Mortal danger of prickly heat in medieval England. "English sweat" - a mysterious disease of the Middle Ages

We talked about many brilliant discoveries in microbiology of the second half of XIX century, which laid the foundation for a new medical discipline - epidemiology, designed to study the patterns of occurrence and development of infectious diseases, ways to combat them and prevent them. We know the situation, conditions and causes of the emergence of many infectious diseases, but we do not know how and why mass diseases stopped at a time when methods and means of their specific diagnosis had not yet been developed.

“The Red Death has been devastating the country for a long time. No other epidemic was so terrible and destructive. Blood was her coat of arms and her seal - a terrible crimson of blood! An unexpected dizziness, a painful cramp, then blood began to ooze from all the pores - and death came ... The disease from its first symptoms to the last proceeded in less than half an hour. This is how an unknown infection is described in the story “The Mask of the Red Death” by the American writer Edgar Allan Poe, in whose work the motifs of death have repeatedly sounded, including from “pestilence”. It is possible that the idea of ​​the story could have been inspired by legends about the cruel epidemics of the so-called "English prickly heat", which swept through England at the end of the 15th and beginning of the 16th century like devastating hurricanes. First, one after another, three outbreaks broke out in 1486, 1507 and 1518, then the fourth outbreak of 1529 went far beyond the borders of England, spreading over a fairly large part of the European mainland. And finally, after the fifth explosion in 1551, English sweat fever disappeared forever from the face of the earth as mysteriously as it appeared.

The first cases of the disease were recorded on August 22, 1486, shortly before Henry Tudor's victory over Richard III at Bosworth. The disease, following on the heels of the troops, reached London. Here she raged for five weeks and brought many people to the grave. The course of the disease was rapid - only a few hours continued the torment, most often ending in death, occasionally - recovery. According to the information that has come down to us, hardly a hundredth of the patients remained alive. According to contemporaries, “the disease always appeared in the form of a fever, which, after a short chill, destroyed the forces as if with one blow and, producing painful pressure in the side of the stomach, pain in the head and deafness with a tendency to sleep, poured a fetid sweat over the body. For patients, the internal heat was unbearable, but any cooling entailed death.

The second epidemic was much weaker, but the third surpassed the first in its cruelty. The disease proceeded at lightning speed: having begun acutely against the background of flourishing health without any precursors, it led to death in 2–3 hours. This epidemic continued for several months. The fourth epidemic attracted the attention of many doctors for two reasons: firstly, as mentioned above, it went beyond the borders of England, and secondly, its scope and severity of the disease varied significantly in different countries. In Copenhagen, up to 400 people died per day, in Göttingen the death rate was so high that several corpses were often buried in one grave, in Livonia, where the disease appeared a little later - in 1530, it destroyed two-thirds of the population. At the same time, out of 15,000 cases in Augsburg, only 800 people died within a few days, and in the next two weeks, out of 3,000, 600. In Strasbourg, deaths were isolated, and the total number of patients did not exceed 3,000. Only 50 people fell ill in Marburg, while the disease was rampant in Saxony, Thuringia and Franconia.

The fifth epidemic began in the English city of Shrewsbury in April 1551 and immediately took many victims to the grave, causing deep confusion among the inhabitants. Many sought salvation in flight, leaving for Scotland and Ireland, which this time the disease bypassed. Its march through the country was not as swift as in previous epidemics; to London, despite the short distance, she reached only after 3 months, and the mortality rate here was already much lower than before.

By this time, the clinical course of the disease was described in sufficient detail. Its distinguishing features were a short (one to two days) incubation period, a sudden onset, most often at night or in the morning, manifesting itself first as chills, and then high fever, pain in the heart, difficulty breathing, cramps in the calves, nausea and vomiting. In more severe cases, a headache, a sharp excitation, delirium, heavy, irresistible sleep (a soporous state) joined. Sweating was so profuse that the patients did not have time to change their underwear, and was often accompanied by swelling of the face and limbs.

Since the recovery came after the crisis, they tried to speed it up with the help of diaphoretic and "cardiac" treatment. True, in England, which the disease visited repeatedly, practical observations led to the idea that such methods do more harm than good. Therefore, the therapy soon became expectant. In Germany, at the first appearance of the disease, too drastic measures, such as sheathing the sick with blankets and feather beds, led to a high mortality rate. Many descriptions of the disease also speak of a skin rash that appeared in later stages and varied in its manifestations: sometimes in the form of dotted red spots, sometimes in the form of larger scarlet spots, sometimes in the form of millet-shaped vesicles. To this day, the etiology and epidemiology of the disease have remained unclear, but many tend to consider English sweat fever a "relative" of epidemic viral influenza.

English prickly heat is not the only disease that appeared, as it were, in order to soon disappear, leaving doctors in bewilderment. More recently, in 1967, a new disease called Marburg disease was added to the list of existing infections, as it broke out in the West German city of Marburg. Here in science Center brought a batch of green monkeys from distant Africa. According to existing international rules, the animals had to serve the prescribed period in quarantine in order to avoid any accidents. But the rules were broken this time. The monkeys were immediately taken for research blood and some organs for the preparation of cell cultures. Apparently, they were sick, as the sad consequences were not long in coming. A few days later, the laboratory staff began to become seriously ill. The patients were in a fever, hemorrhages were noted on the skin, then signs of encephalitis appeared. Of the 25 patients, seven could not be saved. Fortunately, the disease did not leave the laboratory. In 1975, two similar cases were reported in the Republic of South Africa, and one of the patients died.

Severe epidemics of hemorrhagic fever, very similar to Marburg disease, broke out the following year in Sudan and Zaire. The causative agent of fever turned out to be similar in appearance and basic properties to Marburg. It was named the Ebola virus - along the river flowing in the area where the center of the outbreak was located. This virus has been found in rodents. Ticks served as its transmitter, and mosquitoes carried from sick people to healthy people. This is the complex chain that scientists had to unravel in order to identify the cause of the epidemic outbreak. But the reason why the virus suddenly acquired the ability to multiply in the body of new hosts - humans, has not yet been clarified. There are many more such mysteries to be solved.

Among them is the variability of the clinical manifestations of a number of diseases, not only of a viral, but also of a bacterial nature. To this day, there are diseases of syphilis, which has a long history. Its descriptions are found in Chinese manuscripts dating back to 2500 BC. e. In the Pentateuch of Moses, among the punishments for non-compliance with religious rites, ulcers are mentioned, which are identical to syphilitic ones. In Indian medical treatises, there is a disease called "Persian fire", which was treated with mercury. In short, this disease is as old as the world. But in the 15th century, it suddenly assumed an epidemic character and gave clinical forms so unusual in severity and severity that, speaking of the variability of infectious diseases, one cannot but recall the epidemics of syphilis that entered the history of medicine.

The crusades played a significant role in the spread of syphilis. Some medieval healers and philosophers saw the cause of the disease in a mixture of nationalities, but this was not the case, but in the widespread debauchery characteristic of that era. In France, Germany and Switzerland, often in the same house there was a school downstairs, and a brothel upstairs. Brothels in many cities paid a fee to the clergy.

The death of young men on the battlefield led to the predominance of the female population. In this regard, numerous women's monasteries and orders began to emerge. However, life outside the monastery walls was far from chaste. The male part of the clergy did not lag behind women. In one of the reports to King Henry VII, priests were directly called the main distributors of syphilis.

In the 16th century, the clinical course of syphilis began to change. Judging by the sources that have come down to us, four periods lasting two decades can be distinguished in the development of syphilis in the 16th century: the first ends around 1520, the second - around 1540, the third - around 1560.

