Assessing the existence of the male-female health-survival paradox in the past: Dental caries in medieval London.

OBJECTIVES: This study seeks to identify signals of the male-female health-survival paradox in medieval London. MATERIALS AND METHODS: This study uses skeletal data on age, sex, dental caries (n = 592) and antemortem tooth loss (n = 819) from adult individuals from medieval London cemeteries (c. 1200-1540 CE). The association between age and dental caries was assessed using binary logistic regression. The associations among age, time period (pre- vs. post-Black Death), oral biomarker (dental caries or antemortem tooth loss), and sex were tested using hierarchical log-linear analysis. RESULTS: The analyses reveal significantly higher odds of dental caries with increasing adult ages, more older adults after the Black Death, different age distributions of dental caries between the sexes, and a greater decrease in the prevalence of dental caries for females after the Black Death. These results appear not to be an artifact of trends in AMTL. However, this study does not yield evidence suggesting that females experienced both a survival advantage and a decline in oral health at late adult ages after the Black Death relative to males. CONCLUSIONS: These results do not provide evidence of the existence of a male-female health-survival paradox, but they do corroborate existing evidence of improvements in health in general in the aftermath of the Black Death. The decreased prevalence of dental caries after the Black Death may reflect dietary improvements or the effects of selective mortality during the epidemic.

Plague and the Mongol conquest of Baghdad (1258)? A reevaluation of the sources.

This paper reexamines the sources used by N. Fancy and M.H. Green in "Plague and the Fall of Baghdad (1258)" (Medical History, 65/2 (2021), 157-177). Fancy and Green argued that the Arabic and Persian descriptions of the Mongol sieges in Iran and Iraq, and in particular, in the conquest of Baghdad in 1258, indicate that the besieged fortresses and cities were struck by Plague after the Mongol sieges were lifted. This, they suggested, is part of a recurrent pattern of the outbreak of Plague transmitted by the Mongol expansion across Eurasia. Fancy and Green concluded that the primary sources substantiate the theory driven by recent paleogenetic studies indicating that the Mongol conquests of the thirteenth century set the stage for the massive pandemic of the mid-fourteenth century. The link between the Plague outbreak and the Mongol siege of Baghdad relies on three near-contemporaneous historical accounts. However, our re-examination of the sources shows that the main text (in Persian) has been significantly misunderstood, and that the two other texts (in Syriac and Arabic) have been mis-contextualized, and thus not understood properly. They do not support the authors' claim regarding Plague epidemic in Baghdad in 1258, nor do other contemporary and later Arabic texts from Syria and Egypt adduced by them, which we re-examine in detail here. We conclude that there is no evidence for the appearance of Plague during or immediately after the Mongol conquests in the Middle East, certainly not for its transmission by the Mongols.

The Plague in Crete During the 19th Century.

The plague is one of the most dangerous infectious diseases that can affect mankind. The disease has caused countless pandemics over the centuries in many parts of the world, mainly Asia, Africa, and Europe, and has caused over 200 million deaths, making it one of the greatest scourges of mankind throughout the ages. Similar to the rest of Greece, Crete was affected for many years by the plague during the 19th century, which caused significant mortality, both in the cities and the countryside. The lack of doctors, the absence of organized health systems, the ignorance of the origin and modes of transmission, and the belief of the island's Muslim conquerors in destiny and God-given diseases made the spread of the plague very easy, while simultaneously making its control, with measures to protect public health, extremely difficult. This led to the repeated decimation of the island's population, with immeasurable social and economic consequences for its progression and future development.

Historical microbiology: researching past bioevents by integrating scholarship (re)sources with paleomicrobiology assets.

The analysis of past epidemics and pandemics, either spontaneous or of human origin, may revise the physical history of microbiota and create a temporal context in our understanding regarding pathogen attributes like virulence, evolution, transmission and disease dynamics. The data of high-tech scientific methods seem reliable, but their interpretation may still be biased when tackling events of the distant past. Such endeavors should be adjusted to other cognitive resources including historical accounts reporting the events of interest and references in alien medical cultures and terminologies; the latter may contextualize them differently from current practices. Thus 'historical microbiology' emerges. Validating such resources requires utmost care, as these may be susceptible to different biases regarding the interpretation of facts and phenomena; biases partly due to methodological limitations.

