-Hi, I'm Anna Dhody, Curator of the Mütter Museum and Director of the Mütter Research Institute,
and welcome to Going Viral: Infection through the Ages. In this exhibition, we'll learn three main ways
that we, as humans, thought we got sick over time.
-Hi, I'm Chrissie Perella and I'm the former Archivist here at the Historical Medical Library.
The Library holds a large number of texts that illustrate the evolution of infectious theories throughout the centuries.
Displayed in this case behind me are books that represent centuries of medical knowledge, practices, and techniques.
Beginning with the earliest text displayed here in the case, starting in the 11th century,
and following up to the 19th century, these books show how people have tried to make sense of infectious diseases,
and figure out why they get sick and what they can do to treat their illnesses.
The "Regimen Sanitatis" was most likely first composed in the 11th century at the Medical School in Salerno.
It is written in verse, and gives dietary advice and hygiene guidelines for
factors which can affect one's health, including: exercising, bathing, eating, and drinking.
The volume displayed here in this case was printed circa 1481 in Florence. The particular
text in this volume was written in the 1190's as a private manual of health for the Sultan Al-Afdal,
son of Saladin. It was translated from Arabic into Hebrew in 1244 by Moses Ibn Tibbon,
and this was the source for the Latin version made later in the century. It is this Latin
version which brought Maimonides' "Regiment Sanitatis" to the European Christian world.
-So the first theory we're going to explore is the humoral theory. Now, this was not only the first theory,
but also one of the longest. It persisted for over 2000 years, starting with Hippocrates.
Now, the four humors were what we thought dictated your health. You had these four fluids in your body:
blood, phlegm, black bile, and yellow bile. And if any of those humors were out of balance, out of alignment, you were sick.
-Each fluid was linked to a season, an element, an organ, a temperament, and other qualities.
For example, black bile was related to autumn, earth, the gallbladder, melancholy, and was considered to have cold and dry properties.
People also believed the zodiac signs presided over parts of the body and were associated with an element.
The bull, Taurus, ruled over the throat, neck, thyroid gland, vocal tract, and was affiliated with black bile and melancholy.
Complex astrological charts, like volvelles, were used to determine diagnoses and treatments,
which were based not only on the actual physical symptoms, but also temperaments, such as
sanguine, choleric, melancholic, and phlegmatic, and birth signs. Astrological signs are grouped
under their corresponding elements of fire, earth, air, or water. The two qualities of each element,
such as hot and dry or cold and wet, helped medieval healers determine the proper humoral balance for each person.
-Now sometimes, physicians refer to something called a "volvelle" to try to make diagnoses based on some external
factors, like your astrological sign. Now let's see what my diagnosis would be. I'm a Scorpio.
I'm going to see if it lands on it. Did not. Okay, here we go, Scorpio!
Stay! Okay, fine. My humors are hot and wet. I'm supposed to use drying disinfectants like
vinegar and rose water to cool my skin. Do I live?
Nope, I die!
-Although humoral theory is associated with Hippocrates, it was Galen, writing four centuries later,
who took Hippocratic ideas about humors and turned them into a holistic theory of medicine.
The Library's copy of "De Crisibus Libri III" was copied down in the first half of the 13th century in France,
and is a Latin translation written by Gerard of Cremona.
So what did Galen mean by "crises?" Why is this book included in an exhibit about infectious diseases?
Traditionally, a "crisis" in medicine meant a turning point for better or worse. Galen describes a crisis as
"a sudden change in a disease, either towards death or recovery; which last is produced by nature secreting the
good from the bad humours, and preparing the latter for excretion."
In what ways might the bad humors be excreted?
Galen wrote, "It is the peculiar property of burning fevers to be terminated by an eruption of
blood from the nose, or some other part of body; or by a profuse, universal, and warm sweat breaking out
after a rigor; or by bilious vomiting, or some other excretion of the humours."
The good news is that if you get a bloody nose during a fever, you could be on your way to recovery.
The bad news is that you could also be on your way to death, but at least the bad humors will be expelled.