Already in the first period, skin lesions, which previously served as the main symptom of the disease, became quite rare, "pustules" were less pronounced and drier, blood and urine changed towards normalization. The mitigation of the disease was especially noticeable in the favorable climate of Italy, less so in France, while in Germany, with general intemperance and a more severe climate, it proceeded most severely.

In the second period, a new symptom appeared - hair loss, and even eyelashes fell out. Since that time, the custom of wearing beards has come into fashion to demonstrate one's health. A little later, tooth loss joined the hair loss. Gradually, the disease took on an increasingly mild course, because the human body developed protective reactions against its pathogen.

Another example of the variability of the clinical picture of the disease may be alastrim, or otherwise smallpox white, a kind of smallpox with a milder course and less contagious, observed here and there in recent decades; it is apparently caused by a modified variola virus.

Extensive material on the change in the "face" of a number of intestinal infections, typhus and dysentery is presented in interesting book Leningrad professor E. S. Gurevich "Variability of the clinical course of infectious diseases" (L., 1977). About how the nature of the course of acute infectious diseases caused by clostridia, spore-forming anaerobic bacilli, has changed, is described in the book by P. N. Burgasov and S. N. Rumyantsev “The Evolution of Clostridium”. This group includes diseases such as botulism, tetanus, etc. The authors cite a curious order issued back in the 9th century by Leo the Wise in order to prevent common diseases from the use of blood sausages: “According to information that has come down to royal ears, some inhabitants of the empire have a custom bends the intestines with blood and after that they eat them. The honor of my empire cannot allow such criminal human gluttony: anyone who is caught cooking and eating blood products will be stripped naked, severely punished by flogging and expelled from the empire.

Clostridium botulism lives in the soil and in the intestines of herbivores. Human infection occurs through food in which clostridia multiply and produce a toxin.

In the picture of modern infectious pathology, diseases caused by opportunistic microorganisms, that is, those that become the cause of the disease only under certain circumstances, play an increasingly important role. As a rule, this happens when the body's defenses are reduced, for example, overwork, negative emotions, etc. It is under these conditions that previously harmless microbes that peacefully inhabit the body go on the offensive. According to WHO, more people now die from septicemia caused by opportunistic microflora than from typhoid fever, paratyphoid fever, dysentery, whooping cough, scarlet fever and polio combined.

... In 1383, the small German city of Wilsnack was in turmoil. In the local church, ominous red spots began to appear on hosts (as Catholics call cakes for communion). Attempts to wash them off with water did not lead to anything - the spots appeared again and, moreover, in greater numbers. All incomprehensible phenomena in those distant times were most often explained by witchcraft. And the clergy of the Wilsnak church were not slow to find a suitable explanation for what was happening. The blame for the appearance of the spots was laid on the heretics: it is they who deliberately pierce the hosts, which begin to bleed. Hundreds of innocent victims died in the flames of fires and beatings from an angry mob.

In medieval Italy, where blood-red spots often appeared on church fabrics and bread, they were regarded as "drops of the Lord's blood." One day, red spots appeared on corn stew in the house of a peasant, and a day later appeared on other food. Disturbing rumors spread throughout the village: everyone tried to guess what the owner of the house had sinned, on which the curse of heaven had fallen. A local doctor became interested in the origin of the "bloody" spots. It turned out not to be the curse of heaven. Microorganisms were the cause of the stains. When the room was fumigated with sulfur dioxide, they died.

Serracia bacteria are usually inhabitants of water or soil. However, in the 60s of the XX century it turned out that they are not so harmless. Now they are classified as opportunistic pathogens. It turned out that under certain circumstances, serrations can cause a wide range of inflammatory diseases, affecting the urinary tract, intestines, lungs, cause meningitis, otitis media, especially in debilitated individuals.

The composition of the intestinal microflora is quite diverse. In a healthy person, representatives of the intestinal microflora have a well-defined property to inhibit the development of pathogens. Therefore, they perform protective function. But their useful properties do not end there. Permanent inhabitants of the intestines synthesize a number of vitamins, especially group B, participate in the breakdown of intestinal enzymes, thereby ensuring the possibility of their reabsorption - in a word, they perform a number of important functions. As a result of infectious diseases that violate the reactivity of the body, and above all intestinal infections, dysbacteriosis occurs, that is, the suppression of the natural intestinal microflora. I must say that dysbacteriosis sometimes occurs as a result of treatment - under the influence of antibiotics, sulfonamides, immunosuppressants, radiation exposure. Encountering no resistance from the "natives" - representatives of the normal microflora, "strangers" - microbes that are highly resistant to antibiotics and less demanding on the conditions of reproduction, begin to multiply intensively. The group of these "foreign aggressors" includes pyogenic microbes, in particular staphylococcus aureus, some putrefactive bacteria, fungi of the genus Candida and others. The suppression of lactic acid bacteria is accompanied by a decrease in the acidity of the environment, and this, in turn, favors the reproduction of putrefactive bacteria. A decrease in the number of Escherichia coli and bifidobacteria causes the rapid development of cocci, and under these conditions, Escherichia coli not only loses its antagonistic properties and enzymatic activity, but can even acquire toxic properties.

Dysfunction, that is, a violation of the normal functioning of the intestine against the background of dysbacteriosis, outwardly manifests itself in the form of chronic intestinal disorders. And often people, fearing hospitalization on suspicion of dysentery, take antibiotics uncontrollably, unaware that by doing so they only aggravate the disruption of the intestines. And the treatment in this case consists in the normalization of biocenoses (that is, naturally formed communities of microorganisms) with the help of preparations specially created for this case. That is why, as new powerful drugs become available, physicians are becoming more and more active in rebelling against their uncontrolled use. After all, numerous complications arise, as a rule, as a result of self-treatment or fuzzy implementation of the doctor's instructions, especially in cases where it seems to the patient that there are too many appointments, and he cancels this or that medicine at his own discretion.

One of the reasons for the modern originality of infectious pathology is the increasingly vigorous intervention of medical science and healthcare practice in infectious and epidemic processes. This is the widespread use of vaccination methods, especially live agents, passive immunization, the massive use of bactericidal remedies and therapy, which often leads to allergies, chemo- and hormonal drugs, bacteriophages, immunosuppressantosis. The impact of these agents causes adaptive ecological variability of microorganisms and thus not only affects the clinical manifestations of diseases, but also stimulates the entry of "new" bacteria and viruses into the epidemic arena. And this, in turn, contributes to a certain extent to the restructuring of infectious pathology. Displacing or muffling some microbes, that is, acting on long-established biocenoses, we open the way for other microorganisms. For example, the use of antibiotics has led to such a significant rise in diseases caused by staphylococci that have acquired resistance to these drugs that the diseases they cause are figuratively called "the plague of our days." ".

Already from the first hours of the birth of a child, Staphylococcus aureus often settles in the mucous membranes of his nose and throat. And by the time of discharge from the maternity hospital, the number of newborns who are its carriers is from 60 to 90 percent. True, they become smaller with age, but in some people staphylococci "take root" quite firmly. Of course, being a carrier is not yet a disease, but it can be quite likened to a loaded gun that can go off at any moment. There are many reasons that can play the role of a trigger. Recently, cases of newborns with toxic enterocolitis, pneumonia, conjunctivitis and even sepsis have become more frequent. And mothers are increasingly suffering from mastitis.

The list of "crimes" of staphylococcus is long. Staphylococci - inhabitants of the nasopharynx - can provoke tonsillitis, otitis media, sinusitis, respiratory tract infections, pneumonia, purulent pleurisy and lung abscesses. Very dangerous staphylococcal lesions of the cardiovascular system, blood, central nervous system. In a word, to paraphrase the French saying “Cherchet la femme” (“Look for a woman”), with many different diseases, you can say: look for staphylococcus aureus.