Bacteria and viruses have always impacted humankind. They do this directly by causing illness or indirectly by destroying crops and threatening livestock. We can learn a lot by studying disease events of the past ­ for example, we can see how bacteria and viruses have changed over time and predict how they might change in the future. This knowledge could be important to understanding present disease events and predicting future ones. In this review, we propose the concept of 'historical microbiology', which encourages collaboration between scientists, doctors, historians and linguists to provide historical, linguistic and cultural context to our scientific understanding of diseases of the past.

The Black Death in Hereford, England: A demographic analysis of the Cathedral 14th-century plague mass graves and associated parish cemetery.

OBJECTIVES: This study explores the paleoepidemiology of the Black Death (1348-52 AD) mass graves from Hereford, England, via osteological analysis. Hereford plague mortality is evaluated in the local context of the medieval city and examined alongside other Black Death burials. METHODS: The Hereford Cathedral site includes mass graves relating to the Black Death and a 12th-16th century parish cemetery. In total, 177 adult skeletons were analyzed macroscopically: 73 from the mass graves and 104 from the parish cemetery. Skeletal age-at-death was assessed using transition analysis, and sex and stress markers were analyzed. RESULTS: The age-at-death distributions for the mass graves and parish cemetery were significantly different (p = 0.0496). Within the mass graves, young adults (15-24 years) were substantially over-represented, and mortality peaked at 25-34 years. From 35 years of age onwards, there was little variation in the mortality profiles for the mass graves and parish cemetery. Males and females had similar representation across burial types. Linear enamel hypoplasia was more prevalent within the mass graves (p = 0.0340) whereas cribra orbitalia and tibial periostitis were underrepresented. CONCLUSIONS: Mortality within the Hereford mass graves peaked at a slightly older age than is seen within plague burials from London, but the overall profiles are similar. This demonstrates that young adults were disproportionately at risk of dying from plague compared with other age groups. Our findings regarding stress markers may indicate that enamel hypoplasia is more strongly associated with vulnerability to plague than cribra orbitalia or tibial periostitis.

Coping While Black: Comparing Coping Strategies Across COVID-19 and the Killing of Black People.

In the same year the world was thrown into turmoil with COVID-19, the USA also experienced a surge in attention given to the plight of Black people in the policing system, following the killing of George Floyd. Both the COVID-19 pandemic and the ongoing "pandemic" of police and White violence against Black people in the USA cause significant amounts of stress, disproportionately affecting Black people. Utilizing qualitative analysis of responses from 128 Black-identifying participants to an online survey, this investigation seeks to understand how the coping strategies of Black people in the USA compare between the racism-related stressor of police killings of Black people and the generalized stressor of the COVID-19 pandemic. Findings demonstrate that while Black people use overlapping strategies to deal with stress, clear patterns exist with regard to differences across racism-related and non-racism-related stressors. We report important implications for understanding the impact of COVID-19 on Black people, cultural understandings of research on coping, and Black mental health more broadly.

Emergence, continuity, and evolution of Yersinia pestis throughout medieval and early modern Denmark.

The historical epidemiology of plague is controversial due to the scarcity and ambiguity of available data.1,2 A common source of debate is the extent and pattern of plague re-emergence and local continuity in Europe during the 14th-18th century CE.3 Despite having a uniquely long history of plague (∼5,000 years), Scandinavia is relatively underrepresented in the historical archives.4,5 To better understand the historical epidemiology and evolutionary history of plague in this region, we performed in-depth (n = 298) longitudinal screening (800 years) for the plague bacterium Yersinia pestis (Y. pestis) across 13 archaeological sites in Denmark from 1000 to 1800 CE. Our genomic and phylogenetic data captured the emergence, continuity, and evolution of Y. pestis in this region over a period of 300 years (14th-17th century CE), for which the plague-positivity rate was 8.3% (3.3%-14.3% by site). Our phylogenetic analysis revealed that the Danish Y. pestis sequences were interspersed with those from other European countries, rather than forming a single cluster, indicative of the generation, spread, and replacement of bacterial variants through communities rather than their long-term local persistence. These results provide an epidemiological link between Y. pestis and the unknown pestilence that afflicted medieval and early modern Europe. They also demonstrate how population-scale genomic evidence can be used to test hypotheses on disease mortality and epidemiology and help pave the way for the next generation of historical disease research.

Medical knowledge of medieval physician on the cause of plague during 1347/8-1351: traditional understandings to poison theory.

