Plagues, Comets and Volcanoes 

The sixth century AD was a tumultuous period of human history. It marked the end of Classical Antiquity and the beginning of the Middle Ages. Empires fell and new ones rose up to take their place. It was in this period that the legendary King Arthur is said to have led the defence of Britain against Saxon invaders and that Beowulf ruled the Geats. It is also during this period that the most severe phase of global cooling in the last 2,000 years occurred and that the Plague of Justinian devastated the Byzantine Empire.

 

The Great Dust Veil of 536 AD

 

In the summer of 536 AD a mysterious and dramatic cloud of dust appeared over the Mediterranean. This thick veil of dust seemingly appeared from nowhere and darkened the skies between Europe and Asia for almost 18 months. The Byzantine historian Procopius wrote in his report on the wars with the Vandals:

“During this year a most dread portent took place. For the sun gave forth its light without brightness… and it seemed exceedingly like the sun in eclipse, for the beams it shed were not clear”

The dust veil was seen as far east as China and the star Canopus, used by the Chinese to assure themselves of good times ahead and to demark the seasons, was not seen for over a year. There was also summer snow and frost reported there that year. Tree-ring analysis from the same period shows abnormally low growth levels in areas as far apart as Ireland, Sierra Nevada and Chile. Further scientific evidence is provided by ice cores from Greenland and Antarctica, which demonstrate the presence of substantial sulfate deposits, indicating the presence of an extensive acidic dust layer.

In the 18 months that followed there was a period of dramatic global cooling, unseasonal freak weather events, crop failures and famine. The effects must have been terrifying for the people that lived at the time.

The actual cause of this bizarre metrological anomaly has long baffled scientists and historians but the two most often quoted are the ‘volcanic winter’ theory and the ‘comet impact’ theory.

 

Volcanic Winter or Comet Impact?

 

Over the past 30 years or so there have been numerous hypotheses that the global cooling of 536 AD was triggered by a major volcanic eruption that released an immense amount of ash into the atmosphere. In 1984 the Astrophysicist and climate change expert Dr. Richard Stothers suggested that it was caused by an eruption of the Rabaul volcano. More recently in 2013 the American paleoecologist Dr. Robert Dull has suggested that it was actually an eruption of El Salvador’s Lake Ilopango in 535 AD that was responsible.

 

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Ash cloud from the eruption of the Rabaul volcano in 2009 (Image courtesy of Taro Taylor CC BY-SA 2.0)

 

Another popular theory is that the dust veil was due to a comet impact into the ocean that blasted massive quantities of water vapour and debris back into the upper atmosphere. Ice-core Analysis of Greenland ice that was laid down between 533 and 540 AD shows high levels of tin, nickel and iron oxides from an extraterrestrial source in the dust layer. This has led some scientists to conclude that the material was shed by a fragment of Halleys’ comet that may have hit the Earth at around that time.

 

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NASA image of Halley’s comet from 1986. 

 

It is even possible that both of these events may have happened with a comet impact and a major volcanic eruption occurring at around the same time and both playing a contributing role to the appearance of the dust veil.

 

The Plague of Justinian

 

The appearance of the dust veil in 536 AD had a major impact on the people of the time. Global cooling and colder summers caused crops to be damaged before they could be harvested. Widespread famine ensued and this subsequently made the people of the time more susceptible to disease.

In 541 AD a mysterious illness began to appear on the outskirts of the Byzantine Empire. Victims were described as suffering from delusions, nightmares, fevers and swellings in the groin, armpits, and behind their ears. The lucky ones died quickly whilst those less fortunate suffered for many days before their eventual demise. The plague arrived in Constantinople, the capital of the empire, the following year in 542 AD. Procopius was once again on the scene to record the events. He noted that bodies were left stacked in the open due to a lack of space for proper burial and during his lifetime he lost his wife, daughter, grandchildren and most of his servants to the plague. He recorded that at its peak the plague was killing 10,000 people in Constantinople daily, although modern historians feel the real number was closer to 5,000.

The plague has since become known as the Plague of Justinian, being named after emperor Justinian I (527-565 AD), during whose reign it occurred. Procopius blamed the emperor for the plague, declaring that Justinian was either a devil or that he was being punished by God for his evil ways. The emperor himself even contracted the plague, although he was one of the lucky few that survived.

 

What caused the Plague of Justinian?

