Friedrich Schnurrer’s ‘Charte Uber die geographische Ausbreitung der Krankheiten’ (1827)

Side note: Unfortunately, getting into the details of Schnurrer’s map is probably going to take me a considerable amount of time due to its illegibility and the lack of a clear copy anywhere on the web or libraries close to the Greater New York area.

Friedrich Schnurrer’s ‘Charte Uber die geographische Ausbreitung der Krankheiten’ (1827)

Schnurrer’s ‘Charte Uber die geographische Ausbreitung der Krankheiten’ is perhaps the most important map in the history of mapping world disease patterns. The patterns this map depicts are not as regions so much as they are places or points where major epidemics and endemics prevailed. This information in turn Schnurrer obtained from others and due to his studies and observations on epidemic and endemic diseases. Friedrich Schnurrer was one of these early 19th century medical geographers who applied his natural philosophy thinking to the German landschaft notion of the disease, the belief that health and disease were consequences of man and his place on the earth’s surface, and that as man’s place on earth and activities changed over time, so too did the disease types that came to exist on earth, due to the ways in which the environment is modified over time.

Schnurrer’s fame for disease mapping is well documented in the European writings. Very little mention of it is made however in publications that were in English. This tells us that the Schnurrer’s concepts may have not been that popular with the English speaking and reading parts of western Europe. Even in modern classes on geography is is not uncommon to hear academicians discuss this landschaft philosophy that the German writers had in the 1800s. Landschaft is and was very much a German notion I have been told by geography students from Germany, due to the nature of the German philosophy. A little bit of the landschaft philosophy states that the earth itself is an organism, a concept made popular in the United States during the 1980s and 1990s when the Gaia hypothesis became quite popular, as traditional long-lived natural settings of endangered species and total ecosystems were destroyed due to mankind encroachment on the wilderness.

This impact man has on the wilderness in recent years is what led to some of the teachings about wildlife introduced or vectored diseases becoming a major issue in local and global health care. The in-migration of new animal-hosted, insect-vectored diseases like lyme disease and west nile fever, the introduction of new bovine tuberculosis strains, the evolution of “hog cholera”, mad cow and mad elk diseases, the development of a new strain of the avian flu are all examples of how changing the ecology results in the introduction of new disease patterns and types. The German landschaft way of viewing a place in relation to man makes geography a necessity for the first public health specialists of the early 1800s. Landschaft theory represented one view of the macrocosm of the earth and its people, with the study of the microcosm now beginning to develop.

We see Schnurrer’s acknowledgement of the value of knowing the microcosm of disease and health in his writings. One could say that instead of focusing on the body and its humours, it alkalinity, its blood and its overall chemistry, Schnurrer’s approach to understanding disease begins with his interpretation of nature, working its way down to the various parts of the body of man and their reaction to nature’s various components.

A biography on Friedrich Schnurrer was published in 1835 in Neues Rheinisches conversations-lexicon: oder Encyclopädisches …, Volume 10 (p. ), which states as follows (my translation includes paragraphing added to ease readibility and flow):

Schnurrer (Christian Friedrich), a meritorious orientalist, was born 1742 in Kanstadt, Wurtemberg, where there were two convent schools, formed between 1756 and 1760 in Tübingen. It was here he worked as the academy’s teacher in 1762, and then Repitent in Göttingen in 1766; [he] visited Jena, Leipzig, Wittenberg, traveled to Holland and England, and returned from Paris in 1770, and finally returned to the homeland where he successively served as professor of philosophy, Greek and Germanic languages, headmaster of theological faculty and chancellor of the University of Tübingen.

In 1805 he received the Doctor theology of dignity and 1808 the Würtemberg. Civil Merit. Since 1793 he contributed greatly to the Tübingen literary news. In the internal political disputes going on between each other (Würtemberg and Tübingen) Schnurrer of Wurtemberg was initially on the royal side, but he later testified to the counterparty when so inclined. Most recently, he lived in retirement from all shops in Stuttgart, and even had his fine library forwarded to an Englishman, his former student, which was then sold. He died in 1822. Besides being a philologist, he produced Treatises on the Psalms, and work on various prophets in what we call his Bibliotheca arabica (newest Aufl Hall 1811), which serves as glorious proof of his true accuracy and scholarship. D. Paul has issued Orationum; see academicarum Delectus posth. with a biograph Einleit (Tübingen, 1828). S also in Memminger’s Würtemb Jahrb (1824).

