Brian Altonen, MPH, MS

Heinrich Berghaus

(Links to biographies: English, German)

Reference (source for map): Highly recommended link: http://www.davidrumsey.com/maps2851.html

Map reviewed . . .

Planiglob zur Übersicht der geographischen Verbreitung der vornehmsten Krankheiten, denen der Mensch auf der ganzen Erde ausgesetzt ist.

translation (Source: Camerini, 2000) . . .

Planisphere toward a survey of the geographical distribution of the principal diseases to which man is exposed over the whole world

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Distribution of major land masses in the Arctic or Cold, Moderate or Temperate, and Hot or Torrid Zones

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The above map implies three major diseases, one each for three major portions of the globe . The Pocken (Pox) is endemic to the north, elephantiasis and the related Aussutz (more on this later) to the south, and the related Gelbes Fieber (Yellow Fever) along the Equator. The Kropf of the Columbia-Ecuador region is Goiter.

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Notes on 3 disease zones of the Eastern coast of the United States:

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Cholera Diffusion Paths

Cholera came to the US via two shipping routes in 1834. The Northern route brought it into the temperate zone (mostly NYC) during the warmest period of the year. The other brought it in via Louisiana beginning in early Spring (one document indicates even February), with peaks developing starting in April.

Only the 1830s cholera epidemic was mapped by Berghaus. The illustration is dated 1852 (Gotha: Justus Perthes) just beneath its border. The work for this book is mostly dated to somewhere around 1848, but certain portions as late as 1852. The exact printing date for the book from which this map was draw is uncertain, but was at least 1852, making the text content knowledge existing as of 1852. So enough information to produce a map of the 1849-1853 global epidemic had yet to be gathered in this part of Europe, but most likely was just coming in .

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Caribbean-Central America

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Caribbean, up close

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ROUGH TRANSLATION

“The disease related text in the above map reads (note–for the Caribbean region, the “Suden” (South) text in the upper most portion pertains to the States and was reviewed above):

Region of diseases linked to severe heat . . . painful, inflammatory disease, Phrensy (nervous disease/sensitive nerves), Arachnitis (possibly Stage 3 Syphilis with CNS problems, but see glossary), cephalitis (CNS infections, severe headache, with infection or craziness), Fall and Nervous Fevers

Inflammation (inflamed intestines?), Volvulus (probably colic and gas), fast-killing Dysentery

(Black vomit, part of which cutoff) Typhus, Intermittent Fevers, Scorbutus (Scurvy)

The dotted region is detailed in the key/legend below depicts the distribution of Pian or Yaws. This provides us with details on the migration of the Yaws from Africa to the United States region. The propensity of cases of Yaw are in the Caribbean due to slave trade and the related freeing of some of these people across these islands.”

Also note, Barbadoes has Elephantiasis.

Just north of the Panama Isthmus in the Caribbean: “Das Tropische Amerika[,] das Vaterland der Syphilis” = “Tropical America[,] the Fatherland of Syphilis”

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Verbreitung des Gelben Fieber . Fieber der Kuste . . . Matlazahuatl, F[ieber] des Hochlandes . . . Verbreitungs – Bezirk der Pians.

translation . . .

Region of Yellow Fever. Fever of the Coast . . . Matlazahuatl, Fever of the Highlands . . . (Distribution Region) of the Yaws .

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Coast Fever (Fiebre der Custe), Matlazuahuatl and Yaws (Pians) are detailed together in the above Key for the Map of the “Region or District of Yellow Fever” (Verbreitung des Gelbes Fiebers). Verbreitungs – Bezirk der Pians (Distribution or Region of Yaws) is included in this mapping of yellow fever. This makes the link between Yaws and Yellow Fever clear–both have origins from the Slave route from Africa to the Americas. This also points out the heavy use of the Caribbean for the importation of slaves (see other map focused on the dotted section depicting Pians distribution). Climates were similar to certain parts of Africa, especially the regions in and around the Ivory Coast where many slaves came from to this country.