This article sets its investigative goal on determining the medical knowledge of medieval physicians from 1347-8 to 1351 concerning the causes of plague. As the plague killed a third of Europe's population, the contemporary witness at the time perceived God as the sender of this plague to punish the human society. However, physicians separated the religious and cultural explanation for the cause of this plague and instead seek the answer to this question elsewhere. Developing on traditional medical knowledges, physicians classified the possible range of the plague's causes into two areas: universal cause and individual/particular causes. In addition, they also sought to explain the causes by employing the traditional miasma-humoral theory. Unlike the previous ones, however, the plague during 1347-8 to 1351 killed the patients indiscriminately and also incredibly viciously. This phenomenon could not be explained by merely using the traditional medical knowledge and this idiosyncrasy led the physicians employ the poison theory to explain the causes of plague more pragmatically.

EL séptimo sello (1957), entre pestes y sindemias / The Seventh Seal (1957), between plagues and syndemics

Tal que, a otros muchos, sin duda, con el inicio de los confinamientos decretados para intentar contener la actual pandemia, nos vino a la cabeza El séptimo sello (1957 ) de Bergman, relacionando los acontecimientos del tiempo en que se desarrolla la película con los que vivíamos y vivimos actualmente: la epidemia de Peste Negra que asolaba Suecia en el siglo XIV de un lado y la pandemia por Covid-19 de otro, sindemias ambas como algunos prefieren llamarlas.Tomando como disculpa la obra de Ingmar Bergman nuestra pretensión es hacer algunas comparaciones entre la peste medieval y la pandemia actual aportando algunas reflexiones y opiniones personales surgidas muchas de ellas de nuestra propia experiencia durante estos largos meses. (AU)

Such as many others, without question, the beginning of the decreed lockdowns to contain the current pandemic, Bergman's The Seventh Seal (1957) came to our minds, relating the film time events with the current ones: the Black Death pandemic which isolated Sweden in XIV on one hand, and Covid-19 pandemic on the other, both syndemics as some prefer to name them.Using Ingmar Bergman's work as a reference, our aim is to make comparisons between the medieval plague and the actual pandemic, contributing with some reflections and personal opinions, many of them emerged from our own personal experience during these long months. (AU)

Genetic Evidence of the Black Death in the Abbey of San Leonardo (Apulia Region, Italy): Tracing the Cause of Death in Two Individuals Buried with Coins.

The Abbey of San Leonardo in Siponto (Apulia, Southern Italy) was an important religious and medical center during the Middle Ages. It was a crossroads for pilgrims heading along the Via Francigena to the Sanctuary of Monte Sant'Angelo and for merchants passing through the harbor of Manfredonia. A recent excavation of Soprintendenza Archeologica della Puglia investigated a portion of the related cemetery, confirming its chronology to be between the end of the 13th and beginning of the 14th century. Two single graves preserved individuals accompanied by numerous coins dating back to the 14th century, hidden in clothes and in a bag tied to the waist. The human remains of the individuals were analyzed in the Laboratorio di Antropologia Fisica of Soprintendenza ABAP della città metropolitana di Bari. Three teeth from each individual were collected and sent to the Istituto Zooprofilattico Sperimentale di Puglia e Basilicata to study infectious diseases such as malaria, plague, tuberculosis, epidemic typhus and Maltese fever (Brucellosis), potentially related to the lack of inspection of the bodies during burial procedures. DNA extracted from six collected teeth and two additional unrelated human teeth (negative controls) were analyzed using PCR to verify the presence of human DNA (ß-globulin) and of pathogens such as Plasmodium spp., Yersinia pestis, Mycobacterium spp., Rickettsia spp. and Brucella spp. The nucleotide sequence of the amplicon was determined to confirm the results. Human DNA was successfully amplified from all eight dental extracts and two different genes of Y. pestis were amplified and sequenced in 4 out of the 6 teeth. Molecular analyses ascertained that the individuals buried in San Leonardo were victims of the Black Death (1347-1353) and the data confirmed the lack of inspection of the corpses despite the presence of numerous coins. This study represents molecular evidence, for the first time, of Southern Italy's involvement in the second wave of the plague pandemic.

[Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century]. / A propósito de pandemias: Ibn Jatima de Almería anticipa el concepto fisiopatológico de fallo multiorgánico en el siglo XIV.

In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn Jatima from Almeria, wrote Treatise on the Plague, in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty.