 

It had long been suspected from Propcopius’ description that the Plague of Justinian was in fact bubonic plague, the cause of the infamous Black Death that occurred in the 14th century. In 2012 it was finally confirmed that this was the case. A team of researchers anlaysed human remains from ancient gravesites from the period and detected the presence of Yersinia Pestis DNA.

Yersinia Pestis is a particularly nasty bacterium that can infect both animals and humans. It uses rats and other rodents as a reservoir species. Fleas then act as a vector species, acquiring Yersinia Pestis whilst feeding on the infected rodent and the bacteria is then passed to humans via a fleabite. The classic sign of bubonic plague are buboes, horribly swollen lymph nodes. These most commonly appear in the inguinal nodes, situated in the groin region because most fleabites occur on the legs. Those infected will first experience fevers, chills and muscle pains before developing septicaemia or pneumonic plague. Death can occur in less than 2 weeks.

 

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Yersinia Pestis in the gut of an infected flea seen through a scanning electron microscope

 

It seems that just as The Black Death was carried by rat fleas living on black rats that were passengers on merchant ships, so too was the Justinian Plague carried around the ports and trade routes of the Mediterranean.

The outbreak lasted less than 6 months in Constantinople but it is estimated that 40% of those living there died in that time period. The plague would reappear at periodic intervals over the next 300 years and it would eventually claim the lives of 25% of people living in the Mediterranean region. It is estimated that somewhere in the range of 25-50 million people died in total as a consequence of this catastrophic illness. The last recorded recurrence was in 750 AD, but by this time the outbreaks had become less virulent. The plague would then disappear from Europe completely until the 14th Century.

 

Aftermath of the Plague

 

The exact cause of the dust veil and global cooling that occurred in 536 AD may never be known for certain but it is known that it resulted in widespread hardship and famine for the people of the time. It may have also contributed to the advent of one of the most devastating plagues in human history that depopulated the Mediterranean and devastated the Byzantine Empire. Whatever the cause the course of human history was changed forever and Europe would not fully recover until the rise of the Renaissance.

 

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Imhotep – The First Physician

The ancient Egyptian civilisation was the first of the recorded great world civilisations. Little is known about the prehistoric societies that came before Egypt but it is assumed that they were steeped in superstition and that their ability to treat disease was primitive at best and possibly non-existent.

The relative stability that Egyptian society provided allowed for advances in science and technology that elevated them far ahead of those that came before. Farming, religion, trade, and travel all flourished and the beginnings of basic hygiene habits, such as toilets and baths, developed. In this burgeoning civilisation a role for doctors emerged and the Egyptians were the first people to develop a medical profession. The first of these physicians was Imhotep, a man who would go on to become a God.

 

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Statuette of Imhotep in the Louvre, Paris (image courtesy of Hu Totya CC 3.0)

 

The Age of Djoser

Djoser’s reign as pharaoh marked the start of the third dynasty of ancient Egypt in circa. 2650 BCE. It is not known for certain how long he ruled for but it is estimated to have been somewhere between 19 and 29 years. His reign was marked by great technological innovation and several substantial building projects.

It was during the third dynasty that Imhotep was born. Most sources state that he was born in Ankhtow, a suburb of Memphis, which was the capital at that time. Some sources suggest that he may have been born in the village of Gabelein, south of Ancient Thebes. Roughly translated his name means ‘the one that comes in peace’. Imhotep was born a commoner, possibly the son of an architect called Kanofer, but it quickly became apparent that he was one of the sharpest minds of the time and he rose quickly through the ranks and he went on to became Djoser’s vizier, the highest official to serve the pharaoh. He is considered to have had a genius level intellect and in addition to being Djoser’s vizier he was an architect, sage, astrologer and physician.

 

The First Physician

Sir William Osler described Imhotep as ‘the first figure of a physician to stand out clearly from the mists of antiquity’. His medical practices deviated from the use of magic and prayer that other Egyptian healers used and were remarkably advanced for the time.

Although there are no confirmed writings by Imhotep, the famous Edwin Smith papyrus, named after the dealer who bought it in 1862, is considered by many to have originally been written by him. This ancient text is the oldest known written manual of surgery and trauma and describes 48 cases of wounds, fractures, dislocations and tumours. Among the treatments described are suturing of wounds, splinting, bandaging, managing infections with honey and resins and the use of raw meat for the purpose of haemostasis. Immobilisation was advised for lower limb fractures and spinal cord injuries and it also describes reasonably detailed anatomical and physiological descriptions.