Outbreaks of staphylococcal infections occur not only in maternity hospitals, but also in surgical hospitals. This may cause legitimate bewilderment of the reader - after all, he was assiduously inspired during the previous chapters that infections occur most often where unsanitary conditions reign. And the tiled whiteness of the hospital walls is associated with sterile cleanliness. But purity in the ordinary sense and from the point of view of a microbiologist is by no means an identical concept. In addition, the body of people in a hospital bed is weakened by a previous illness, injury, surgery, childbirth, and this favors the development of infection. As a result of cruel selection in the struggle for existence, it was in medical hospitals that strains of staphylococci with multidrug resistance appeared. And antibiotics, powerless against them, have already acted as ... their defenders, eliminating microorganisms competing with staphylococci.

How to deal with a hospital infection? The traditional way - sanitation of the nasopharynx, according to many doctors, led to an even greater dead end: taking antibiotics increased the number of resistant staphylococci. Most antiseptics with long-term use adversely affected the mucous membranes, and with short-term use they practically did not help. They tried to populate the nasal mucosa with weakly virulent strains in the hope that they would force out the pathogenic flora, but the result was the opposite: harmless staphylococci acquired pronounced aggressive properties. It became clear that only strict isolation of patients, specific treatment and strict adherence to the rules of asepsis and antiseptics would reduce the incidence and interrupt the transmission of nosocomial infection.

The concepts of "microbes", "bacteria" in the minds of many people are strongly associated with the word "pathogenic". However, it is not. Tiny particles of life are involved in almost all processes of creation and preservation of the biosphere. As the invisible world penetrates, the interest of scientists in them does not decrease, but increases.

Bacteria have been the main experimental material for genetic research for many years. This is a very convenient object, since the life of many generations passes in a short time before the eyes of the researcher. Genetic engineering allows you to give microbial populations "orders" that are not related to their natural functions. For example, the Indian scientist of the Koran was the first to synthesize a yeast gene and introduced it into E. coli, turning it into a miniature factory for the production of tyrosine tRNA encoded in this gene. A group of scientists from the University of California managed to get a bacterial cell to produce the growth hormone somatostatin.

The successes achieved inspire science enthusiasts, giving hope that in the near future it will be possible to construct strains useful for medicine. However, the expansion of work in the field of genetic engineering can lead to dangerous consequences. Such genetic material can enter the natural environment, causing unforeseen epidemiological consequences. The reality of these fears is great enough. This is evidenced by the emergence of drug-resistant bacteria not only due to the uncontrolled use of large doses of antibiotics by people, but also due to the inclusion of their microdoses in animal feed.

What are the mechanisms of this phenomenon? It turned out that in bacteria that have become resistant to drugs, genetic information is transmitted through additional channels: through special extrachromosomal formations - plasmids. The latter are transmitted from cell to cell with the help of conjugation - the sexual process. They spread especially quickly after meeting with the enemy, in this case - with medicines.

In 1983, two American states- Minnesota and South Dakota - swept outbreaks of food poisoning. The causative agent of the disease was Salmonella Newport. All patients were found to have strains of bacteria containing the same plasmids and therefore resistant to such strong antibiotics as ampicillin, carbanicillin and tetracycline. It turned out that tetracycline was added to cattle feed on large livestock farms. And a week before the disease, the victims ate schnitzels bought in the stores of these farms. The source of antibiotic-resistant salmonella in this case was food.

So, maybe those who, doubting the possibilities of science, are right who believe that any intervention in natural processes ultimately brings more harm than good? And that the reward for the gifts of civilization sometimes exceeds their value?

Supporters of patriarchal antiquity idealize the past, overly exaggerate the negative consequences of scientific and technological progress, and try to explain its indisputable achievements not by objective prerequisites, not by the creative energy of the human mind, but by the expression of the will of higher powers, the omnipotence of God. However, it is becoming more and more difficult for theologians to defend such a view of the world. After all, it was the scientific analysis of cause-and-effect relationships that helped a person to comprehend a lot of empirical observations, to know the laws of macro- and microworlds. And brilliant proof of this is the new successes of Soviet scientists in the fight against epidemic diseases.

Microbes and viruses are cunning and insidious - they constantly change their "face". This is very clearly seen in the example of the most common disease - the flu. They will not have time to create an effective vaccine against one strain, as a new one is on the offensive, against which it is powerless. And yet it turned out that it is possible to outwit the disease. To do this, it was necessary to change the very principle of designing a vaccine. It turned out that no matter how the influenza virus changes, a tiny portion of its protein shell always remains stable. It was used by the employees of the Institute of Immunology of the USSR Ministry of Health when creating a vaccine, although it is not an immunogen in itself. And in order to force lymphocytes to produce antibodies that attack precisely the unchanged part of the membrane, it was necessary to “sew” it to a molecule of such a substance to which lymphocytes actively respond. A new universal vaccine is currently undergoing clinical trials.

A modern surveillance service must solve a difficult task - to correctly determine the time of an impending danger, the territory on which an enemy invisible to the eye is activated, and the risk collective. Then comes the turn of special immunological and bacteriological studies. The fact is that awakening microbes leave traces long before the onset of diseases. With the help of the so-called molecular probes, it is possible to establish the exact state of microbes and viruses.

Of course, not all the secrets of nature have already been solved. Many discoveries are still waiting in the wings. To defeat diseases, it is very important to unite the efforts of scientists from different countries. Science must serve humanity.

Notes:

The original meaning of the word was associated with ideas about unclean spirits that cause thunderstorms, whirlwinds, blizzards and other manifestations of the rampant elements. Over time, outbreaks of mass diseases began to be called a fad, suggesting that it was the wind that was their real physical cause.

Popov G. Russian folk medicine. SPb., 1903, p. 137.

Asepsis- preventive measures aimed at preventing the entry of microorganisms into the wound, body cavity during operations, dressings, medical and diagnostic procedures. Antiseptics- therapeutic and preventive measures aimed at the destruction of microorganisms in the wound or the body as a whole.

For more on this, see: Chizhevsky A. L. Earth echo of solar storms. M., 1976; Chizhevsky A. L., Shishina Yu. G. In the rhythm of the sun M., 1969; Yagodinsky V. N. Dynamics of the epidemic process. M., 1977.

So, prickly heat, what is it? In medieval England, people died en masse from this disease, but in fact it is not such a serious disease. Prickly heat is a disease of the skin that manifests itself in the form of dermatitis due to increased sweating. The rash is small red blisters, which are often accompanied by swelling. In general, this irritation is characteristic of young children, although it also occurs in adults, as was the case in medieval England. Prickly heat usually accompanies heart disease, endocrine disorders, and can also appear as a result of obesity.

Learn more about the causes of sweating

This kind of rash occurs as a result of a violation of the evaporation of sweat from the surface of the skin.

But the cause of increased sweating can be such ailments and conditions as:

• Cardiovascular diseases.
• Violations in the functioning of the endocrine system, diabetes mellitus.
• Excess body mass index.
• Heat.
• Use of cosmetics and fatty creams in the heat.
• Strong physical activity.
• Stay in an unventilated and hot room.
• Out-of-season clothing made from breathable fabric.
• Disease of the nervous system.
• Hot climate.
• Failure to comply with basic hygiene.

The last point, perhaps, became fatal for the inhabitants of medieval England. Prickly heat at that time appeared due to the fact that people walked for a long time in clothes wet with sweat or wore shoes that had poor contact with the air.

English epidemic

Prickly heat first appeared in medieval England in 1485. This epidemic flared up intermittently for nearly a century. By a strange coincidence, prickly heat manifested itself as soon as Henry Tudor came to power. Not even two weeks have passed since the beginning of his reign, and a strange epidemic has already managed to claim several thousand lives. For the Tudor dynasty, this was a fatal sign: as soon as they took over the ruling elite, prickly heat quickly spread throughout medieval England.