["The pestilence vicious was ": "The Black Death" of XIV century in Rus].

The pandemic of plague, that affected Eurasia in middle of 40s - early 50s of XIV century and remained in history as as "The Black Death", became one of the most death-dealing epidemics that ever stroke humankind and recorded in historical sources. Owing to that many documentary and narrative sources remained intact, the history of this pandemic is considered as well examined. This is evidenced by enormous historiography of the problem, including works of the most different character and orientation. Yet, it should be admitted that in national Russian historiography the issues related to history of this pandemic on the Russian land remain to be insufficiently studied. This condition is related to limitation of source base from one hand and to inadequate development of comprehensive approach to exploration of this page of national history. The article, on the basis of analysis of chronicle texts, reconstructs general picture of the pandemic in the Russian land and characterizes its consequences.

Assessing the origins of the European Plagues following the Black Death: A synthesis of genomic, historical, and ecological information.

The second plague pandemic started in Europe with the Black Death in 1346 and lasted until the 19th century. Based on ancient DNA studies, there is a scientific disagreement over whether the bacterium, Yersinia pestis, came into Europe once (Hypothesis 1) or repeatedly over the following four centuries (Hypothesis 2). Here, we synthesize the most updated phylogeny together with historical, archeological, evolutionary, and ecological information. On the basis of this holistic view, we conclude that Hypothesis 2 is the most plausible. We also suggest that Y. pestis lineages might have developed attenuated virulence during transmission, which can explain the convergent evolutionary signals, including pla decay, that appeared at the end of the pandemics.

A propósito de pandemias: Ibn Jatima de Almería anticipa el concepto fisiopatológico de fallo multiorgánico en el siglo XIV / Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century

En el año 1348 una pandemia de la llamada «peste negra» asoló la humanidad y cambió el orden social, económico y geopolítico del mundo, tal como sucede actualmente con la causada por el coronavirus SARS-CoV-2. El médico del reino nazarí de Granada, Ibn Jatima de Almería, escribió un Tratado sobre la peste en el cual se encuentran semejanzas epidemiológicas y clínicas entre ambas plagas. Así, dentro del contexto de la medicina greco-árabe, descubrió el contagio respiratorio y por contacto de la peste, y atribuyó su fisiopatología a una insuficiente refrigeración pulmonar del calor innato generado en el corazón y vehiculizado por el humor sanguíneo, equivalente al sistema de trasporte de oxígeno, lo cual generaba residuos tóxicos, como los radicales libres, que abocaba a un fallo multiorgánico (FMO) irreversible, factor de mortalidad como en la Covid-19. Por su similitud, sería el primer antecedente conocido del concepto fisiopatológico de FMO, hallazgo que enriquece nuestro patrimonio científico-histórico de la especialidad. (AU)

In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn Jatima from Almeria, wrote Treatise on the Plague, in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty. (AU)

Regarding pandemics: Ibn Jatima from Almería anticipates the physiopathological concept of multi-organ failure in the 14th century.

In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn-Jatima from Almeria, wrote "Treatise on the Plague", in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty.

El médico (2013): Medicina en la Edad Media / The physician (2013): Medicine in the Middle Ages

En la Inglaterra del siglo XI, un huérfano de 8 años llegará a ser el aprendiz de un cirujano-barbero. Aprende las habilidades básicas de este oficio (sacar dientes, hacer sangrías y pequeñas cirugías) pero no es suficiente. Así que decidirá llegar a ser un médico. Para ello, viajará a Oriente Medio donde se encuentra la más famosa escuela de Medicina. En Persia, logrará entrar como alumno en la madrasa de Ibn Sina (Avicena) donde recibirá una formación teórica y práctica de la medicina, así como de otras disciplinas para lograr ser un médico. (AU)

England, XI century, an 8-year-old orphan becomes a surgeon-barber apprentice. Learning basic skills of this trade (pulling teeth, bloodletting and minor surgeries) but this is not enough. So he decides to become a physician travelling to Middle East, where the most famous medical school of the world was. In Persia, he will be able to enroll as student at Ibn Sina´s madrasa (Avicenna) where he will receive theoretical and practical training in medicine as well as other disciplines to become a physician. (AU)

Julian of Norwich's Mystic Vision as a Site for Rebuilding Societal Unity in the Aftermath of the Black Death.

