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The diagnosis of certain epidemics throughout history is not exempt from review, on the one hand, because the medical diagnosis is not apodictic but probabilistic and because the concept of disease depends directly on the medical act.
On the other hand, the terminology used has changed substantially throughout the history of medicine, which can cause serious errors if the reading is not done properly.
For example, before the birth of microbiology, the term ‘plague’ was used to refer to any epidemic with high mortality regardless of whether it was caused by Yersinia pestis. Moreover, the dictionary of the Royal Spanish Academy today defines ‘plague’ as any disease that causes great mortality.
A microscopic mercenary
In the fifth century a. C. developed one of the most devastating epidemics of antiquity, an infectious disease that killed a third of the Athenian population and that has gone down in history as the ‘plague of Athens’.
This epidemic ended the Golden Age of the polis, breaking the balance that existed between Athens and Sparta, in favor of the latter.
For a long time it was thought that it was a plague epidemic. However, subsequent findings allowed the light of the etiology to be focused on another bacterium, the Salmonella enteritis.
This microorganism was discovered in 1880 by the German pathologist Karl Josep Ebert, which is why for a long time it was known as Ebert’s bacillus.
That of the Hellenic peninsula was not the only time that the pathogen interfered in the lines of history. He was also responsible for a mysterious disease that broke out during the conquest of Mexico and became known as ‘cocoliztli’, that in Castilian could be translated by pestilence or evil.
According to the most reliable chronicles, it killed 50-90% of the indigenous people, greatly favoring the work of the Spanish troops on American soil.
Reapers’ War
Some time later (1651), Ebert’s bacillus once again played a prominent role in another contest, in this case one that took place on peninsular soil. That year the troops of Felipe IV established themselves in the municipality of Sant Martí de Provensals –at the gates of the Barcelona wall– initiating an endless siege of the city of Barcelona.
The event took place within the framework of the well-known Reapers’ War, a denomination that relates to the weapons used by the peasants (sickles) to face the royal troops.
The Bourbon military camp was established in an area near the Llobregat River and, apparently, the soldiers took advantage of the nearby springs, swamps and pools to provide themselves with drinking water, both for consumption and for hygiene tasks. This was precisely the breeding ground that made it possible that, while the drums thundered threateningly, the pathogen tirelessly claimed a trail of lives.
The true story could not be unraveled until the 21st century when it was discovered that some of the fighters resting in shallow graves were dressed in military dress and with boots on. This fact was truly unusual at the time, since the shortcomings of the moment forced the clothing to be reused.
In some cases, the researchers even found coins next to the bodies, which led to the suspicion that the gravediggers had been in a great hurry to dispose of the bodies. Some of the bodies lay piled up in mass graves and did not show traumatic injuries, which led to the assumption that the death had been caused by causes unrelated to the war. Thanks to the study of some dental pieces, it was possible to unmask the presence of Ebert’s bacillus, the real killer.
These examples show that disease is not only a biological reality, but a human construction that must be contextualized in a specific historical moment and in specific sociocultural coordinates.
Pedro Gargantilla is an internist at El Escorial Hospital (Madrid) and the author of several popular books