-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.