His son, Frederick S., born in 1784 to Tubingen, studied medical science there and then in 1805 went to Würzburg followed by Bamberg, Göttingen and Berlin.

He then moved to and lived for quite some time in Paris, where he worked in the hospital, especially in the Zoological Museum Jardin des plantes, and engaged in private studies. In 1811 he became acting Chief Physician to Herrenberg, 1814, and then Chief Physician to Vayhingen at Flam, where he had multiple opportunities to observe epidemics.

In the spring of 1830 he was physician to the Duke of Nassau, where he died on the 9th of April, 1833, leaving behind the following documents: Materials of Nature [in relation to/in honor of] epidemics and contagions (Tübingen, 1810), in which he expressed the desire to treat the disease theory as a part of natural philosophy and in this way study disease as a landschaft notion, attaching it to ground and body, and as a theory that treats each of these parts as independent of each other, with auxiliary sciences developed and used by us to learn more about disease; Geographical nosology, or the study of the changes in the diseases of the various Areas of Earth (Stuttg 1814) [perhaps ‘Gegengen’ is a typographical error common to printing, and should be gegenden for area or place] , Chronicle of the disease in conjunction with the simultaneous processes in the physical world and in the history of man (Tübingen 1823-24, 2 vols), a work that is as thorough as all similar works on, from home and abroad, on General Pathology (Tübingen, 1831).

We also owe him for his most interesting maps on the spread of the diseases. Worthy of note is that as a connoisseur Schnurrer had not exceeded the limits of the Russian empire in the time of cholera, in a small work, the first in the later overflowing amounts of cholera literature (The cholera morbus, 2 edition, Stuttgart, 1831) that behoove the “dark contagion” this disease presented, almost every single doctor to observe this disease had he later taken the opportunity to join in Schnurrer’s pursuit, would have you learned about it correctly from the beginning, and saved thousands of lives and millions in money.

To help us understand Schnurrer’s lines of reasoning for the philosophy of disease he developed, a quick review of his personal writings will shed some light on his interests in natural philosophy. One of his first professional writings was published in 1805, entitled (translated) “Observations on the effects of oxidating materials on germination and its efficiency, for different seeds for things of various external characters.” Schnurrer implies with this work his curiosity about nature’s abilities to impact the development and emergence of new events, and the chemistry behind how new things develop and evolve. The old notion stated that fermentation was responsible for life and how this philosophy helped to explain the development of animalcules was still fresh in the minds of some scientists. There had yet to be a strong link formed between the notion that animalcules existed in areas where certain illnesses could be born. Without any firm knowledge concerning the cause for disease, the kinds of theories proposed for diseases stated that poisons, viruses (as seen back then, a small, invisible, very active and tormenting object), germs, and miasma caused sickness, along with human temperament, inheritance, constitution, fate, and God.

To those who allowed God into their version of this philosophy, this allowed for inexplicable events of nature to develop, such as the birth of a new disease or the ejection of a new epidemic-causing substance from the earth’s core. People who were more into the natural philosophy of health, lessened God’s role in these events and blamed nature for the changes that happened. Schnurrer was one such writer, philosopher and speculator about the natural causes for disease. He claimed that nature provided for us the stimuli needed for diseases to develop, which we can either adjust to and undergo changes for, or be of some form of improper behavior and form thereby becoming ill and diseased.