(Much of the above is discussed later)

The above is a close up of the Matlazahhuatl (name documented as such ca. 1550), an epidemic that struck the Aztec-Mayan region during the 16th century. The identification of this disease remains uncertain. Yellow fever, variations of typhus, and other common fevers are most commonly considered.

One possibility never fully researched is that Matlazahhuatl is a form of tick fever, which due to its lack of marsh-related ecological requirements, is a possible European born disease introduced to the New World, effectively diffused inland to the highlands via commercially important domesticated animals routes. This is very early for a tick fever in American history, and perhaps fairly early as well for the some for parts of Europe. But the timing of this introduction allows for a possible early introduction of tick born diseases from Western Europe. The simple onset of an already local native tick fever carrier, host and/or vector related disease is also possible (Texas fever?), but the lack of regular recurrences might rule out this possibility. Since this disease was primarily of the highlands regions, it was probably not yellow fever, a product of mosquitoes imported, mostly from Africa, thriving along the eastern coast and inland along coastal and brackish water marshland regions.

On this next map Vomito negro refers to the black vomit, black rings below the eyes, and other conditions associated with what some considered to be an equivalent to the plague. The fact that Gelbes Fieber (Yellow Fever) regions are noted along with Vomito negro demonstrates the emphasis placed on symptoms. These were the same disease for the most part, but since physicians were focused on symptoms like fever, fever behaviors (cycles), skin color, etc., diseases were more often identified based on primary symptoms and not any known or suspected cause.

It is possible that one common perception of yellow fever is that one acquired fevers when he/she was close to land, and that the chief symptoms of black vomit was more related to oceanic places and travels (the sickness expressed itself more while on board ships, due to simple sea-sickness as an added feature). We also see a very basic elevation based disease definition behavior: to a medical topographer, a disease may progress from being vomito negro on board ships to gelbes fieber or its winter version typhus, as well as other forms of intermittent (malaria) and constant fevers depending upon the time of the year and latitude/place. Further inland we see the development of spotted fevers (inland marshes), and bay or lake fever (see New York concepts of Lake Fever for Seneca Lake, which I reviewed on another page), and then Highland fevers (this map), which could be perceived as different forms of Mountain fever expressing differently due to latitude differences– i.e. to the north there was the Rocky Mountain Fever or Typhus (due to deer ticks) discovered and documented in the 1830s to 1850s, and to the south the much older Matlazahuatl (this map), each located where the highest elevation regions and plateaus are found.

There is even a little bit of the old 4 humours, 4 colors/elements logic to this, subliminal signs more important to the layperson, domestic, untrained or indigenous healer. In theory, a febrile disease proceeds from intensely hot (red?) with black bile to hot/very warm yellow bile, heading inland to moist (white, mucilaginous, constant fever regions) and then dry and at high elevations cold or frigid. Fitting the red/heat or fire element into this is the key to this logic. On board a ship we might see an individual show signs of red before black, then yellow and finally white (pallidness), with black a certain indicator of possible death, yellow an imbalance, and white a sign of extreme weakness with loss of constitution and vital energy/enriched well fed blood.

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Note the strong evidence for latitude related disease regions, matching the philosophy of disease based on the three zones of the world then defined: Arctic or Cold, Temperate or Middle/Moderate, and Tropical, Hot or Torrid.

The diseases of Europe are Schwindsucht = tuberculosis/consumption ; Gicht = gout; Steinkrankh = Kidney and Bladder Stones; Kropf = Goiter. Weichselzopf is reviewed later. For Africe: Pians = Yaws. Elephantiasis and Cholera are self-explanatory. Muse rere over Indiaremains undefined, but perhaps is linked to the Asiatic cholera (a migratory route?).

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Pians – Yaws

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(See translation of above test in later version of this figure)

For the above: Schwindsucht = tuberculosis/consumption ; Gicht = gout; Steinkrankh = Kidney and Bladder Stones; Kropf = Goiter. Weichselzopf is reviewed in section following the next figure.