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Plates VI & VII of the Edwin Smith Papyrus from the New York Academy of Medicine

 

Imhotep is thought to have diagnosed and treated over 200 diseases in his lifetime including tuberculosis, appendicitis, gout, gallstones and arthritis. He also performed surgery and he may have also founded the first ever school of Medicine in Memphis.

As well as being the first named physician, Imhotep is also the first named architect and was responsible for the most famous building projects of Djoser’s reign, the great stepped pyramid at Saqqara. Djoser himself would eventually be buried there after his death and it is now better known as the pyramid of Djoser.

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Imhotep was also a famed architect and built the stepped pyramid of Djoser

 

The famed American archaeologist and Egyptologist James Henry Breasted said of Imhotep:

In priestly wisdom, in magic, in the formulation of wise proverbs; in medicine and architecture; this remarkable figure of Djoser’s reign left so notable a reputation that his name was never forgotten. He was the patron spirit of the later scribes, to whom they regularly poured out a libation from the water-jug of their writing outfit before beginning their work.”

 

The deification of Imhotep

100 years after his death his status was elevated to that of a demigod and around 2000 years after his death in 525 BCE, Imhotep’s status was finally elevated to that of a God of medicine and healing. Together with Amhotep, he was one of only two Egyptian commoners to achieve that status. It is told that people brought offerings in his honour to Saqqara, such as mummified Ibises and clay models of diseased organs and limbs, in the hope of being healed of diseases from which they were suffering.

The story of Imhotep is a truly remarkable one. A commoner by birth that laid the foundations for the medical profession over 4500 years ago and over 2000 years before the birth of Hippocrates. His legacy affected the great civilisations that followed and without him medicine may not be where it is today.

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Spanish Flu: The Deadliest Pandemic in History

In the Spring of 2009 a new strain of influenza began to infect people in Mexico. Reports suggested that the outbreak had started in February due to farming practices at a pig farm and it was henceforth given the name ‘swine flu’. By April, cases had started to spread and were appearing in the United States and other countries.

At the time I was working as an Emergency Medicine Registrar and I can clearly recall the sensationalized press reports that were being printed. As the cases increased in number there was a palpable sense of panic. I had worked through the SARS outbreak a few years earlier, which had also received a great deal of media attention, so I was not unaccustomed to this sort of scenario.

By the autumn, cases were becoming more widespread in the UK and I was one of the first clinicians to contract the illness at the Hospital where I was working. I spent a few days in bed with high fevers, joint pains and an annoying cough but made a quick recovery and was back working shifts a week or so later.

On August 10th 2010 the pandemic was declared as being over by the WHO. The death toll for the 2009 swine flu pandemic was recently estimated as being around 284,500 people. It has been established that swine flu was caused by the H1N1 strain of influenza, the same strain that caused the most devastating pandemic in human history, the 1918 outbreak better known as ‘Spanish flu’.

 

Aftermath of the Great War

Between July 1914 and November 1918, Europe and much of the rest of the World would be ravaged by one of the deadliest conflicts in history, World War I. For four years both sides would be locked in a tactical stalemate caused by the advent of trench warfare. By 1918 much of world was suffering food shortages and malnutrition. The most profoundly affected were the soldiers, and disease flourished in the trenches, with typhus, malaria and trench foot being commonplace.

In the spring of 1918 people started to fall ill with flu. The initial wave of the illness was not too different to a standard flu epidemic but later that year in August 1918 a second wave hit. This time large numbers of soldiers were beginning to fall ill with a much nastier version of the flu. Death rates were alarming and reports of the illness were censored by the most of the major powers involved in the conflict including Britain, France, the United States and Germany. Spain was a neutral country during World War I and their press was free to report on this new illness. It caught the attention of the Spanish people when King Alfonso contracted it and became gravely ill. The uncensored reporting in Spain gave the impression that Spain was the most-affected area and for this reason the pandemic has been referred to ever since as the ‘Spanish flu’.

By around November 1918 the number of new cases fell abruptly. Many speculate that the virus mutated to a less severe strain. A third, smaller peak occurred in early 1919 and by Spring of that year the pandemic was over.