“Without a chance of recovery” - this is precisely the characteristic that can be given to the disease of prickly heat in the Middle Ages. As soon as a person became a victim of an epidemic, he was automatically considered dead. Of course, attempts were made to treat, but at that time they did not bring the desired results.

sweaty fever

Prickly heat was accompanied not only by skin dermatitis, fever was always its constant companion. As a result, this disease became known as English sweating fever, she returned to England 5 times, taking new lives with her.

During the reign of Henry VIII, death from sweating fever was terrible and painful. There were even rumors among the population that as long as the Tudor dynasty ruled, the disease would not leave England. In 1528, the epidemic broke out with such force that the ruler had to dissolve the court and leave the country. The last pandemic in England was dated 1551.

Versions

As you know, in medieval Europe, more than half of the population died from the plague, however, its cause has long been found. But what triggered the English sweating fever remains a secret even today. Scientists can only speculate.

Oxford and Cambridge suffered the most from the epidemic, where more than half of the population died from the disease. What are the causes of prickly heat in England in the 16th century? Is it something unknown (like fate or divine punishment) or is it a kind of unexplored virus? So far, scientists put forward only versions:

• In ancient times, the main sources of infection and epidemics were complete unsanitary conditions. Already in the Middle Ages, the air in England was contaminated with toxic fumes, because people did not really care about how to dispose of waste (usually they decomposed peacefully in the doorways). The contents of the chamber pots shamelessly poured out of the windows, and muddy streams flowed through the streets, poisoning the soil. Because of this disregard for the environment, even the water in the wells was unfit for consumption. Naturally, such conditions could cause many serious diseases, and not just prickly heat.
• It is also believed that in medieval England prickly heat is a disease caused by the bites of lice and ticks, which even today carry dangerous infections.
• It was also believed that prickly heat was caused by hantavirus (a disease that affects rodents and is dangerous to humans). True, the scientific community has not proven this.
• The epidemic could have been caused by the testing of a new bacteriological weapon, or prickly heat was simply a type of flu.
• There is a version that prickly heat developed due to the addiction of the British to ale ( alcoholic drink, which was popular during the reign of Henry VIII).
• And, of course, they blame the Tudor dynasty for everything, in particular the ruler Henry 8, who appeared on the territory of England with an army of French legionnaires, thereby laying the foundation for the spread of a new disease - prickly heat.

Medieval scholars believed that English sweating fever was due to the damp climate, warm clothing during the hot season, earthquakes, and the position of the planets. Of course, most of these assumptions are devoid of logical foundations.

How did the disease manifest itself in the Middle Ages?

There is an opinion that prickly heat in ancient england It is a disease from which there is no escape. Today prickly heat is not considered something dangerous, but in those distant times, few people escaped from it. The first symptoms began to appear immediately after infection. The patient began to have a severe fever, chills and dizziness. All this was accompanied by unbearable pains in the neck, shoulders, arms, legs and head. After a while, the patient developed a fever, he began to become delirious, the heartbeat quickened, and an unbearable thirst began to torment the person. At the same time, the patient was observed profuse sweating.

In most cases, the heart simply could not withstand such a load, but if a person infected with prickly heat managed to survive, then a rash appeared on his body.

Types of rash

The rash that appeared on the body during prickly heat was of two types:

1. In the first case, these were scarlet-like scaly patches. In general, in addition to general discomfort and itching, they did not cause problems.
2. In the second case, hemorrhagic blisters could be observed, which bled at autopsy.

Dangerous during the illness was the appearance of drowsiness. The patient was not allowed to sleep, because if he fell into a dream, he would not wake up again. If a person remained alive for a day, then he could recover.

Immunity and treatment

Treatment of prickly heat in medieval England seemed possible, however, the method was far from medical. The doctors of that time insisted that the room should have a moderate and constant temperature, the patient should be dressed according to the weather, he should not be cold or hot, the only way a person could increase his chances of recovery. The opinion was erroneous that it was necessary to sweat - this only aggravated the condition.

It is worth noting that immunity was not developed against prickly heat, a recovered person could get sick again and more than once. In this case, he was doomed - the affected immune system was no longer restored.

prickly heat victims

Usually, the epidemic broke out in the warm season and hit people selectively. Surprising is the fact that most of the victims of miliaria were healthy and strong people from wealthy families. Very rarely women, children, old people and weak men suffered from this disease. If they were struck by this disease, then they coped with it surprisingly quickly and easily.

It is worth noting that foreigners and people from the lower stratum of the population were spared the disease, but the noble and healthy citizens faded away after a few hours.

Six aldermen, three sheriffs, two lords from the royal family, the crown prince Arthur of Wales, representatives of the Tudor dynasty, the beloved son of Henry VIII and the sons of Charles Brandon - they all became victims of prickly heat. This disease took people by surprise. That is why it is said that in the Middle Ages, the disease of prickly heat is an almost incurable disease. No one knew about the causes, nor about the correct treatment, nor about who would be the "victim" next time. The one who was full of energy yesterday, the next day could be dead. Even today, the prickly heat epidemic has left many unanswered questions.

The French philosopher Émile Littre rightly remarked:

Suddenly, a deadly infection emerges from an unknown depth and cuts off human generations with its destructive breath, like a reaper cuts off ears of corn. The causes are unknown, the action is terrible, the spread is immeasurable: nothing can cause greater anxiety. It seems that mortality will be limitless, devastation will be endless, and that the outbreak of fire will stop only for lack of food.

The last time an epidemic of prickly heat appeared in the world in 1551. After no one heard about her, she disappeared as suddenly as she appeared. And what we call prickly heat today is fundamentally different from that terrible disease that, with a manic predilection, hunted healthy and full of strength people.

Today, the treatment of prickly heat, as a rule, does not cause any particular difficulties, and after a day or a week of treatment, there will not even be traces of an unpleasant ailment on the skin.

As a rule, "modern" prickly heat most often worries young children who have not yet developed and do not fully function sweat glands. What cannot be said about the manifestation of this disease in the Middle Ages in England, when people first spoke about this disease with horror and fear. And what troubles did prickly heat cause in the Middle Ages? What is its origin? In order to find out, you need to look into history.

English sweat epidemic

In the Middle Ages, English prickly heat was called English sweating fever and denoted an infectious disease with an unclear genesis. A feature of the disease is a high mortality rate among the population. It should be noted that the inhabitants of England suffered from the disease from 1485 to 1551.

According to sources, prickly heat in England was not of English origin, since it began with the advent of the Tudor dynasty to the government. In the summer of 1485, Henry Tudor and the Earl of Richmond (who lived in Britain) landed in Wales, defeated Richard III at Bosworth, after which Tudor became King Henry VII. His army consisted of French and British mercenaries, in the wake of which was the disease.

The disease was first witnessed in England between the landing and the battle, namely from 7 to 22 August 1485. England prickly heat is an epidemic, already one month later (from September to October) it “took” several thousand people, after which it subsided.

People perceived this beginning of the reign of King Henry as a bad omen and said that he was destined to rule in torment. Further, the prickly heat disease in the Middle Ages progressed in 1507-1517 and took away half of the country's population, spread to the continents in Calais and Antwerp, where it broke out in the form of a local lesion.

After 11 years (1528), the sweat epidemic broke out in England for the fourth time. During this period, the whole country was in a fever, the king dismissed the court and left the capital. The disease of the century spread, first spreading to Hamburg, then Switzerland, Rome, Poland, the Grand Duchy of Lithuania, Novgorod, Norway and Switzerland.

As a rule, in these countries, the epidemic lasted no more than two weeks. By the end of 1528, she disappeared everywhere, with the exception of Switzerland, where she "mastered" until the next year. Italy and France remained "untouched".