Weichselzopf = occasionally associated with deliberate or cosmetic employment (cultural groups that due to this malady grew this hair with massive, length rat tail and dreadlock style patterns), but usually referring to a malady also called Trichoma, Cirragra, and Plica polonica. As a malady, Plica polonica, is also associated well with Pediculosis capititis. The conditions of animals with hair balls are sometimes assigned this disease name as well.

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Kropf = goiter, appearing in the center part of this map. Pol. Granze der Pocken-Seuche is the Small Pox, identified as Small Pox. (Pocken is Pox in general, inferring a less exact diagnosis of pox and pox-like skin problems, including perhaps cysts, bites, chancre (canker), abscesses and simple cases of skin cancer.)

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Verbreitungs Bezirk des Aussatzes is dissemination district for leprosy. Aussatzes is Leprosy. This disease (the yellow tinted area) follows the tropical/subtropical latitudes on this map.

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Heinrich Berghaus’s Physikalischer Atlas (Physical Atlas) — 1848

(J. Camerini translated this as ‘Planisphere toward a survey of the geographical distribution of the principal disease to which man is exposed over the whole world’).

J. Camerini. Heinrich Berghaus’s map of human diseases. Med Hist Suppl. 2000; (20): 186–208 [Link]

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Rough translation:

South Africa’s Climate is one the the Healthiest. . . Outbreaks or epidemics found in the Cap-Colonie are unknown. Fever occurs due to the various effects of the temperature differences noted for this region, if people are not ready for it. In summer, it sometimes causes yellow fever and neuropathies associated with lung complaints. In winter, it is bad for the chest — an unfavorable place to stay for Consumptives

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Aussatz for the most part = leprosy.

There are three well defined zones of regions in the map above. Pocken (Pox) appears in the hinterlands of North America. By 1845, many Native American settlements are now in the western midwest and further westward. Pocken is a Temperate Zone disease. Gelbes Fieber (Yellow Fever) is a tropical disease, in a region where there is more ocean water than land surface. Elephantiasis and Aussatz (better defined in the next paragraph) is primary an South America disease. Reviewing other parts of this map. Elephantiasis is pretty much a southern hemisphere disease, which may have influenced some early thinking as to its cause, origins and methods of spread (by seasonal winds restricted to either hemisphere, and rarely migrating across the equator to the opposing latitudes). Aussatz is certainly northern hemispheric, with a Biblical history, but by 1850s is being labelled bihemispheric by most medical geographers.

Elephantiasis and Aussatz. In 1792 P.G. Hensler wrote a treatise on the similarities and differences between lepra (leprosy) and aussatz (the name assigned to the scaley, flaking skin disease, leprosy). Up until the late 1800s, aussatz was associated with elephantiasis. In J. Houghton’s essay on Lepra in Dunglison’s Cyclopedia of Medicine, (pp. 125-134, see p. 134 (fn)), the problems with this diagnosis are well defined. The remarkable similarity between the two is illustrated in the following. Without going into the detail of the pathology and mechanisms, a major difference between the two pertains to the appearance of the leg and the unmistakeable scrotal edema seen for elephantiasis. Throughout much of this time, Leprosy had strong biblical connotations, resulting in the same for elephantiasis.

An important feature of the map worth noting is a possible relationship Berghaus implies between leprosy and elephantiasis. The identification of the elephantiasis region on the above map is very clear. The fact that its border is a linear indicator suggests either that Berghaus implied the two have similar regions, or that leprosy is a milder form and/or precursor to elephantiasis, found predominantly at the outer edge of the elephantiasis region. Closer inspection however shows the leprosy line intersects and passes through the elephantiasis region, with the dotted line suggesting a migration route. This may however be reading too much into the handicraft skills of the artisan coloring this map with a water color paint. The goldenrod paint may have simply been applied a little beyond the desired borders of the author of this book in the region near the name “Bolivia”.

