidemics weakened the Roman Empire, a similar process occurred at the far end of the Eurasian landmass. Early Chinese civilization was centered in the temperate north, especially in the valleys of the Yellow and Yei rivers. (Southern China, though watered by the more famous Yangtse Kiang River, was civilized much later, largely due to tropical diseases.) From 170 A.D. onward, massive plagues preceded by floods hit the Yellow River valley of northern China. Depopulation was followed by peasant revolts and political turmoil, resulting in the collapse of the Han Empire around 220 A.D.

  Just as Christianity emerged from the chaos in the Roman world, a messianic religion based on Taoism emerged in the disintegrating Han territories. By 184 A.D., the Taoist sect of the “Great Peace” had 360,000 armed followers. Chang Chiao, who claimed healing powers, led them. These Taoists worshipped the lord Huang Lao, a hybrid of the fabled Yellow Emperor, Huang Ti, and a deified Lao Tzu, founder of the original Taoist movement. They believed that disease was the consequence of sin, and they distributed healing amulets at the spring and autumn equinoxes. Unlike Christianity, this messianic version of Taoism failed to survive over the long term. Buddhism, from India, displaced it over the next few centuries.

  Buddhism and smallpox in first-millennium Japan

  During the years 735–737 A.D., a massive smallpox epidemic swept through Japan. The smallpox epidemic was preceded by a famine in 732–733, and the resistance of the population was doubtless lowered. Although sparsely populated regions were scarcely affected, the death rate was 70% or greater in some of the most crowded areas. The overall mortality for the whole of Japan was probably at least 30%. Smallpox was on the rampage in China during the fourth century or earlier and had moved to Korea by the mid-500s. It presumably moved from Korea to Japan: It was first reported in the port of Dazaifu, which is on the Japanese coast opposite the Korean peninsula.

  The depopulation of Japan resulted in several major reforms in the areas of taxation, farming loans, and land tenure. It also had a great effect on religion. Emperor Shomu had been brought up as a Confucian. At the beginning of his reign, Buddhism, an import from India via the Chinese mainland, was tolerated but strictly controlled. When the famine struck, Shomu felt responsible: “The rivers are dry and the five grains have been damaged. This situation has come about because of our lack of virtue.”

  When the plague of smallpox followed, Shomu was even more certain he was to blame: “Recently untoward events have occurred one after the other. Bad omens are still to be seen. I fear the responsibility is all mine.” Shomu responded to the crisis by donating massive sums and ordering Buddhist temples to be built all over Japan. Although the economy was already tottering as a result of so many taxpayers dying in the epidemic, his daughter, Empress Shotoku, followed his example. Like her Roman counterpart, Fabiola, she cared deeply for the sick. Sadly, her excessive contributions helped bankrupt the state. Despite these unfortunate financial side effects, Buddhism was instituted at the expense of Confucianism.

  The European Middle Ages and the Black Death

  The Black Death is especially terrifying. Unlike most infectious diseases, nursing has little effect on the fatality rate from plague. Until antibiotics became available, the death rates for the bubonic (60%–70%) and pneumonic (99%) forms of plague remained unchanged by any treatment. As noted earlier, in the major Roman epidemics of the second and third centuries, the Christians made major progress because nursing greatly reduced the fatality rate. However, neither nursing nor prayer stopped the relentless march of the Black Death.

  The effects of the Black Death on religion were complex and, in some ways, contradictory. The inability of the Church to stop the plague or cure the sick resulted in a great loss of faith, not so much in God as in the religious establishment. To be fair, although many of the higher clergy fled, the high death rates among the ordinary priests indicate that most of them performed their duties until the end. Many writers of the day, including William Langland (1322–1400), noted the unworthiness of the higher clergy. As a supporter of a purified Christianity, Langland saw their worldliness as a threat to the Holy Church and remarked, “So we need an antidote strong enough to reform these prelates … who are hindered by their possessions.” Education in the 1300s was largely under ecclesiastical control, and doctors of medicine were therefore taught and licensed by the Church authorities. Thus, the failure of medicine to cure the plague was also associated with the Church.