The last time an outbreak of English sweat was recorded in 1551.

The first symptoms of miliaria and the course of the disease

Prickly heat in medieval England began with severe chills, accompanied by headaches and dizziness, and later, severe pain in the neck, shoulders and limbs. Three hours later, a person developed a severe fever, a huge amount of sweat appeared, he was disturbed by a feeling of thirst, increased heart rate, sharp pains in the heart, and delirium was noted. There were no characteristic skin rashes. If, after another two hours, the person did not die, a rash appeared on his body. Initially, it affected the neck, chest, after which it spread throughout the body.

The nature of the rash is morbilliform, scarlet-like or hemorrhagic, on top of which transparent bubbles with liquid formed, which, later, dried up and in their place there was a slight peeling of the skin. The main and most dangerous in the Middle Ages was drowsiness, since it was believed that if the patient was allowed to fall asleep, he would no longer wake up.

If the person managed to survive, the temperature dropped and by the end of the week, he was healthy.

It is rare that someone managed to survive from the manifestation of the disease, but if a person fell ill for the second time, he was no longer destined to survive, since the immune system was no longer restored after the first attack. As a rule, out of 100 infected, no more than two or three people survived. The most interesting thing is that prickly heat in England, as a disease of the century after 1551, was no longer diagnosed.

It was believed that the patient could be cured by making him sweat even more. But, as a rule, a person died much faster from such treatment.

What caused prickly heat in the Middle Ages?

Despite the fact that prickly heat in the Middle Ages was a fairly common problem, but still, even to this day, the causes of the disease of the century remain mysterious. Thomas More (English writer, thinker, humanist) and his descendants believed that prickly heat in England arose as a result of dirt and the presence of certain harmful substances and other unsafe components in nature.

In some sources, one can find references to the fact that the sweat disease was identified with relapsing fever, which was spread by lice and ticks, but there is no mention of the presence of characteristic bites and their marks (irritation).

Other sources say that the disease of the middle age in England arose due to hantavirus, which causes a pulmonary syndrome, hemorrhagic fever. But, the peculiarity is that it is extremely rarely transmitted, which is why this identification is not generally recognized.

Some sources say that the manifestation of prickly heat in those days was a form of influenza, but most scientists are critical of this statement.

A theory is put forward that this form of prickly heat is the work of man and is the result of testing the first bacteriological weapon that had a directed effect.

Affected by outbreaks

Some sources claim that the bulk of those who died from the disease of the century are healthy men who lived in London and England as a whole. Women, children and the elderly were less likely to become infected. The incubation period ranged from 24 to 48 hours, after which the first symptoms appeared. As a rule, already in the next few hours a person either died or survived (this was known for 24 hours). It is also important to note that high-ranking people were among the victims, namely two lords - mayors of London, three sheriffs and six aldermen (outbreak of 1485).

The royal family of the Tudor king also suffered. It is believed that Arthur and the Prince of Wales, and the king's eldest son, died from the "sweat of the century" (outbreak of 1502). In 1528, Henry's wife, Anne Boleyn, was infected, but they recovered and managed to survive the epidemic of the century.

The outbreak of 1551 claimed the boys, aged 16 and 14, Henry and Charles Brandon, who were the children of Henry's daughter Mary Tudor and Charles Brandon.

One can find many descriptions of this disease of the century in the literature.

During the Middle Ages, the most horrendous disasters seemed insignificant compared to the massive infectious diseases that carried away more lives than war or famine. In the 14th century alone, about a third of the inhabitants of Europe died from a colossal plague epidemic. The history of mankind has three pandemics of the bubonic plague (from the Greek bubon - “swelling in the groin”), one of which was the “plague of Justinian”. In 542, the disease appeared in Egypt, from where it spread along the northern coast of Africa and into Western Asia. From Syria, Arabia, Persia and Asia Minor, the epidemic spread to Constantinople, quickly took on a devastating character and did not leave the city for several years. Every day 5-10 thousand people died from the disease; the flight only contributed to the spread of the infection. In 543, outbreaks of plague were noted in Italy, Gaul, in the villages of the left bank of the Rhine, and in 558 the Black Death returned to Constantinople. Subsequently, the plague appeared regularly, almost every decade, causing great damage to European states. In addition to the bubonic form, characterized by the appearance of dark tumors on the body, other forms of this disease were observed, for example, pulmonary or fulminant, in which there were no symptoms and death seemed to overtake a healthy person. According to ancient engravings, one can form an opinion about the scale of the tragedy caused by the complete impotence of doctors in the face of a deadly infection. The devastating effect of the plague is clearly expressed in the lines of A. Pushkin's poem "A Feast During the Plague":

Now the church is empty;

The school is deafly locked;

Niva idly overripe;

The dark grove is empty;

And the village as a dwelling

Burnt is worth

Everything is quiet, one cemetery

Not empty, not silent.

Every minute they carry the dead,

And the groans of the living

Fearfully ask God

Soothe their souls!

Every minute you need a place

And graves among themselves,

Like a frightened herd

Cling in a tight line!

People died a few hours after infection, barely having time to realize their condition. The living did not have time to bury the dead, and the corpses lay in the streets, filling the city with a poisonous stench. In the absence of effective medicines, doctors were left to trust in God and give way to the man with the “black wagon”. This was the name of the gravedigger, whose services were really needed: the timely burning of corpses partly contributed to the reduction of the disease. It has been noticed that people serving the city during the epidemic became infected much less often than their fellow citizens. Recorded in historical chronicles amazing facts selectivity, when the disease bypassed entire neighborhoods or individual houses.

I dreamed of a terrible demon: all black, white-eyed ...

He called me to his cart, in it lay the dead and babbled

Terrible unknown speech ... Tell me, was it in a dream?

Though the street is all our silent refuge from death,

Shelter of feasts, imperturbable by nothing,

This black cart has the right to go everywhere.

(A. S. Pushkin)

The saddest pages of history are associated with the second plague pandemic, which began in 1347. During the 60 years of the Black Death in Europe, 25 million people died, that is, approximately a quarter of the population of the continent, including the inhabitants of England and Greenland. According to medieval chronicles, “because of the plague, entire villages and cities, castles and markets were depopulated to such an extent that it was difficult to find a living person on the street. The infection was so strong that the one who touched the sick or the dead was soon caught by the disease himself and died. Confessors and confessors were buried at the same time. The fear of death kept people from loving their neighbor and the priest from fulfilling his last duty to the departed.” In France, the victims of the second plague pandemic were Jeanne of Bourbon, wife of the French king Philippe of Valois; Joan of Navarre, daughter of Louis X. Spain and Germany buried their rulers Alphonse of Spain and Gunther; all the brothers of the Swedish king died. After the disease receded, residents of many cities in Europe erected monuments to the victims of the plague. Reliable events associated with the epidemic were reflected in literature and painting. The Italian writer Giovanni Boccaccio (1313-1375) was in Florence in 1348. Shocked by the death of his father and all the horrors experienced during several years of living in an infected city, he described the plague epidemic in famous novel"Decameron". Boccaccio was the only writer who presented the "Black Death" not only as a historical fact or allegory. The composition consisted of 100 stories told on behalf of the noble Florentine ladies and young people. The story takes place against the backdrop of a plague epidemic, from which a noble society was hiding in a country estate. The author considered the plague as a social tragedy or a crisis in the state of society during the transition from the Middle Ages to the New Age. At the height of the epidemic in big cities 500 - 1200 people died daily, and it was impossible to bury such a huge number of dead in the ground. Pope Clement VI, who was then in Avignon (Southern France), consecrated the waters of the Rhone River, allowing corpses to be thrown into it. “Happy descendants, you will not know such hellish misfortunes and consider our testimony about them as scary tale", - exclaimed the Italian poet Francesco Petrarca, reporting in a letter about the tragedy of the beautiful Italian city Florence. In Italy, about half of the population died from the plague: in Genoa - 40 thousand, in Naples - 60 thousand, in Florence and Venice 100 thousand died, a person, which accounted for two-thirds of the population. Plague was supposedly brought to Western Europe from East Asia, through the ports of North Africa came to Genoa, Venice and Naples. According to one version, ships with crews that died from the plague washed up on the shores of Italy. Ship rats, who did not leave the ship in time, settled in port cities and transmitted a deadly infection through fleas, which were carriers of the so-called plague sticks. On the littered streets, the rats have found ideal living conditions. Through rat fleas, soil, grain, domestic animals, and people were infected.

