Redefining Pestilence: Typhus and Plague in Early Modern Europe

Epidemic typhus, long recognized as circulating in premodern Europe, has received little direct attention from historians. Records of typhus, recognized as a distinct disease, appear in the sixteenth century when medical writers sought to distinguish typhus from other pestilential fevers that seemed to circulate with increasing frequency, particularly plague. Typhus became one of many diseases that physicians gave new or renewed attention to, using their observations and experiences in outbreaks to redefine pestilential fevers. The first clinical discussion of typhus was offered by Italian physician Girolamo Fracastoro as part of the larger work On Contagion (1546). In 1574, three Spanish physicians, Luis del Toro, Alfonso López de Corella and Luis Mercado, each published treatises focused only on this “punticular fever.” The appearance of multiple treatises at the same time reflects ongoing debates among medical practitioners, over how to distinguish this pestilential fever from true plague. The distinction mattered because public health systems used in response to plague outbreaks were considered harsh and disruptive. People strongly feared not only plague itself as a deadly contagion, but also the restrictions on people and markets that came with it. Less deadly pestilential fevers, such as typhus, were deemed as demanding caution but not the same rigor in response. Analyzing published medical treatises as well as archival accounts of epidemics, this paper argues that efforts by sixteenth-century medical authorities to understand typhus as a distinct form of pestilence were motivated by both practical concerns of public health and intellectual interest in refining medical knowledge based on experience.