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No. 2534:
History and Epidemic Disease

Today, medical historian Helen Valier offers us a new look at history and epidemic disease.  The University of Houston's Honors College presents this program about the machines that make our civilization run, and the people whose ingenuity created them.  

A 19th century version of an old folksong recalls responses to the 1665 Great Plague of London.  Ring a-ring o'roses, a pocket full of posies, atishoo, atishoo we all fall down

Sheet Music for Ring a Ring O’Roses from Alice Bertha Gomme

In those days, we stuffed our pockets and noses full of sweet smelling flowers and herbs in an effort to ward off the ‘miasma' or disease-carrying stench.  Tamiflu and 'flu vaccines may have replaced a pocket of posies in our disease fighting armory. But perhaps now as we face the growing epidemic of swine flu, we can look back on this old song and reflect on a timeless fear: that infectious disease — silent, invisible, and unpredictable — might just yet creep up and have us all fall down. 

A portrait of Samuel Pepys completed by John Hayls in 1666Seventeenth-century English diarist Samuel Pepys recorded the widespread panic and terror caused by the rapid spread of the Great Plague. His telling is certainly highly dramatic in parts. He recalls an incident in which the coachman of his Hackney Carriage (the old version of a yellow cab) suddenly became delirious with the plague as he drove Pepys to an appointment. But Pepys' diary also points us to a deeper, more enduring question. How do we as a society deal with epidemic disease? What does the past have to tell us about this question? 

Historian Charles Rosenberg looks at past responses to epidemic disease, including the Great Plague. Then he proposes that we're often slow to acknowledge a coming epidemic. We dismiss or minimize reports. Economic and social requirements demand that we continue as normal. When the burden of disease reaches a point at which it can no longer be ignored, we tend to panic. We begin to search for a rational explanation that'll give us at least the illusion of control over an arbitrary and random enemy. We go out into the marketplace and purchase what we can: facemasks, hand sanitizer, boot-legged Tamiflu: anything that'll give us the sense that we're guarding our essential vulnerability to infection. 

A 17th century doctor wearing a mask in which to carry posies of flowers and herbsThe next step in this pattern according to Rosenberg is our willingness to blame and scapegoat. In Pepys day foreigners, immigrants and the poor were targets of legal sanction and moral reproach. In today's world we fret and finger point over porous borders and the rapidity of global travel. We ask ourselves, are they major factors behind disease spread? As in Pepys day such accounts and particularly the suggested remedies are heavily moral and political in tone and content. 

So are we to learn anything from the history of epidemic disease? Perhaps yes, if we're able to interpret our actions as age-old attempts to explain frightening and unpredictable events. Through explanation we seek control. Epidemic disease, even in a high technology world, is a reminder to all of us of the frailties and phobias that make us all so fallible as human beings. But if we can find humility in our fears, then perhaps we've made use of the lessons of history after all. 

I'm Helen Valier, at the University of Houston, where we're interested in the way inventive minds work. 

(Theme music)

Explaining Epidemics: And Other Studies in the History of Medicine C. Rosenberg. Cambridge: Cambridge University Press, 1992. 

Read the Diary of Samuel Pepys online at

A kindergarten class perform the nursery rhyme:


  1. A 17th century doctor wearing a mask in which to carry posies of flowers and herbs.
  2. A portrait of Samuel Pepys completed by John Hayls in 1666.
  3. Sheet Music for Ring a Ring O'Roses from Alice Bertha Gomme, The Traditional Games of England, Scotland, and Ireland, London: David Nutt (1898), p. 108. 

Helen K. Valier (BA, University of Cambridge, MSc., Ph.D., University of Manchester, UK) is an historian of medicine and an Instructional Assistant Professor with the Department of History and The Honors College at the University of Houston. As coordinator for the Medicine & Society Program at Houston, she creates curricula for undergraduate students wishing to study the history, ethics and politics of medicine and healthcare. Her first book (co-authored with J.V. Pickstone) Community, Professions and Business (Manchester NHS Trust, 2008) was a study of the UK National Health Service in Manchester, England, across half a century. She is currently writing a book on the comparative history of clinical trials in cancer therapy in the UK and USA.