Modern doctors associate the epidemic nature of the plague with the terrifying unsanitary conditions of medieval cities, which, from the point of view of hygiene, differed unfavorably from ancient policies. With the fall of the Roman Empire, the useful sanitary and hygienic achievements of antiquity became a thing of the past, the strict instructions regarding the elimination of waste were gradually forgotten. The rapid growth of European cities, deprived of basic hygienic conditions, was accompanied by the accumulation of household waste, dirt and sewage, an increase in the number of flies and rats that became carriers of various infections. English peasants moved to a new place of residence in the cities, capturing livestock and poultry along with their belongings. Geese, ducks, pigs roamed the narrow crooked streets of London, mixing excrement with mud and garbage. The unpaved, rutted streets looked like sewers. Piles of waste grew to unthinkable limits; only after the stench had become unbearable were the heaps raked to the end of the street and sometimes dumped into the Thames. In summer, the sun's rays did not penetrate the caustic layer of dust, and after the rain, the streets turned into impenetrable swamps. Not wanting to drown in the mud, the practical Germans invented a special "spring shoes of a city dweller", which was an ordinary wooden stilts. The solemn entry of the German Emperor Frederick III into Rettlingen almost ended in drama when the monarch's horse got bogged down in sewage. Nuremberg was considered the most comfortable city in Germany, along the streets of which it was forbidden for pigs to roam, so that they "do not spoil and spoil the air."

Every morning, the townspeople emptied chamber pots directly from doors or windows, sometimes pouring a fragrant liquid on the head of a passerby. Once such a nuisance happened to the French king Louis IX. After that, the monarch issued a decree allowing the inhabitants of Paris to pour sewage out the window only after shouting “Beware!” Three times. Probably, perfumery was invented in order to make it easier to endure the stench: the first perfumes were produced in the form of aromatic balls that medieval aristocrats applied to their noses while driving through city streets.

The Dutch theologian Erasmus of Rotterdam (1467-1536), who visited England at the beginning of the 16th century, forever remained an ardent opponent of the British way of life. “All the floors here are made of clay and covered with marsh reeds,” he told his friends, “and the bedding is so rarely updated that the lower layer often lies for decades. It is soaked in saliva, vomit, human and dog urine, spilled ale, mixed with fish leftovers and other rubbish. When the weather changes, a stench rises from the floors, in my opinion, very unhealthy.” One of the descriptions of Erasmus of Rotterdam spoke of the narrow streets of London, resembling winding forest paths, barely separating the tall houses hanging on both sides. An indispensable attribute of the "paths" was a muddy stream into which butchers threw tripe, soap makers and dyers poured poisonous residues from vats. The muddy stream flowed into the Thames, which served as a sewer in the absence of a sewer. The poisonous liquid seeped into the ground, poisoning the wells, so Londoners bought water from peddlers. If the traditional 3 gallons (13.5 liters) was enough for drinking, cooking and rinsing chamber pots, then bathing, washing and mopping could only be dreamed of. The few baths of that time were also brothels, so the pious townspeople preferred to wash at home, arranging a bath in front of the fireplace once every few years. In the spring, the cities were inhabited by spiders, and in the summer, flies overcame. Wooden parts of buildings, floors, beds, wardrobes infested with fleas and lice. The clothes of a "civilized" European were clean only after purchase. Former peasants washed according to the village custom, using a mixture of manure, nettle, hemlock and soap crumbs. Clothes treated with such a substance stank worse than dirty ones, which is why they washed them in case of emergency, for example, after falling into a puddle.

The plague pandemic provided the physicians of the XIV century huge stuff to study the plague, its signs and methods of spread. For many centuries, people did not associate epidemic diseases with unsanitary conditions of existence, attributing ailments to divine wrath. Only the most courageous healers tried to apply, albeit primitive, but real therapy. Taking advantage of the desperation of the relatives of the infected, numerous impostors "from among blacksmiths, weavers and women" "healed" through magical rituals. Mumbling prayers indistinctly, often using sacred signs, healers gave drugs of dubious quality to the sick, at the same time appealing to God.

In one of the English chronicles, a healing procedure is described, during which the healer already read spells first into the right ear, then into the left, then into the armpits, did not forget to whisper into the back of the thighs, and ended the healing with the utterance of "Our Father" next to the heart. After that, the patient, if possible, with his own hand, wrote sacred words on a leaf of laurel, signed his name and put the leaf under his head. Such a procedure usually ended with the promise of a quick recovery, but the patients died soon after the doctor left.

Erasmus of Rotterdam was one of the first to note the relationship between hygiene and the spread of epidemic diseases. Using the example of the English, the theologian condemned bad customs that contributed to the transition of individual ailments into epidemics. In particular, overcrowded, poorly ventilated hotels were criticized, where even during the day there was twilight. In London houses rarely changed bed sheets, households drank from a common cup and kissed everyone they knew when they met on the street. The society accepted the views of the Dutch theologian with doubt, suspecting a lack of faith in his words: “He has gone too far, just think, he says that even such sacred traditions as confession, washing children in a common font, pilgrimage to distant tombs contribute to the spread of infection! His hypochondria is known; on the subject of his own health, he corresponds with a large number of doctors, sending daily reports on the state of his urine.

After the devastating epidemic of the 14th century, scientists had to recognize the infectious nature of the plague and begin to develop measures to prevent its spread. The first quarantines (from Italian quaranta gironi - "forty days") appeared in the port cities of Italy in 1348. By order of the magistrates, visitors with goods were detained for 40 days. In 1403, the Italians organized a hospital on the island of Lazarus, where the monks cared for patients who fell ill on ships during forced detention. Later, such hospitals became known as infirmaries. By the end of the 15th century, the kingdoms of Italy had a reasonable quarantine system that made it possible to isolate and treat people who came from infected countries without difficulty.

The idea of ​​isolating contagious patients, which initially referred to the plague, gradually spread to other diseases. Since the 16th century, the monks of the Order of St. Lazarus have taken lepers to their hospitals. After the inglorious end of the Crusades, leprosy appeared in Europe. Fear of an unknown disease, which disfigured not only the appearance, but also the human psyche, determined the intolerant attitude towards the unfortunate on the part of society, secular and church authorities. It has now been found out that leprosy is not as contagious as it was imagined by medieval inhabitants. Not a single case of infection of doctors or nurses in modern leper colonies has yet been registered, although the staff is in direct contact with the infected.

The period from infection to death often lasted several decades, but all the languid years the sick person was officially considered dead. Lepers were publicly buried in the temple and declared dead. Before the advent of shelters, these people gathered in colonies arranged far from any settlements in specially designated areas. The "dead" were forbidden to work, but they were allowed to beg, passing through the city walls only on appointed days. Dressed in black mantles and hats with a white ribbon, the lepers walked in a mournful procession through the streets, scaring off those they met with the ringing of a bell. When shopping, they silently pointed at the goods with a long cane, and in the narrow streets they pressed against the walls, maintaining the prescribed distance between themselves and the passerby.