 

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The three pandemic waves: weekly mortality rates in the UK from 1918-19

 

I had a little bird

A striking feature of the 1918 flu pandemic was the speed and efficiency with which it spread. The extremely limited Public Health measures available at the time and lack of any effective treatment or vaccine left Physicians helpless against it.

Children at the time would skip rope to a rhyme, which alluded to its infectivity:

‘I had a little bird,

Its name was Enza.

I opened the window,

And in-flu-enza.’

The close proximity of the troops huddled in the trenches caused the flu to spread rapidly amongst them. As these troops returned home the flu spread to the general population. Increased travel and massive troop transportation during the war quickly made it a global phenomenon and the numbers of people affected were huge. One of the most alarming features of this particular flu pandemic was the unexpectedly high death rate, particularly in healthy young adults, that was associated with it.

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Soldiers from Fort Riley, Kansas, with Spanish flu (Photo by unnamed U.S. Army photographer)

 

Why did Spanish flu kill so many people?

Between 1918 and 1919 20% of the World’s population would contract the Spanish flu. The total death toll will never be known for certain but is estimated to be between 50 and 100 million, which is between 3 and 6% of the total World population at the time. This is a staggering total that makes it one of the deadliest pandemics in human history. To put this number in perspective it is thought that more people died in the year that the flu pandemic lasted than in the 4 years that the bubonic plague raged across Europe. It has also been said that more people died of Spanish flu in 24 weeks than died of AIDS in 24 years.

The symptoms were unusual also, so much so that some of the early cases were misdiagnosed as dengue, cholera or typhoid. Bleeding from the nose, ears, gastrointestinal tract and underneath the skin was reported in many cases. Some patients even died from haemorrhage within the lung itself. One observer at the time wrote that:

One of the most striking of the complications was haemorrhage from mucous membranes, especially from the nose, stomach and intestine. Bleeding from the ears and petechial haemorrhages in the skin also occurred”

The majority of the deaths were caused by secondary bacterial pneumonia but many also died directly from the effects of the virus itself. It was a truly terrifying illness.

The pattern of morbidity and mortality was very different to other flu outbreaks. Flu is usually a killer of the very young and old, Spanish flu however was mostly killing those in the 20 to 40 year old age range, the group that is usually most robust and least affected. Young pregnant women were particularly susceptible.

It is now believed that the reason that it killed so many young healthy people was because it triggered a cytokine storm. Cytokines are responsible for cell signaling and play a key role in the immune response. Cytokine storm is a phenomenon whereby this reaction becomes uncontrolled and too many immune cells are produced. This exaggerated response leads to increased inflammation in the areas affected and causes much more severe symptoms and higher mortality rates. In effect a strong healthy immune system became a liability rather than an asset. This unusually severe form of flu killed as many as 20% of those infected, compared with a mortality rate of 0.1% for a standard epidemic.

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American Expeditionary Force victims of Spanish flu at a U.S. Army Camp Hospital (Photo by unnamed U.S. Army photographer)

 

Where did the pandemic really start?

There has been much speculation about the true origin of the Spanish flu. We know that it did not actually originate in Spain but until recently the exact source of the pandemic has been something of a mystery.

Recent work by Canadian historian Mark Humphries may have finally solved this puzzle. Humphries has discovered records that suggest that the mobilization of 96,000 Chinese laborers to work behind the Allied lines may have been the source. The archives that he discovered show that an outbreak of a respiratory illness, that was identical to Spanish flu, occurred in northern China months earlier than the European outbreak, in November 1917. Other medical records show that over 3,000 of the 25,000 Chinese Labor Corps Workers transported across Canada to Europe in 1917 ended up in medical quarantine, many with flu-like symptoms. It may be the case that these laborers transported the influenza virus with them to the Western Front from China. Further evidence for this hypothesis has been provided by historian Christopher Langford, who has shown that China suffered a lower mortality rate from the Spanish flu than other nations did. This could possibly be due to immunity in the population from earlier exposure to the virus.

 

Lessons from the past

Every year we are subjected to new flu epidemics and lives are lost. The World Health Organisation is constantly on the look out for signs of a new deadly outbreak. Medical science has progressed tremendously over the past 100 years and we are better prepared than ever before to deal with a pandemic with public health measures, antivirals, antibiotics and vaccines. But global travel and the spread of disease have never been easier and the next swine flu or SARS epidemic may be just around the corner. Hopefully when the next pandemic breaks, the lessons we have learned from Spanish flu will help us to control it.

