Field of Science

History of Scarlet Fever: Witches, The Occult and The Renaissance

In the last installment, we looked back to the time of Hippocrates, and his description of a streptococcal disease in 430 BCE. We continue with the story some two thousand years later.
It has been a turbulent era, with empires falling, fiefdoms rising and a decline of scientific thought in the western world. The era described by Petrarch as the "Dark Ages" was coming to an end, with sparks of the enlightenment appearing over europe. The fruits of Arabic golden age philosophers such as Avicenna, al-Razi were reaching various libraries and scholars.
It was the time of Heinrich Cornelius Agrippa, who was famous for his works on magic. It was these that often attracted ire from the religious orthodoxy that dominated Europe. He is an intriguing historical figure, but not the focus of this piece. the focus is on his student, Johann Weyer. Regrettably, Agrippa died before Weyer could finish his training with him. At a loss, Weyer ended up attending medical school in France. It was these experiences which moulded Weyer into an expert in both medicine, and magic.
It was these two skills which became useful to him when he encountered the "Malleus Maleficarum". For those of you not up to date on hysteria inducing books of the 15th century, let me explain. This book consisted of the "evidence" that witchcraft existed, the forms it took, and advice on how to catch them. Endorsed by the church, copies of this book spread throughout europe, and fuelled the hysteria that lead to Witch hunts.
Johann Weyer :Extra points if you can spot the optical illusion

Weyer however, debunked the Malleus Maleficarum  in his own book "De praestigiis daemonum".
 In it, he presented evidence that these women were afflicted with mental issues, and should handled by physicians, not law courts and angry mobs.
 Whilst he never doubted the existence of supernatural entities such as demons and angels, he was sceptical of the degree to which these beings interracted in human affairs. As he got older, he moved away from magic, and concentrated more on the study of medicine.
 In the winter of 1563,  Weyer recorded the outbreak in lower germany referred to as "The Great Plague" . In his account , he states that this disease had spread to various cities in Europe, such as Danzig, Vienna, Cologne and even London.
In the region of the lower rhine, A disease appeared that caused swelling of glands in the throat, which was associated with a characteristic rash. This pestilence proliferated throughout the winter, travelling up the rhine all the way to Basel. The plague claimed the lives of many children, and was a cause of childbed sickness in young mothers. Various authors have speculated that this disease could have been scarlet fever. However, as with the previous post in greece, the descriptions for this disease are relatively vague.
The problem with these descriptions are the same as the ones I described in my previous post on hippocrates and the ancient Greeks. For nearly two thousand years, there had been little or no advances in the description and the treatments for this disease. However, had Johann Weyer been aware of advances in medical science occurring in Italy, he may have provided a far more rigourous identification of the plague of which he had been a witness.

The Renaissance had reached Italy nearly a century before northern Europe. Italy was the trade hub of europe, importing goods from the east to sell on to the west. And with these goods came various artisans and scholars, who helped to translate many works from Islamic scholars, as well as lost works from Ancient Greece.
Works of Galen reached Italy, and were taught in various schools of medicine. However, due to prohibitive laws on human dissection in Galen's time, much of his works were based on what he gleaned from dissecting barbary apes. Such was his repute that many of his claims on anatomy went unexamined for many years.
One man, Andries Van Wesel would change this. He approached anatomy from a more practical standpoint.  He is known better by the latinized name he published under, Andreas Vesalius.
He was among the first people to perform human dissections. He pioneered a practical approach to teaching whilst he held a post at the  University of Padua. He would get students involved in dissections. He is probably best know for the detailed images of human anatomy that populate his medical works. It was this culture of detail that he impressed upon his students, one of whom was a man from Palermo named Giovanni Filippo Ingrassia. Ingrassia already possessed a wealth of experience in the art of animal dissection, and had travelled to further his studies into human anatomy.
 Vesalius's attention to anatomical detail is a lesson that Giovanni Ingrassius took to heart. After his studies, he returned to sicily, where he would work as a physician and lecturer, eventually contributing much to the literature. It was in 1553 whilst he was working as a physician that he published a book which contains a description of a disease he called “rossalia”. His detailed description of the etiology of this disorder indiciated beyond reasonable doubt that he was the first person to produce a stringent identification of the disease we now know as scarlet fever. Using his method of identification, it became possible to look at this as one disease, and distinguish it from others with similar symptoms, such as measles.
He eventually attained became  the "protomedicus" of Sicily, placing him in charge of public health for the region. When the "Great Plague" described by Weyer reached the shores of Sicily, they were lucky to have a man as experienced as Ingrassius in charge. He recognised the contagious nature of disease, and frequently used isolation as a means of bringing it under control.
However, there was still yet more to be revealed about Ingrassia's rossalia, which we shall return to in the next post.


"An historical account of the plague and other pestilential distempers which have appear'd in Europe ..." - 1722 Richard. Brookes

"An account of the sore throat, attended with ulcers: a disease which hath of late years appeared in this city, and in several parts of the nation" - 1748 John Fothergill

Journal articles:

Rolleston, J. (1928). THE HISTORY OF SCARLET FEVER BMJ, 2 (3542), 926-929 DOI: 10.1136/bmj.2.3542.926

Cappello F, Gerbino A, & Zummo G (2010). Giovanni Filippo Ingrassia: A five-hundred year-long lesson. Clinical anatomy (New York, N.Y.) PMID: 20803570

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