After the end of the Crusades, leprosy spread across Europe on an unprecedented scale. Such a number of patients was not in antiquity and will not be in the future. During the reign of Louis VIII (1187-1226), there were 2,000 leper shelters in France, and there were about 19,000 on the continent. With the beginning of the Renaissance, the incidence of leprosy began to weaken and almost disappeared in modern times. In 1892, a new plague pandemic shocked the world, but the disease arose and remained in Asia. India lost 6 million of its citizens, a few years later the plague appeared in the Azores and reached South America.

In addition to the Black Death, residents medieval Europe suffered from the "Red Death", as they called the pestilence. According to Greek mythology, the king of the island of Crete, the grandson of the legendary Minos, once during a storm promised Poseidon to sacrifice the first person he met for returning home. It turned out to be the son of the ruler, but the victim was considered objectionable, and the gods punished Crete with a pestilence. The mention of this disease, which was often considered a form of the plague, was found in ancient Roman chronicles. An epidemic of pestilence began in besieged Rome in 87 BC. e., becoming the result of hunger and lack of water. The symptoms of the "Red Death" are described in the story American writer Edgar Allan Poe, who presented the disease in the image of a fantastic creature: “For a long time the Red Death devastated England. No epidemic has ever been so terrible and destructive. Blood was her coat of arms and her seal - a terrible crimson of blood!

An unexpected dizziness, a painful convulsion, then blood began to ooze from all the time and death came. As soon as purple spots appeared on the body of the victim, and especially on the face, none of the neighbors any longer dared to support or help the plague-stricken. The illness, from its first symptoms to its last, lasted less than half an hour.

The first sanitary systems in European cities began to be built only in the 15th century. The initiator and head of the construction of hydrotechnical complexes in the Polish cities of Torun, Olsztyn, Warmia and Frombrok was the great astronomer and physician N. Copernicus. On the water tower in Frombroke, the inscription has survived to this day:

Here conquered waters are forced to flow up the mountain,

To quench the thirst of the inhabitants with an abundant spring.

What nature denied people -

Art overcame Copernicus.

This creation, among others, is a witness to his glorious life. The beneficial effect of cleanliness was reflected in the nature and frequency of epidemics. The installation of water pipes, sewerage, regular garbage collection in European cities helped to get rid of the most terrible diseases of the Middle Ages - such as plague, cholera, smallpox, leprosy. However, infections of a respiratory (respiratory) nature continued to rage, notorious for the inhabitants of the cold European continent also from time immemorial.

In the 14th century, Europeans recognized a mysterious ailment that manifested itself in profuse sweating, intense thirst, and headaches. According to the main symptom, the disease was called prickly heat, although from the point of view of modern medicine it was one of the forms of influenza with a complication in the lungs. From time to time, the disease arose in different countries of Europe, but most often it disturbed the inhabitants of foggy Albion, which is probably why it received a second name - “English sweat”. Suddenly ill, a person sweated profusely, his body became red and stank unbearably, then a rash appeared, turning into scabs. The patient died within a few hours, without even having time to see a doctor.

According to the surviving records of English doctors, one can restore the course of another epidemic in London: “People fell dead while working, in church, on the street, often not having time to get home. Some died opening the window, others stopped breathing while playing with children. The more robust prickly heat killed in two hours, for others one was enough. Others died in their sleep, others agonized at the moment of awakening; the population died in joy and sorrow, rest and work. The hungry and the well-fed, the poor and the rich, perished; in other families, all members of the household died one by one. There was black humor among the people about those who "had fun at dinner and died at dinner." The suddenness of infection and equally quick death caused considerable difficulties of a religious nature. Relatives usually did not have enough time to send for a confessor, a person died without unction, taking away all his sins to the next world. In this case, the church forbade the burial of the body, and the corpses were piled up behind the cemetery fence.

Lord human grief satisfy,

They went to the happy land of their children,

The hour of death and misfortune was given ...

Human losses from prickly heat were comparable only to mortality during the plague. In 1517, 10,000 Englishmen died. People fled London in panic, but the epidemic took over the whole country. Cities and villages were frightened by empty houses with boarded up windows, empty streets with occasional passers-by who "dragged home to die on staggering legs." By analogy with the plague, prickly heat affected the population selectively. Oddly enough, the first to become infected were “young and beautiful”, “middle-aged men full of life”. Poor, thin, infirm men, as well as women and children, had a great chance of surviving. If such persons fell ill, they endured the crisis quite easily, eventually recovering quickly. Wealthy citizens of strong physique, on the contrary, died in the first hours of the disease. The chronicles preserved recipes for prophylactic potions compiled by healers, taking into account superstitions. According to one of the descriptions, it was required to "crush and mix nightshade, chicory, sow thistle, calendula and blueberry leaves." In difficult situations, a more elaborate method was suggested: "Mix 3 large spoons of dragon saliva with 1/2 spoon of crushed unicorn horn." Powder from the horn of the unicorn has become an indispensable component of all medicines; it was believed that he could keep fresh for 20-30 years, and only increasing its effectiveness. Due to the fantastic nature of this animal, the drug existed only in the imagination of healers, so people died without finding real medical help. The most devastating epidemic of prickly heat in England coincided with the reign of King Henry VIII, famous for his cruelty. There were rumors among the people that the Tudors were to blame for the spread of the infection and the "sweat" would not stop as long as they occupy the throne. Then medicine showed its impotence, strengthening faith in the supernatural nature of the disease. Doctors and the sick themselves did not consider prickly heat an ailment, calling it "Christ's punishment" or "punishment of the Lord", angry at people for disobedience. However, in the summer of 1517, the monarch supported his subjects, unexpectedly being the best doctor in the state. Having buried most of the retinue, the royal family waited out the epidemic in a "remote and quiet dwelling." Being "beautiful, fat man middle age,” Heinrich feared for his life, deciding to fight prickly heat with potions of his own making. The king's pharmaceutical experience successfully ended with the preparation of a drug called the "root of strength." The composition of the medicine included the roots of ginger and rue, mixed with elderberries and rosehip leaves. Preventive action occurred after 9 days of taking a mixture previously infused with white wine. The author of the method recommended keeping the potion "by the grace of God ready all year round." In the event that the disease occurred before the end of the course of prevention, then prickly heat was expelled from the body with the help of another drug - an extract of scabiosa, bead and a quart (1.14 l) of sweet molasses. In a critical stage, that is, with the appearance of a rash, Heinrich advised to apply the "root of power" to the skin and seal it with a plaster. Despite the king's conviction in the invincible strength of his methods, the courtiers "cured" by him dared to die. In 1518, the death rate from prickly heat increased, but measles and smallpox were added to the well-known disease. As a preventive measure, people who buried a relative were banned from appearing on the street. Straw bundles were hung over the doors of houses where a sick person was, reminding passers-by of the danger of infection. The French philosopher Emile Littre compared epidemics to natural disasters: “Sometimes one has to see how the ground suddenly shakes under peaceful cities and buildings collapse on the heads of the inhabitants. Just as suddenly, a deadly infection emerges from an unknown depth and, with its destructive breath, cuts off human generations, just as a reaper cuts off ears of corn. The causes are unknown, the action is terrible, the spread is immeasurable: nothing can cause greater anxiety. It seems that mortality will be limitless, devastation will be endless, and that the fire that has broken out will stop only due to a lack of food.

The colossal scale of the incidence terrified people, causing confusion and panic. At one time, physicians presented to the public the results of geographical observations, trying to connect epidemic diseases with earthquakes, supposedly always coinciding with epidemics. Many scholars have cited the theory of miasma, or "contagious fumes, generated by subterranean decay" and coming to the surface of the earth during volcanic eruptions. Astrologers offered their own version of the nature of epidemics. According to them, diseases arise due to the unfavorable position of the stars over a certain place. In recommending fellow citizens to leave "bad" places, the astrologers were right in many respects: by leaving the affected cities, people reduced crowding, involuntarily contributing to a decrease in the incidence.