Another part of the medical philosophy evolving with earth in its background was the medical electricity philosophy. By 1800, man knew that the body itself had a vital spark or form of electric power within. The ability of a muscle to twitch on its own without a nerve connected to it anymore told some that life forces existed down to the tissue level, not just as a full and living body feature. Nature’s electricity existed in the clouds and sky as well, and this form of energy called electricity could be generated by artificial means. In 1800, Galvani had just created the first fluid based battery like device, capable of eliciting the spark. This resulted in a re-emergence of other forms of medical electricity, such as the glass cylinder or globe-based static electric generator or the Leyden’s jar from decades before. These devices resulted in a theory of life and disease that focused on the vital spark concept and how it related to our health and well-being, as the studies of scientists focusing on the more physical basis of nature became more devoted to their own anti-metaphysical philosophies for life and health, individuals liek Schnurrer whose goals were to remain focused on the physical or materialistic world and the landschaft-eigenthumlichkeit tradition–a study of the sensitivity of man and man’s body (eigenthumlichkeit) to his natural environment (landschaft).

These changes in natural science traditions led Schnurrer to follow up his original dissertation on oxydatarum and the germination of diseases with a new writing in 1810 entitled “Materials in a general theory of nature in epidemics and contagions”. This essay and its sequel called Materials in support of a single doctrine on epidemics and contagion. This was published in 1815 and helped further define for us how diseases and epidemics could be events due to the events of nature. Just two years prior to the 1815 essay, he published his nosology of diseases–Geographical Nosology, or The doctrine of the changes of the disease in regard to the various foregoing changes in earth, in conjunction with physical geography and natural history of man. With this he solidifying all of the beliefs now out there that relate disease to place. As the title implies, diseases change as the earth we live upon changes.

The following biography provides us with further insight into his professional success.

Schnurrer’s other notable writings demonstrate the transition in disease theory now taking place due to the natural philosophy focus (translated from the titles in the above)

Contribution for a section on diseases in the 1817 Ersch Gruber’sche Encyclopadie der Wissenschaften. 1817.
“Chronicle of the plague, in conjunction with simultaneous events in the physical world and human history”. 1823-4.
“History of an epidemic of fever sweat that arrived early in the spring of 1829”. 1829.
“The geographical distribution and causes of intermittent fever.” 1830.
“The cholera morbus, its distribution, its coincidences, the methods of healing, its various parts or independent agents, and its interpretation on a larger scale.” 1830, 1831.
“General pathology, based upon our experience and progress during the nineteenth century” 1831.

Schnurrer’s first and second writings are a follow-up to a notion now popular in the American medical press. The notion that the world was changing due to civilization, followed by changes in land use and appearance, also implied that if diseases are of natural origins, that we are changing the nature of diseases as well each time re-cultivate domestic lands and farms from regions where wilderness once prevailed. Such changes in nature would most certainly disturb whatever balances once existed there, making way for new environments to develop and new diseases to form.

The development of large numbers of typhoid and yellow fever epidemics during this time seemed to demonstrate that such a theory might n fact be true. Noah Webster’s review of epidemics, published in 1804, concluded that epidemics like the plague and the fevers ensued due to the changes we produced in our natural settings, in particular our forest and fields, by razing one to give rise to the other, and to turn the wildcrafted field settings into more tame, productive domestic farming, orchard and livestock settings. A number or early British physicians had also made these observations about disease and land use change, but applied such a philosophy more to their goals of colonization than to trying to simply better the health of various societies. The wholistic point of view of nature and disease, the environment and disease, the land and disease, as well as all of these combined into one complete, gestaltic discipline known as the landschaft theory (focus on the whole) and Schnurrer’s focus on the Eigenthumlichkeit (sensitivity or awareness of the parts) as well. This could only be a result of the natural philosophy taught by German philosophers and scholars.

In the first of the two biographies above, this is further supported by the following line:

“. . . he expressed the desire to treat the disease theory as a part of natural philosophy and in this way study disease as a landschaft notion, attaching it to ground and body, and as a theory that treats each of these parts as independent each other, as auxiliary sciences used by us to learn more about disease.”