-Our next theory is the miasma theory or the miasmatic theory, and that comes from
the Greek word for "bad air." And that's exactly how they thought you got sick: from inhaling bad smelling air.
So, for instance, if you smelled a foul smell and then came down with cholera,
it was that smell that caused the cholera, nothing else. This theory persisted from around the 1600's up to the mid-1800's.
In the 1660's in Europe, during the great plague outbreaks, we saw the emergence
of the plague doctor outfit. Now this outfit is very well known for the mask with the long beak,
but that long beak had a purpose: it was to contain nice-smelling herbs, maybe a little
vinegar to combat the "evil" miasmatic smells.
-This book, written by Manoel Da Gama Lobo in 1881, discusses how the association of stagnant, foul smelling swamps
with epidemic diseases like yellow fever, was used as evidence for the miasma theory of disease.
In reality, the problem was the mosquitoes rather than the smell.
-While we know now that the miasma theory was not accurate, it actually had some positive results.
Because they thought it was the bad smelling air and all the detritus around them that caused the sickness,
it resulted in widespread sanitation systems, widespread cleanups throughout parts of Europe,
the United States, and elsewhere. And that actually ended up helping curb contagious diseases that were waterborne especially,
like cholera, but also things like malaria and yellow fever because by cleaning up that foul smelling water, you also
eliminated where the mosquitoes would breed. Now, on top of combating the bad smells, they also tried to
use good smells when it came to cleaning. Now, ask yourself, what does the smell of clean,
what does that smell like to you? Does it smell like bleach? Or maybe citrus? Evergreen?
Who knows? We all have different types of smells that we associate with clean. Now, back in the day, they associated some
fairly harsh chemicals that they used to clean with. And, in fact, I can smell this wafting off of here as well.
Now 150 years ago or more, if you were walking down the city streets, maybe in some highly
populous city like Philadelphia, for instance, what do you think you would smell? Well, probably not roses.
Due to the high density of population and the lack of sanitation at the time,
more likely you'd be smelling something like what I'm smelling right now coming from this barrel:
maybe some rotten fish, some rotting vegetable matter, maybe even some "night soil." Look it up, I'm not going to talk about it.
-This book, here, talks about an early theory of infection. It was written in the 10th century by Ibn Cena, or Avicenna.
He was a Persian physician whose encyclopedic "Libre Canonis" presented an early theory of contagion,
including the concept that diseases could be transmitted via breath.
This book was written by Athanasius Kircher, and was published in 1659,
also representing an early theory of infection. Kircher described the presence of little worms,
or "animalcules," in the blood and concluded that the plague was caused by microorganisms.
-Our last theory today is germ theory, the theory that persists today. And it basically states that
we get sick because of harmful germs that invade our body and cause infection, sickness, or death.
Now, this started around the 1860's and, because of the understanding of how we got sick, it enabled
us to move forward with medicine to combat that. Things that arrived like antibiotics in
the early 20th century. So our last theory, as germ theory, is the one that we're sticking with for now.
-Today, we know that washing our hands frequently and wearing masks can help stop or slow the spread of diseases.
However, in the 19th century, hand washing was somewhat of a novel idea. In 1847, Ignac Semmelweis
established a new form of prophylaxis for physicians to use when delivering babies:
hand washing. This simple step prevented many women from dying of childbed fever.
-Thank you for joining us on this tour of Going Viral: Infection through the Ages.
I hope you had a disturbingly informative good time!
But I also hope you'll take with it some important information like, well,
wash your hands, stay safe, and we hope to see you here at the Mütter Museum very soon!
-Chrissie, what's your sign? -I'm actually on the cusp of Pisces and Aries,
so let's check both! -Let's check both. So what does it say here?
-Pisces: your humors are hot and wet. Open windows on the north side of your house
to dry and cool your environment. Do I live?
No, I die! -Oh well, not so effective. What about your other sign, Aries?
-My humors are hot and dry. Ease your digestion by eating cold foods like salad.
Do I live? No, sadly I die again.