History of Medicine

 RICHARD MEAD AND PLAGUE

 

         In May 1719, several crewmembers on trading vessels arriving at Marseilles from the Middle East fell ill and died. The Chief Surgeon of Health found no evidence of contagion, only that the men suffered a "malignant fever."  By July, however, plague was recognized, the city was overwhelmed with the dead and dying, the well-to-do were fleeing, doctors and clergy were fleeing, even food producers such as bakers and butchers left town. The city was desperate and short of food. Beggars and galley slaves were enlisted to dig mass graves and bury the dead and smokey fires lit up the streets. Hospitals were overwhelmed and makeshift facilities sprang up. All to no avail. The final tally of the dead is estimated at between 40,000 and 60,000, with more in the surrounding Provence area. 

Translation of de Croissante's
work (Internet Archive)

       

         The following year, the “Counsellor and Orator” of Marseilles, Pichatty de Croissainte, published a journal of the plague, detailing the tragic events. Across the Channel, an English translation of de Croissainte’s journal appeared almost immediately. England’s last experience with plague had been the great London epidemic in 1665, a devastating event still in public memory. Daniel Defoe’s Journal of the Plague of London of 1722 is thought to be based on de Croissante’s work. The British Secretary of State asked London’s most prominent physician, Dr. Richard Mead, to advise on measures to prevent plague from visiting British shores. 

Richard Mead (Wikipedia)

         Richard Mead was born in Stepney, near London, in 1673. Following a nonconformist primary school education, he studied at Utrecht, Leyden (botany and medicine), and Padua (philosophy and medicine). He opened a practice in London in 1696, rising quickly in prominence. He gave anatomy lectures to the Company of Surgeons, was appointed physician to St. Thomas’ Hospital, received a medical degree from Oxford, a fellowship in the College of Physicians, and was elected to the Royal Society. He encouraged the wealthy Thomas Guy to fund a hospital for “incurables,” now the famous Guy’s Hospital. John Radcliffe, the leading physician in London (after whom the illustrious Radcliffe Infirmary is named), and physician to William III, took a liking to

John Radcliffe (Wikipedia)

Mead. When Radcliffe died in 1714, Mead moved into his house and inherited his fashionable gold-headed cane. The cane passed to a few later distinguished physicians and currently resides at the College of Physicians. Gold-Headed Cane awards for excellence in medicine are now granted by several medical societies and schools.

         

John Radcliffe's Cane on cover of The Gold-
Headed Cane by William Macmichael
 (Internet Archive)

Mead was an interesting choice to advise on plague. He had no direct experience with plague but carefully studied its history. He was one of the best educated men of his time, a friend of scientific figures like Halley (of comet fame) and Newton, of leading physicians, and a schoolmate and correspondent of Herman Boerhaave, the famous clinician in Leyden. He had published a work on poisons and a work concerning celestial influences on health based on the new Newtonian mechanics, a book that influenced Franz Mesmer in his formulation of the magnetic fluid theory of disease. 

         Mead condensed his thoughts in a brief work entitled A Short Discourse Concerning Pestilential Contagion, and the Methods to Be Used to Prevent It. On page two Mead writes, “Contagion is propagated by three causes, the air; diseased persons; and goods transported from infected places.” Mead recognized that plague moved from place to place, ruling out a generally

Mead's work on plague and contagion
(Internet Archive)

contaminated atmosphere, a common “non-contagionist” target, as a source of epidemics. When Mead spoke of air, he was referring to local air, into which the sick released poisonous atoms, a phenomenon to explain how people not in direct contact with the sick still developed plague. These “contagious atoms” (his words) caused disease nearby but were dispersed by wind to become ineffective more distantly, something he compared to London’s smokey air. The ideas are similar to those voiced by Girolamo Fracastoro in 1546, though Mead does not mention him. Neither man could have known about rats and fleas as carriers and transmitters of plague but Mead’s concept of contagion in the local atmosphere is a reasonable substitute. Thomas Sydenham, incorrectly, held that epidemics resulted from an interaction of atmospheric factors and emanations from the earth, a concept stemming from Hippocrates.

In short, Mead concluded that a quarantine would be effective. A quarantine was duly invoked, and England remained free of the pestilence. Considering that rats sneaking ashore could have foiled the quarantine measures, luck was probably a factor, though the basic idea has proven to be sound. Mead’s book on plague went through nine editions and appeared in several languages. Though some recommendations changed, the basic ideas remained the same.

         Mead was also involved in the first experiment with variolation (inoculation with live smallpox material to produce immunity), introduced by Lady Mary Montagu from Turkey. Six prisoners condemned to death received inoculation into the skin. All survived and were set free. Mead and other physicians involved in the trials recommended variolation, even in the face of a 2-3% mortality from the procedure.

         In the 1740s, Mead helped establish a foundling hospital. He, in concert with the artist William Hogarth, encouraged artists to show their creations in the hospital’s halls as a way to raise funds. 

Foundling Hospital (Wellcome Library and Wikipedia)

Gainsborough, Joshua Reynolds, and Hogarth exhibited works. It was the first public art gallery in London and influenced the formation of the Royal Academy of Art. 

Foundling Hospital Chapel, where Handel regularly performed his Messiah.
(Wikipedia)

         Mead wrote other works, managed a large practice, dispensed medical consultations to apothecaries in coffee houses (common at the time), collected books and works of art, and was a generous humanitarian. He was considered by C.E.A. Winslow, former professor of public health at Yale University School of Medicine, and others, one of the pioneers of preventive medicine.

         

SOURCES:

 

Meade, R H, In the Sunshine of Life: a Biography of Dr. Richard Mead, 1673-1754. 1974; Dorrance & Co., Philadelphia.

 

Winslow, C E A, “A Physician of Two Centuries Ago: Richard Mead and his Contributions to Epidemiology.” Bull History of Medicine 1935; 3: 509-44.

 

Roos, A M, “Luminaries in Medicine: Richard Med, James Gibbs, and Solar and Lunar Effects on the Human Body in Early Modern England.” Bull History of Medicine 2000; 74(3): 433-457.

 

Williamson, R, “The Plague of Marseilles and the Experiments of Professor Anton Deidier on its Transmission.” Medical History 1958; 2: 237-52.

 

Hattie, W H, “Richard Mead: A father of Preventive Medicine.” Canad Medical Assoc Journal 1928; 19(1): 101-5.

 

Zuckerman, A, “Plague and Contagionism in Eighteenth-Century England: The Role of Richard Mead.” 2004; Bull Hist Med 78(2): 273-308.

         

Anon, “The Great Plague of Marseilles.” BMJ  1900; May 12, p1172.

 

Mead, R, A Short Discourse Concerning Pestilential Contagion, and the Methods to be Used to Prevent It. London, 1720.

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