If we review the German concept of medicinische geographische, we find there remained this lack of connection between the Germanic and English geographers for quite some time in the early 1800s. By 1840, two epidemics had passed and yet the best examples of success disease mapping pointed to the German disease mappers, whose works were published mostly in German publications. In an essay on this published in Bibliotheca epidemiographica, sive catalogus librorum de historia morborum epidemicorum tam generale quam speciali comscriptorum (Jena, 1843) by Heinrich Haeser, the followers geographers are noted as being most important to the profession, in terms of how they managed the new cholera epidemics emerging:

The product of Schnurrer’s work on the same emerged during this time, as did his most important creation linked to his philosophy–his map of world disease behaviors and endemic-epidemic disease patterns.

The Maps

In 1817, the diffusion of a unique form of deadly diarrhea took place in parts of Europe. This disease made it about halfway to the western edge of the continent from the Middle East, a consequence of the massive amounts of travelers engaging in the mass exodus to Mecca to be there on their holy day, a tradition of their religion. A little more than a decade later, in 1827 about, this diarrhea finally made its way all the way to the heart of commerce in western Europe, where it took many lives and became commonly known as the malignant or Asiatic cholera.

At first, Schnurrer did not map the behavior of this disease. Since the early 1800s he like other medical geographers had been focused one the locations of people on the earth in general. His first opportunity to actually map diseases in the world came in 1815, with the publication of his book . . .

In this book he reviews the ways people live around Europe, Asia, the Middle East and Africa, but focuses mostly on those places we are already very much familiar with in terms of habitability–the temperate zone of the earth where the bulk of the people lived and where much of the global commerce took place. So from 1815 to the time when a new form of cholera struck western Europe, scholars like Schnurrer were still trying to understand better the way in which the people and their places of occupation and economy fared in relation to each other. The question of how these relationships were impacted by something such as disease was not yet as important as it had to be in order to become a part of global studies scholars like Schnurrer were engaged in.

When the cholera became deadly in the Orient, being a scholar of this culture, Schnurrer took the opportunity to travel to this part of the world to witness and learn about this event, since it was having an important influence on travel and migration in general, and the economic activities that were typically engaged in between countries.

Schnurrer’s map is a first attempt to make sense of the many reports about disease patterns provided by ship captains and military leaders during their professional travels. The first reports of diseases from abroad were brought back to homelands by international explorers and military fleets. In fact, throughout the nineteenth century the military ship remained the fastest means for anything from abroad to travel from one place to the next, across long waterways. The military ships, due to their rapid travel and living quarters on board, were the first to bring diseases from one place to the next, and especially continent to the next. With the commencement of major migration patterns mostly by land involving the annual Meccas, all of this changed, and people’s attention was drawn to diseases that could become a worldwide geographical public health issue.

Important to note on Schnurrer’s map are those places without diseases abundant in numbers or varieties. These are places where for the most part people and settlements aren’t as of yet well established. These maps associated with Schnurrer’s work were produced in 1831 and published as a part of the popular magazine . . . .

Their publication came as a result of the return of Asiatic cholera. The main map depicts the locations of different “diseases” in general, or better yet, signs and symptoms related to being ill. It was accompanied by maps devoted specifically to the migration and behaviors of cholera.

Unfortunately, the only version of the map uncovered so far is illegible due to the photography of the time and the overall lack of interest in this part of the map’s history. In due time, it is hoped that a rendering of these rare map can be found with legible handwriting. Until then, I (we) can only take educated guesses about what each section of writing actually states about the disease patterns of the world. A few sections of the writing are decipherable, notes on which accompany some of the close ups presented for given regions.

MAP 1

Charte uber die geographische Ausbreitung der Krankheiten

(Map of the geographic distribution of diseases)

The text heading eastward from Scandinavia could read: “Specific [diseases] travel at horribly fast speeds over the northern or Polar parts”

The second and third words that are legible in the text curving around the east edge of the Caribbean Islands are something like “gieber fieber” for yellow fever. This way of presenting that piece of information artistically resembles what we find elsewhere. Therefore, it is possible that much of Schnurrer’s writing was later simplified on Berghaus’s map of World diseases published about 12 years later, meaning other portions of Schnurrer’s text may also deduced by reviewing Berghaus’s map, followed by Muhry’s 1856 map, and perhaps Johnston’s 1856 map.