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saviour of mothers

Ignaz Semmelweis – ‘The Saviour of Mothers’

I can vividly remember being taught how to ‘scrub up’ as a third year medical student. The careful scrutiny of the theatre sister filled me with fear. Had I touched the wrong part of the scrub pack? Were my hands completely sterile? On more than one occasion I completely forgot to put on my facemask and had to start again from scratch. The consultant surgeon rapidly lost patience with my ineptitude… ‘Barton, what the hell are you doing?! Get in here and hold this retractor now!’

There is something almost ritualistic about the whole experience. The mantra that aseptic technique saves lives is one of the very first things learnt by medical students. The prevention of the spread of harmful organisms is far better than dealing with potential sepsis caused by poor hygiene. It saves countless lives on a daily basis in hospitals all around the world.

It all seems so obvious now, but as hard as it is to imagine this wasn’t always the case. In fact there was a time when it was considered to be positively unseemly to wash your hands if you were a physician, the mere suggestion that you should causing great offence. This might still be the case today if it weren’t for the work of Ignaz Semmelweis.

Ignaz Semmelweis was born to a wealthy family on July 1st 1818 near Budapest in Hungary. He initially studied Law at the University of Vienna before switching to Medicine in 1838. He completed his medical training in 1844 and subsequently decided to specialise in obstetrics, being appointed as an assistant on a maternity ward at the Allgemeines Krankenhaus (General Hospital) in Vienna in 1846.

 

Vienna General Hospital
Semmelweis was appointed to work on a maternity ward at Vienna General Hospital in 1846.

 

In the mid-1800s deaths from puerperal infections, at the time referred to as ‘childbed fever’, were commonplace. A puerperal infection is any infection of the female reproductive tract occurring after childbirth, usually a bacterial infection of the uterus. The most commonly implicated bacteria are Streptococcal spp. and Staphylococcal spp. Even today these can spread to the bloodstream and cause septicaemia, and with no antibiotics available then death was frequently the outcome.

Semmelweis quickly became interested in these puerperal infections, and in particular the dramatic difference in death rates between the two different maternity divisions that operated at the Allgemeines Krankenhaus for the two different classes of patients. In the first division, to which he had been appointed, the deliveries were carried out by medical students and physicians. In the second division the deliveries were carried out by midwives. He observed that women in the first division had a 13-18% rate of post-delivery mortality compared with only a 2% rate in the second division. There surely had to be an explanation for this vast difference?

In the mid-1800s the germ theory of disease had not yet been established and the miasma theory was still strongly supported. Miasma theory held that disease was spread by a poisonous form of ‘bad air’ that was emitted from rotting organic matter. It was something of a mystery as to why such a difference in mortality rates should be occurring.

 

Miasma Theory
A representation of miasma theory by the artist Robert Seymour.

 

Semmelweis’ first observation was that women in the first division gave birth on their sides, whilst women in the second division gave birth on their backs. Perhaps this was could be the reason for the differing mortality rates? He decided to change practice and had the women in the first division also give birth on their backs. This resulted in no change in the mortality rates.

His next observation was that a priest would walk through the ward of the first division ringing a bell following a death. This didn’t happen in the second division. Semmelweis hypothesized that the priest must have terrified the women so much that they subsequently developed a fever and died. He made the priest abandon the bell ringing and change his route. Once again there was no change in the mortality rates. At this time Semmelweis was starting to become frustrated with his failure to isolate the cause of the discrepancy in the mortality rates.

It was at this point that something very important occurred. A close friend of Semmelweis, a pathologist called Jakob Kolletschka, had cut himself with a scalpel blade whilst performing an autopsy on a patient who had died of childbed fever. Kolletschka became unwell and subsequently died from ‘cadaveric fever’. It was thought that miasma from the corpse had been transferred to him. Death in this manner for pathologists was a common occurrence at this time. Semmelweis studied his friend’s case and came to the crucial realization that he had died suffering the exact same symptoms as those of childbed fever. Kolletschka’s death had provided him with a vital clue.

 

A painting of an 1800s autopsy by the artist Enrique Simonet. 
A painting of an 1800s autopsy by the artist Enrique Simonet.