  Unlike in the Roman era, no viable alternative religion was waiting for an opportunity to take over. The result was fragmentation of authority within the realm of Christianity rather than the infiltration of a new religion. One aspect of this was a great upsurge in the veneration of previously obscure saints who were supposed to have healed plague victims. Shrines were richly endowed, and new religious brotherhoods formed themselves around these healing saints. In a way, this was a reversion to the polyt
heism of the Romans and Greeks, when many gods and goddesses hawked their wares in a marketplace of theologies. But instead of autonomous gods and goddesses, a multiplicity of saints remained within the bounds of Christianity. Many ordinary people believed that God was displeased, presumably because the established church or Christian society was impure and corrupt in some manner. Outbreaks of violence occurred, directed at Jews, loose women, lepers, and other outcast groups. Sometimes these groups were accused of actually spreading the plague; at other times, they were accosted for polluting society by their very existence, so bringing down the wrath of God.

  In the long term, the greatest effects on religion were indirect and took place over the next two centuries. The Black Death shook the feudal system apart and freed up Western society. Lack of manpower led to mechanization and a readier acceptance of new inventions, such as printing. The collapsing feudal system spurred the growth of nationalism. This, in turn, led to local rulers resisting the centralized control of the papacy. Hence, the religious reforms of Luther in the early 1500s found widespread support, especially among the northern countries. The prime example of this is, of course, Henry the Eighth of England, who split away from the Catholic Church and founded the Church of England. When the monopoly of the Vatican was broken, the growth of religious freedom was free to proceed. Slowly, our modern forms of parliamentary democracy and industrialization emerged.

  The Great Plague of London

  The Great Plague of 1665 was the last time an epidemic of bubonic plague ravaged London. Although it was nowhere near as terrible as that of the 1300s, it was still terrifying. The government instituted public prayer and days for fasting and public confession of sins. The churches were crowded with people imploring God to stop the pestilence. By the 1600s, British Christians were split between those loyal to the Church of England and the Dissenters (Puritans, Presbyterians, and other nonconformist sects). During the crisis, they prayed together in each other’s churches. When the plague passed, the barriers among the separate denominations gradually arose again.

  During the early days of the outbreak, London was rife with fortune tellers and soothsayers who, for a small consideration, would tell you your chances of surviving the plague. These prophets for profit merged imperceptibly with conjurors who claimed to possess magical cures and a multitude of quacks selling secret and infallible remedies of a more “scientific” nature. Many Londoners took to wearing charms and amulets to ward off the evil spirits causing the pestilence. These amulets were remarkably similar to those the Coptic Christians used in earlier centuries. They included magic words, such as Abracadabra, signs of the zodiac, and the Jesuits’ mark of IHS (Iesus Hominorum Salvator, Latin for “Jesus, Savior of Men”).

  Loss of Christian faith in industrial Europe

  It is a common misconception, especially in the United States, that intellectuals led the movement away from religion. If anything, the reverse was true. Just as political correctness finds its most avid supporters on today’s university campuses, the intellectuals of earlier times generally went along with the religious establishment. He who pays the piper calls the tune. By the time Darwin proposed the theory of evolution, organized religion was already losing its grip. In England, the world’s first industrial democracy, the first demographic group to desert religion en masse was the urban working class. As industrialization proceeded, there was a bulk flow of population from the countryside into the manufacturing towns. These migrants mostly came from rural areas where religion was a significant part of community life. As they settled in the towns, they tended to leave religion behind.

  Villages have a sense of community, and middle-class suburbia values respectability. Both are major contributors to religious conformity. But other factors were at work. The overcrowded urban poor were the most susceptible to infection. Thus, those who were most often the victims of plague and pestilence abandoned a religion that seemed increasingly ineffective. Rural populations were more spread out, and the rural poor often escaped the worst effects of epidemics circulating in the towns. The more prosperous lived more spaciously and more hygienically, so they, too, paid a lower toll to infectious disease. Villagers who prayed together in their parish church for the plague to pass them by often had their prayers answered. In contrast, the inner-city poor who attended church were as likely to be infected there as anywhere else. The great epidemics of the age of industrialization were aided and abetted by the crowding from increasing population and urbanization. Thus, the urban working classes were alienated from traditional religion.

