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Saturday, April 18, 2015

400-1743: The first use of the term influenza

In the ancient world all diseases were attributed to the wrath of the "diety." If a Pandemic ravaged a village, town or nation, it was attributed to an angry god or spirit.  Both the ancient Greek poet Homer (800-701) and Hippocrates (460-370) described pandemics during their lifetimes.  It's probable some of these were attributed to the influenza virus.

Homer describes how Zeus used his thunderbolt to "punish impiety," and "for vengeance for an insult offered to his priest, the shafts of the Sun-god carried sickness into the Argive camp, destroying first the dogs and mules, and then thousands of warriors," writes Arthur Hopkirk, in his 1914 book "Influenza."  (1, page vii and viii)

In reality these warriors may have died of a pandemic caused by a virus or bacteria, such as influenza.  Although the ancients had no clue about the internal workings of the human body, nor about invisible invaders of the human body.  It was easier for them to believe in fake gods and attribute them when bad things like plagues happened.
"On mules and dogs th' infection first began;
And last, the vengeful arrows fix'd in man."
Those described as having sweats and chills (signs of a fever) were the most likely to succumb to the disease.  In man's desire to help his fellow man, the following were the remedies tried (1, page 15-16):
  • Purging
  • Venesection
  • Bleeding by the ranal vein
  • Emetics
And sometimes the remedy wreaked more havoc than the plague.  If ruthless venesection was performed, this in and of itself could have been the killer.  Yet the plague was blamed nonetheless.

The plague struck again and again.  In 412 B.C. the following was written regarding a plague in Rome (1, page 16):
“A plague, however, which broke out at that time and gave more alarm than it proved destructive, diverted the people’s attention from the forum and political disputes to look after their families and take care of their health. The city was all over oppressed with sickness, though no great mortality ensued.”
It struck again (or so historians think) in (1, page 20-26)...
  • 827 A.D. in France and Germany
  • 876 in Italy
  • 889 in Germany
  • 927 in France and Germany
  • 996-97 in England
  • 1173 in Germany and Italy (it was called "a dense fog" in Italy, first authentic outbreak)
  • 1239
  • 1311
  • 1323 in Italy and France
  • 1327-28
  • 1357
  • 1287 in France and Germany
  • 1403 in Paris, France
  • 1404
  • 1410-11 in France
  • 1413-14 in France
  • 1427 in France caused a "Poisonous air."
  • 1438
  • 1482
  • 1505
  • 1510
The following quote comes from 1323 (3):  
In the year, 1323, and in the month of August, there was a pestilential wind, which caused nearly all the inhabitants of Florence to fall sick of cold and fever, and the same thing took place throughout almost of whole of Italy.
And the following from 1327 (3):
In the said year and month, there was throughout the whole of Italy an infection fever caused by cold; but few people died of it.
Regarding the 1387 outbreak, the following was written (4):
There came a general pestilence in the whole country, with cough and influenza, so that hardly one among ten remained healthy. 
Regarding the 1427 outbreak, an anonymous chronicler from St. Albans wrote (1, page 25-6):
In the beginning of October, a certain rheumy infirmity which is called 'mure' invaded the whole people, and so infected the aged along with the younger, that it conducted a great number to the grave. 
The remedy for the 1387 pandemic, which took few lives, was "decoctions of chamomile and coriander berries, sweetened with syrup and poppies; clymasta; diaphoretics; and low diet." (1, page 23)  This would have been a more pleasant remedy compared to what the ancient Greeks treated the symptoms.  

Many of the deaths that resulted occurred on the fifth or sixth day, and Hippocrates notes that death usually occurred on the seventh day.  Later, in the first century A.D., Galen agreed with Hippocrates that death usually occurred on the seventh day.  (1, page 17)

At some point in our history, sometime in the ancient world, the concept that little creatures in the air may be responsible for spreading some diseases was postulated, although who postulated this theory, and when, remains a mystery.
Hopkirk says the first to write of this concept may have been the Greek "polyhistorian" Varro (117-36 B.C.), who wrote the following:
It is to be observed that wherever there are marshy districts certain most minute animals will grow, which cannot be discerned by the eye; but, carried by the air, reach the body through the mouth and nostrils, causing serious disease." (1, page x)
Varro was referring to the malaria plague in "Corfu when Pompey was there with an army and fleet."  Although the same concept may be applied to other contagious diseases, such as influenza.  Varro recommended the following to prevent the spread of the disease malaria: (1, page x)
  • Isolation
  • Ventilation
  • Destruction of insanitary dwellings
  • Etc.
Influenza is known to cause much grief for those afflicted with it, although it causes only a few deaths.  Usually those who die from it are over the age of 65 or have some chronic underlying medical condition that is complicated by influenza.