 

Autopsies were commonly performed at this time and it was standard practice for medical students and physicians to handle corpses immediately before proceeding directly to the wards to treat patients or perform deliveries. Semmelweis suspected that ‘putrid particles’ from these autopsies were getting onto their hands and being transferred to the obstetric wards, and that this was responsible for the increased infection rates in the first division. He decided to test this hypothesis with a study that instituted hand washing using a chlorine of lime solution before deliveries. Mortality rates in the first division fell immediately to 2%, the same as in the midwife led division. Spurred on by his discovery he decided to wash the medical instruments used as well. This time the mortality rate dropped further to only 1%. The case was closed, hand washing should become standard practice, or so it would seem.

Semmelweis’ superior, Professor Johann Klein, disagreed with his findings and opposed his institution of hand washing. He supported the theory that the hospital’s new ventilation system was transmitting miasma and causing the childbed fever cases. He refused to renew Semmelweis’ assistant professorship and, feeling betrayed, Semmelweis left Vienna and returned home to Budapest.

 

Semmelweis, aged 42 in an 1860 copperplate engraving by Jenő Doby
Semmelweis, aged 42 in an 1860 copperplate engraving by Jenő Doby

 

In 1851 Semmelweis was appointed head of obstetrics at St. Rochus Hospital, where he continued his work on hand washing and also successfully reduced maternal mortality rates. In 1855 he became a professor at Pest University, where he once again managed to reduce maternal mortality rates.

Later, in 1861 he published the book, ‘The Etiology, Concept, and Prophylaxis or Childbed Fever’, but it received a number of unfavourable reviews and was widely criticised. By this time he was becoming markedly embittered by the opposition to his work and findings. Following these reviews he lashed out against his critics in a series of open letters that were full of bitterness and desperation.

 

Semmelweis’ 1862 Open Letter to all Professors of Obstetrics  
Semmelweis’ 1862 Open Letter to all Professors of Obstetrics

 

His conduct became increasingly erratic and sources state that he was becoming an embarrassment to his colleagues. By 1865 he was drinking heavily and his behaviour worsened, being described as irrational, odd, and inappropriate. He was spending more and more time away from his family and began to frequent prostitutes.

There is considerable debate as to the exact cause of his behavioural changes. It has been suggested that he may have been suffering from Alzheimer’s disease or that perhaps he had tertiary syphilis. It may simply be that the constant criticism and ridicule that his life’s work received drove him mad. Later that year he was committed to a Viennese insane asylum. He was only an inpatient for two weeks but during that time he endured severe beatings, was secured in a straightjacket, doused with cold water, and administered castor oil as a laxative. He died on August 13th 1865 from a gangrenous wound that was possibly caused by one of his beatings. In an ultimate ironic twist his cause of death was given as pyaemia, he had died from sepsis aged only 47.

Semmelweis was buried in Vienna on August 1865, having received no recognition in his own lifetime for his work on the prevention of disease transmission. Another 20 years would pass until his work was revisited and he finally received credit. By 1880, following work by Louis Pasteur and Robert Koch, the miasma theory was largely abandoned, the germ theory of disease established and the value of hand washing truly appreciated. Long after his death Semmelweis would be remembered as the ‘Saviour of Mothers’. The term ‘the Semmelweis reflex’ is used as a metaphor for ‘the reflex-like tendency to reject new evidence or new knowledge because it contradicts establish norms, beliefs or paradigms’.

It is perhaps best to finish this remembrance of Semmelweis with a quote by the man himself from his final hours: “When I look back upon the past, I can only dispel the sadness which falls upon me by gazing into that happy future when the infection will be banished … The conviction that such a time must inevitably sooner or later arrive will cheer my dying hour.”


 

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otzi the iceman

The Coldest Case – Lessons from the Iceman

I am an unashamed fan of history and spend much of my time away from Medicine reading about history and listening to podcasts such as the excellent ‘Hardcore History’ by Dan Carlin. This particular article was inspired by Daniele Bolleli’s incredible work on his ‘History on Fire’ podcast.

On September 19th 1991 the well-preserved mummy, of a man who lived around 5,300 years ago was discovered by two German hikers in the Ötzal Alps on the Austrian-Italian border. This mummified body has proved to be one of the most important archeological finds in recent history and has since been named Ötzi the Iceman. Whilst listening to Daniele’s podcast I was immediately struck by the medical relevance of this discovery. (more…)

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