One of the first scientifically based concepts was put forward by the Italian physician Girolamo Fracastoro (1478-1553). In his main job, the three-volume book "On contagion, contagious diseases and treatment" (1546), the scientist outlined a systematic doctrine of the infection and the ways of its transmission. Fracastoro studied at the "Patavinian Academy" in Padua, where he received a professorship and stayed on to teach. G. Galileo, S. Santorio, A. Vesalius, G. Fallopius, N. Copernicus and W. Harvey graduated from the University of Padua. The first section of the book is devoted to general theoretical provisions derived from the analysis of the works of the great predecessors - Hippocrates, Aristotle, Lucretius, Razi and Avicenna. The description of epidemic diseases is placed in the second volume; Fracastoro considered all known forms of measles, smallpox, malaria, prickly heat, not missing details in the discussion of rabies, malaria and leprosy. In the last part, ancient and modern methods of treatment are presented to the author.

The fundamental work of the Italian physician laid the foundation for scientific terminology regarding infectious diseases, their nature, distribution and methods of dealing with epidemics. Rejecting the popular theory of miasms, Fracastoro offered his colleagues his doctrine of "contagion". From the point of view of a professor from Padua, there were three ways of transmitting the infectious principle: bodily contact, through objects and by air. The word "contagia" was used to refer to a living, reproducing entity secreted by the affected organism. Being confident in the specificity of the causative agent of infection, Fracastoro introduced the concept of "infection" (from the Latin inficere - "infiltrate, poison"), by which he understood the imperceptible introduction of "contagion" into the body of a healthy person and his "damage". At the same time, the word “disinfection” took root in medicine, and in the 19th century, a follower of the Italian physician, a doctor from Germany, K. Hufeland, first used the designation “infectious diseases”.

With the weakening of the plague and leprosy, a new misfortune came to Europe: at the end of the 15th century, an epidemic of syphilis swept the continent. The most reliable reason for the appearance of this disease is the version of the infected sailors from the ships of Columbus. The American origin of lues, as syphilis was otherwise called, was confirmed in 1537 by the Spanish doctor Diaz de Isla, who had to treat the crew of a ship that arrived from the island of Haiti. Venereal diseases have existed since the Stone Age. Sexually transmitted diseases were mentioned in ancient manuscripts and were always associated with love excess. However, in the absence of knowledge about nature, their infectious principle was denied, the ability to be transmitted through common dishes or in utero, that is, from mother to child. Modern doctors know the causative agent of syphilis, which is pale treponema, as well as the fact that timely treatment ensures complete recovery. The sudden rapid spread of lues puzzled medieval doctors, although there was a clear relationship with long wars and mass movements of pilgrims. The desire for hygiene, which had barely begun, again began to decline: public baths began to close, which had previously been strongly recommended to the population in order to prevent the usual infection. In addition to syphilis, the unfortunate inhabitants of Europe suffered from smallpox epidemics. Mortality from a disease characterized by high fever and a rash that left scars on the face and body was extremely high. As a result of rapid transmission through the air, smallpox killed up to 10 million people every year, and the disease drove people of any age, rank and financial situation to the grave.

Crystal prickly heat most often develops on the skin of young children. It has the form of transparent or whitish bubbles, the diameter of which does not exceed 1 mm. Bubbles can merge with each other, forming large lesions, burst and dry out, with the formation of crusts. Most often, crystal prickly heat appears in the forehead or simply on the face, neck, shoulders, back, or the entire surface of the body. Papular miliaria is a frequent "guest" on the skin of adults, especially in the hot season or in conditions of high humidity. Outwardly, it looks like a rash of small flesh-colored bubbles, the size of which can reach up to 2 mm. It occurs more often on the surface of the body, especially on the sides, on the arms and legs of a person. Often, papular miliaria is accompanied by peeling of the skin and superficial itching, which can cause a person some discomfort.

Red prickly heat can occur both in infants and in children and adults. It has the appearance of bubbles that are filled with cloudy contents, and in diameter, which reaches 2 mm, are surrounded by a red halo.

At the same time, the bubbles are independent and not prone to merging, they itch very much, especially when sweat or high humidity is released.

The "favorite" places of prickly heat are human skin folds and friction points. Red prickly heat is quite common in women, especially pregnant women. This is due primarily to the fact that the body of a pregnant woman is subject to sharp changes in hormone levels and, as a result, increased sweating. In addition, during pregnancy, body volume increases, which creates additional skin folds - the favorite places for prickly heat.

There are frequent cases of red prickly heat on the palms, especially in people who are prone to nervous experiences, which is accompanied by increased sweating.

Thus, appearance prickly heat directly depends on its type, but the symptoms, as a rule, are the same in all cases. A specialist will always help to distinguish which kind of prickly heat has appeared on the skin, at the same time suggesting what exactly needs to be done in such cases.

Diagnosis of prickly heat and possible complications

As a rule, an accurate diagnosis does not cause difficulties for a specialist. And already at the initial examination, based on the characteristic complaints of the patient, the pediatrician or therapist makes a conclusion about the presence of miliaria.

Medieval sweatshirt, 16th century. England.

For more than a century, an epidemic of a mysterious disease has been flaring up here and there on the territory of the state. Mostly young males aged 25–30 years are ill, the incubation period is about a day, after which severe chills, fever and convulsions appear.

After another couple of hours, suffocation begins, profuse sweating, and the entire body of the patient is covered with a small rash and he dies. The survival rate was very low, and the disease itself was called "English prickly heat", due to the presence of characteristic sweating and a rash.

And only modern scientists were able to unravel the mystery of the medieval "prickly heat", which was nothing more than a severe form of influenza. .

The exception is complications that can result from infection of scratches, which leads to extensive and weeping skin lesions and diaper rash.

In rare cases, a young or inexperienced specialist may confuse the presence of a rash and its appearance with similar rashes with chickenpox, measles, urticaria or allergies, or even mistake it for acne.

Treatment of the disease

Treatment of prickly heat pursues the main goal - to ensure unhindered access of oxygen, that is, air, to the affected areas of the skin. Only under this condition is possible a speedy recovery and the disappearance of the rash.

It is also necessary to take care of hygiene, in order to avoid infection of scratches and further complications.

To achieve these goals, experts recommend the following methods and treatments that are suitable for both children and adults:

Regular bathing in herbal infusions - oak bark, chamomile, string - helps to fight all types of prickly heat. The use of rubbing the affected areas of the skin with infusions of herbs.

Treatment of natural skin folds with special drying powders, both for children and adults, will help remove excess sweat. Treatment of the rash and the skin under it with special antiseptic solutions and aerosols helps not only to cure prickly heat, but also to prevent infection.

In case of infection of the affected areas, regular use of antimicrobial agents (solutions, ointment) is prescribed.

It is strictly forbidden during the treatment of prickly heat, and in the subsequent period, wearing clothes made of dense or synthetic fabrics, using various kinds of cosmetic creams and oils, as well as the abuse of soap.

Prognosis of the disease and its prevention

The prognosis of prickly heat, as a disease, is favorable. As a rule, after a few days and following all the necessary recommendations, the rash noticeably subsides, and in a short time they disappear altogether.

They help prevent the appearance of prickly heat and get rid of existing rashes.

Regular observance of all hygiene procedures. Remove sweat secretions from the surface of the skin in a timely manner, for example, after work or physical training.

Wearing clothes made from natural fabrics and appropriate sizes (to avoid chafing). Observe moderation in physical activity at elevated ambient temperatures, or at high humidity.