Ann G. Carmichael

Studying causes of death in the past: problems and models.

The authors provide an overview of articles in this issue of Historical Methods which is devoted to new approaches to the historical study of causes of death. Topics covered include cause-of-death registration in the past assessing long-term changes in causes of death and suggestions for future research directions. (ANNOTATION)

Infection hidden hunger and history

The relationships among undernutrition infection and mortality among the worlds poor are examined and an attempt is made to examine the social and demographic significance of these links. Comparisons are made between the present situation of populations in developing countries and that of populations of the past particularly regarding synergism which means that the behavior of most diseases is shaped by the nutritional state of the affected host. The importance of taking into account the morbidity patterns of past populations when studying mortality is stressed.

Reflections on the classification of causes of death

On November 11–14 1993, Indiana University hosted a conference on the ‘History of Registration of Causes of Death’, with funding from the US National Institute on Aging and the National Institute of Child Health and Human Development. The conference brought together historians of medicine and historically-oriented demographers and epidemiologists to discuss the origins of the recording of causes of death and the possible uses of these documents in demographic and epidemiological research. Demographers and epidemiologists would like to use long-run series of causes of death to examine the effects of social and economic conditions, the availability of health care, and specific risk factors on mortality. Many important questions (such as the effects of early health experiences on old-age morbidity and mortality) are best studied with data on changes over long periods of time. However, it is very difficult to construct a consistent series of deaths by cause over time because advances in medical theory and practice have led to significant changes in the classification of diseases. For example, it is unclear whether the prevalence of heart disease was increasing, decreasing, or constant before 1940, because heart disease was often classified under other categories. The essays in this special number of Continuity and Change offer a range of insights on the historical circumstances in which cause-of-death registration emerged. They help us to see the ways in which medical theory, medical practitioners, and their increasingly influential professional organizations shaped the conceptualization of reporting of causes of death. Gunter Risses ‘Causes of death as a historical problem’ serves as an overview of the problems that social historians of medicine find underlying any continuous history of mortality experience. Above all, he argues, medical historians react as historians, wary of Whiggish confidence in state records without attention to the ideologies governing their creation.

Universal and particular: the language of plague, 1348-1500.

What disease or diseases caused the recurrent, demographically punishing epidemics that Europeans called plague? During the last twenty years a once prevalent historical consensus about causes and consequences of European plagues has dissolved, prompting new archival research as well as novel technological and interdisciplinary approaches to material evidence. The core debates about the history of plague are not, however, limited to scholars of medieval and early modern Europe. Molecular biologists over the last decade have determined that the organism that causes plague today, Yersinia pestis, is a relatively recent emergent pathogen descended from a significantly less lethal gastro-intestinal parasite, Yersinia pseudotuberculosis. Furthermore, fifty years ago microbiologists accepted a model of three different “biovars”—biochemically different variants—of Yersinia pestis, which were tidily aligned to three historical pandemic waves: antiqua, mediaevalis, and orientalis. That synthesis, too, is seriously challenged. There are instead at least eight Yersinia pestis strains and four biovars, and all have emerged within the last 5000 to 20,000 years.1 This organism remains a likely perpetrator of the great plagues in Europe because all Yersinia pestis biovars can be extraordinarily lethal in human bodies. Most medievalists, including those who doubt that the Black Death and subsequent plagues could have been caused by Yersinia pestis, make a modern assumption that the Black Death indeed had some unique microbial cause. No one yet has argued in a sustained fashion that the plague was a “perfect storm” of many different epidemic infectious diseases, but one could.2 Nor has a radical scepticism emerged—for example, that the causes of each and every local or regional epidemic called peste/pestilentia by contemporaries need to be investigated separately, unrelated to other local contexts—but that, too, might be possible. If we would be truly rigorous, we cannot assume that a “plague” in one place was due to the same specific microbial cause as a pestilence in another locality, even during this worst of all recorded pandemics. There needs to be evidence for such a claim. During the High Middle Ages Europe was thickly settled, but profoundly rural; great cities were exceptional, and regional markets were not well integrated.3 In the early modern centuries, market centres were far better connected: a significant epidemiological difference. Scholars, nevertheless, analyse individually later medieval and early modern pestilences, accepting local differences and local historical contexts. Nor do most maintain that, given one location, all the sizeable pestilences over these later centuries were necessarily due to the same cause. Historians simply do not accept that “plague” (peste) had or has one universal translation applicable over both time and space—except when we consider the Black Death. In other words, some of the doubts expressed in recent years are solely about Yersinia pestis as the cause of plagues in Europe, and do not contest the view that a single pathogen was principally responsible for the pan-European epidemic of 1347–50. Even more remarkably, there has been little doubt among the doubters that whatever microbe caused the Black Death also caused the next epidemic wave of the 1360s—and so on. Plague language, both modern and medieval, thus begins with plagues universality.

Past Fasts: Medieval Saints with the Will to Starve@@@Holy Anorexia@@@Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women

Foreword Note on the Text Authors Note The Boston Poems Cups 1-12 The Park The Faerie Queene The Moth Poem Image-Nations -4 Les Chimeres Charms Great Companion: Pindar Image-Nations 5-14 and Uncollected Poems Streams I Syntax Pell Mell Great Companion: Robert Duncan Streams II Exody Notes Great Companion: Dante Alighiere Wanders So Oh! Afterword Index of Titles and First Lines