The woman known as Julian of Norwich, the first female author in the English language, survived a pandemic which tore English society apart. The first outbreak of the bubonic plague in Norwich was in 1349 when Julian was only six years old and continued for another twenty-one years of sporadic outbreaks in East Anglia. Despite this formative experience, scholarly treatments of the plague's impact on Julian's writing focus primarily on her use of maternal imagery as a pre-existing general trend in mystic texts which developed a new significance in post-plague religious writing. The divine mother figure was now not only a creator but a source of protection and comfort. While this is certainly true, this is also perhaps a bit myopic. A holistic view of her book of "Showings" reveals that the plague and its aftermath are actually central to her theosophical project. By evoking imagery of the Black Death in her explanation of the Passion and the existence of suffering, Julian of Norwich sought to restore unity to medieval English society through a re-envisioning of the Holy Trinity as Earthly authority figures: family/household, Holy Mother Church, and feudal lord.

Misunderstandings of the transmission of the Black Death to Western Europe : a critical review of De Mussis's account.

This article aims to critically review de Mussis's report of the events at Caffa. De Mussi says in his account that Tartars catapulted their dead compatriots infected by the plague into the besieged city of Caffa in order to contaminate the Genoese defending the city and that some Genoese galleys fleeing from the city transported the disease to Western Europe. Some historians interpret his report of Tartars catapulting plague-infected bodies as an act of biological warfare, and others do not trust his account as a reliable historical record, while some works rely on his account, even though they do not interpret it as evidence of biological warfare. This article tries to determine whether his account is true or not, and explain historical contexts in which it was made. De Mussi was not an eye-witness of the war between the Tartars and the Genoese in the years of 1343 to 1437 in Caffa, contrary to some historians' arguments that he was present there during the war. In addition, he understands and explains the disease from a religious perspective as does most of his contemporary Christians, believing that the disease was God's punishment for the sins of human beings. His account of the Tartars catapulting their compatriot's bodies may derive from his fear and hostility against the Tartars, thinking that they were devils from hell and pagans to be annihilated. For de Mussi, the Genoese may have been greedy merchants who were providing Muslims with slaves and enforcing their military forces. Therefore, he thought that the Tartars and the Genoese were sinners that spread the disease, and that God punished their arrogance. His pathological knowledge of the disease was not accurate and very limited. His medical explanation was based on humoral theory and Miasma theory that Christians and Muslims in the Mediterranean World shared. De Mussi's account that Caffa was a principal starting point for the disease to spread to Western Europe is not sufficiently supported by other contemporary documents. Byzantine chronicles and Villani's chronicle consider not Caffa but Tana as a starting point. In conclusion, most of his account of the disease are not true. However, we can not say that he did not intentionally lie, and we may draw a conclusion that his explanation was made under scientific limits and religious prejudice or intolerance of the medieval Christian world.

History of the Plague: An Ancient Pandemic for the Age of COVID-19.

During the fourteenth century, the bubonic plague or Black Death killed more than one third of Europe or 25 million people. Those afflicted died quickly and horribly from an unseen menace, spiking high fevers with suppurative buboes (swellings). Its causative agent is Yersinia pestis, creating recurrent plague cycles from the Bronze Age into modern-day California and Mongolia. Plague remains endemic in Madagascar, Congo, and Peru. This history of medicine review highlights plague events across the centuries. Transmission is by fleas carried on rats, although new theories include via human body lice and infected grain. We discuss symptomatology and treatment options. Pneumonic plague can be weaponized for bioterrorism, highlighting the importance of understanding its clinical syndromes. Carriers of recessive familial Mediterranean fever (FMF) mutations have natural immunity against Y. pestis. During the Black Death, Jews were blamed for the bubonic plague, perhaps because Jews carried FMF mutations and died at lower plague rates than Christians. Blaming minorities for epidemics echoes across history into our current coronavirus pandemic and provides insightful lessons for managing and improving its outcomes.

[Pandemics: Lessons from the past]. / Pandémies : les leçons du passé.

Since Antiquity, pandemics periodically strike humanity. Plagues of Athens, galenic, justinianic, and medieval plagues provoked millions of deaths, and subsequent famines and socio-political changes. Smallpox was a scourge affecting the royal courts too. The influenza H1N1 of 1917 brought more deaths than the Great War. The decline of Europe benefited to the USA, dominant power during the XXth century. The present pandemic of coronavirus Covid-19 will have important economic consequences, some of then being unsuspected yet.