  Cleanliness is next to godliness

  “We should hear no longer of ‘Mysterious Dispensations,’ and of ‘Plague and Pestilence’ being ‘in God’s hands,’ when, so far as we know, he has put them into our own.”—Florence Nightingale, Notes on Nursing, 1859

  During the nineteenth and twentieth centuries, technology took the field against infectious disease. Clean water, sewers, flush toilets, toilet paper, soap, antiseptics, warm and dry housing, and better nutrition all combined to reduce the spread of infectious disease. Toward the end of the 19th century, Louis Pasteur declared, “It is now in the power of man to cause all parasitic diseases to disappear from the world.”

  Although this was a trifle optimistic, the gains in life expectancy and general health were impressive. Already reeling from the onslaught of civil engineering, infectious disease took another massive beating from the successive discoveries of vaccination in the late nineteenth century and of antibiotics in the mid–twentieth century. Life expectancy in the advanced nations today is nearly twice that at the start of the nineteenth century.

  Not only did religion fail to cope with epidemic disease, but science was successful where religion failed. Religion lost its monopoly on healing, and medicine became an independent, secularized profession. Before the modern era, organized religion jealously guarded its right to dispense healing and exert control over life and death. Today even those who still practice religion routinely go to a doctor when they are sick. We sometimes hear the saying “doctors acting like God.” While intended to puncture pomposity, there is a deeper truth here. As long as scientific medicine is effective, many people today feel little need for supernatural intervention.

  9. Manpower and slavery

  Legacy of the last Ice Age

  During the last Ice Age, the Bering Strait between Asia and North America became a land bridge joining the two continents. Primitive Asian tribes wandered across into North America and migrated southward. As Earth warmed up again, the ice retreated, and some 10,000 years ago, contact between America and Asia was sundered. For some ten millennia, the inhabitants of the American continent remained isolated from the rest of mankind. During this critical period, most of the epidemic diseases characteristic of the Old World made their appearance.

  About 500 years ago, contact resumed when Portugal and Spain, soon followed by the other European naval powers, discovered and conquered the Americas. The result was one of the most spectacular population crashes in history. During the century following contact, the indigenous population of the American continent declined by some 95% due to epidemics. Although the European invaders inflicted some military casualties, the overwhelming number of fatalities were due to infectious disease. The indigenous population of America had no previous exposure to the diseases circulating among Europeans and dropped like flies. Historians ask whether the European conquest would have been successful without the help of infectious disease. Did the Europeans deliberately spread epidemics? What role did religion play in the response to the imported epidemics? In contrast, biologists wonder why no American diseases were capable of wiping out 95% of the population of Europe or Asia. For that matter, what diseases did precontact Americans suffer from?

  The New World before contact

  From a biological perspective, two outstanding issues are noteworthy. First is the apparent lack of major epidemic infections circulating in the Americas before contact. Second, although th
e American civilizations were technologically still in the Stone Age, they produced remarkably dense populations, especially in Central America. Some accounts suggest that the Aztecs and Incas had almost no major epidemic diseases and lived unusually long lives before European contact. Other sources recount major epidemics, often following periods of famine.

  Archeological data indicates that life expectancies in pre-Columbian America were short, perhaps around 24 years in the early classic Maya period and declining thereafter. These estimates are even lower than for medieval Europe and raise the question of what pre-Columbian Americans died of. The dense agricultural populations of Mesoamerica depended excessively on maize (corn) as a staple foodstuff and suffered from dietary deficiency due to a shortage of meat and fresh vegetables. Consequently, their susceptibility to a variety of intestinal and respiratory diseases was greatly elevated. Overcrowding and poor sanitation also contributed.

  Several serious insect-borne infections were present in pre-contact America: Chagas disease, Leishmaniasis, Carrion’s disease, Lyme disease, and Rocky Mountain spotted fever. These are all caused by protozoa or bacteria and are restricted in range by the insects that carry them. What the Americas lacked was any major virus disease that spread from person to person. Though hard to believe, this appears to be confirmed by the fact that no epidemics from America devastated Europe. The only major disease the Americans contributed seems to be syphilis. Although syphilis is a serious problem, it does not cause virulent, fast-moving epidemics such as smallpox, measles, or influenza. Tuberculosis and perhaps typhus were also present on the American continent before Columbus made contact.