Prior to the 16th century influenza was referred to by various names, depending on the geographic region of the person describing it.  Sometimes it was simply referred to as a pest, pestilence, or plague.  Historians determine if the "plague" was influenza by descriptions of the symptoms, a high morbidity, yet low mortality rate.  If many deaths resulted, chances are that particular plague was not influenza. (1, page 4-5)

The term influenza may actually have come from a misinterpretation of the Italian word influence.  The idea here is that around 1357 people believed the position of the stars "influenced" outbreaks of the disease.  Although how this term superseded all the other terms and made it's way into medical nomenclature remains a mystery.  (1, page 6)(2, page 31)

The following are just a few other names used to describe various pandemics or endemics most historians figure were influenza (1, pages 8-9):
  1. Burzelen:  1307 in Germany (meaning to stumble?)
  2. Le tac or le horion:  1411 in France
  3. Tonawasches Fieber:  1414 in Germany (Because occurred in Danube district)
  4. Coqueluche: 1414 in France (Caused oppressive pain in the head)(Victims wore cap on head)
  5. Ladendo:  1427 in France
  6. Schafkrankheit or Schafhusten:  1580 in Germany (Sheep's disease, cough)
  7. Galanteriekrankheit or Modefieber: 1709 in Germany (Galant malady, fashionable fever)
  8. Le Grippe:  1743 in France (from "agripper," meaning to sieze quickly and cause sore throat
  9. Petite poste or petite courrier:  1762 in France
  10. Zamporina:  Brazil in 1780
  11. La Coquette:  France 1780-81
  12. Russische Krankheit (lightning catarrh):  1782 in Germany (due to its sudden onset)
  13. Corcunda (hunchback disease):  Brazil in 1816.  Violent cough made you hunch your back
  14. Polka Fever:  1846-7 in Brazil
In Great Britain during the 14th and 15th centuries, common names were faucht and slaodan.  Creatan was a word derived from creat (chest), and was another common name.  In 1562 it was called "the newe acquayntance.  In 1580 "the gentle correction."  It was also referred to as "the jolly rant," "the new delight," "the Dunkirk rant," and "the knock-me-down fever." (1, page 9)

An outbreak in Britain in 1485 was described as "English Sweat." It was so back that "King Henry VII had to postpone his coronation," according to Evelyn Kelly and Claire Wilson in their 2011 book "Investigating Influenza and Bird Flu."  "The disease was treated with tobacco juice, lime juice, and bloodletting." (2, page 32)

Finally, in 1743, the term influenza was used to describe influenza.  No one knows why, but this is the term that stuck, and has since made it's way to medical nomenclature.  The only exception was in Germany, where the Grippe was the term commonly used as of 1743.  

While the names varied through early history, the "grip" the disease held on it's victims were similar:
  • Catarrh:  Inflammation of the respiratory tract (nasal congestion)
  • Fever:  Usually over 100 degrees
  • Chills:  Associated with the fever
  • Headache:
  • Body or muscle aches: Especially of the back, arms and legs
  • Dry cough: Helps spread the disease from one victim to the next
  • Fatigue and weakness:  General feeling of tiredness
  • Suspended Business: Many stopped working to take care of their families
It's generally the commonality of symptoms described, the high rate of morbidity, and low mortality, that has allowed historians to feel confidence these epidemics and pandemics were probably influenza.  

  1. Hopkirk, Arthur F., "Influenza: It's History, Nature, Cause and Treatment," 1914, New York, Charles Scribner and Sons
  2. Kelly, Evelyn B., PhD and Claire Wilson, "Investigating influenza and Bird Flu: Real facts and real lives," 2011, Enslow Publishers, U.S., Chapter 2, "The History of Influenza," pages 29-47
  3. Hopkirk, op cit,Gluge, "in the course of his argument, quotes the following passages from Buoninsegni’s Istoria Fiorentina, Florence, 1580." The passages are recorded on page 21 of Hopkirk's book.  
  4. Hopkirk, op cit, from Jakob von Konigshoven Stassburg Chronicles, of 1387, as recorded by Hopkirk on page 22 of his book
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