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Translations of some of the terms on the above maps (from http://translation.babylon.com/german/to-english/)

• acutes Blutspeien – acute spitting (coughing up) of blood
• Anhaltsend – Continuous (for continuous fever)
• Arachnitis-possibly 3d state Syphilis with CNS problems, but also may be head trauma, severe headache or tuberculosis related.
• Auszekrung — German name assigned to a particular set of symptoms, usually associated with consumption. These symptoms include emaciation, drying up of the body, cough or spitting up of phlegm (and blood), with atrophy, cachexy and marasmus setting in as time progresses. See Wikipedia Definition (in German).
• Aussatz – scaling of the skin; a disease with uncertain diagnosis from about 1500 to 1900. Possibly syphilis according to one writer ca. 1500 (link), leprosy and its derivatives according to Dunglison in his Cyclopedia of Medicine.
• Auszehrung – severe emaciation, fatigue (like consumption)
• Blatter der schwarzen – possibilities: a) a bladder disease, with blackening as part of its symptomatology, b) stomach related disease resulting in black coffee ground like vomit; c) a painful, inflammatory, swollen joint disease much like rheumatism. This term literally means “black walnut”. This is perhaps a descriptive popular name given to a condition due to its appearances.
• Blutungen – bleeding
• Braune – the color brown
• Beschwerden – complaints
• Cephalitis – inflammation of the brain due to bacterium or virus, sometimes other infectious and non-infectious disease causes; possibly used as well to refer to severe headaches, with particular symptoms; infant paralysis due to encephalitis and poliomyelitis mighy also be linked to this disease form and presentation.
• Entzundungen – inflammation, burning, swelling and redness
• Faul-fieber – putrid fever
• Fieber – fever
• Fieber der Kurst – Coastal [Yellow] Fever
• Gehern entzund – literally “brain on fire”; other term for this time is apoplexy, from the sun and heat; conditions akin to heat exhaustion or stroke.
• Geistesverwirrung – mental confusion, disturbance or disorder
• Gelbes Fieb[re] – Yellow Fever
• Gemisch der Kranheiten – Mixture of illness (reference to Middle Atlantic states with diseases from the north and south)
• Gicht – gout
• hartnackige Verstopfungen – “stubborn blockages’, probably for mucus plugs in the lungs, difficulty breathing.
• Hautkrankheiten – inflammation (hot, burning) of the skin
• Hemorrhagien der Lungen Endemisch – Endemic Bleeding of the Lungs (consumption or tuberculosis).
• Hypertrophien der Herzens – enlargement of the heart
• Hemorrhagia
• Irsinn – insanity
• Krankhafte Affection d. Darmkanals – Diseases of the Digestive Tract
• Kropf – Goitre
• Leberkrankheiten – Liver Disease
• Muse reres – [unknown]
• Nerv. Fieber – Nervous Fever
• Nervenleiden – neuropathy, nervous system disease
• Ohrentzundung – ear inflammation; otitis
• Phrenezie – frenzy, see Gehern entzund, which this is probably and extension of.
• Pians – Yaws
• Pocken – usually small pox (and perhaps some related pox)
• Pocken-seuche – Small Pox
• Schnell todtende Dysenterien – fast killing dysentery
• Schlagflusse – stroke or apoplexy
• Schnupfen – sniffles
• Schwindel – dizziness
• Schwindsucht – consumption, tuberculosis
• Steinkrankh – “Solid” diseases (stones of gall, kidney, bladder)
• ungunstiger aufenthalt fur Schwindsuchtige – unfavorable stay for Consumptives
• Unterleib -Entzundungen – Inflammation of the stomach, abdomen; also cramping?
• Verbreitungs – “Dissemination District” or Region
• Verbreitungs Bezirk des Aussatzes – Dissemination district of leprosy.
• Verstopfungen – constipation
• Volvulus – twist in the intestines, but here probably intestinal blockage, severe constipation following diarrhea, lack of stool with severe pain.
• Vomito negro – black vomit (yellow fever, plague)
• Wahnsinn – to go mad or insane; another version of lunacy, insanity.
• Wassersucht –
• Wechselfieber – intermittent fever
• Weichselzopf –

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Sections of the Box with Disease Zones defined

(work in process)

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Cold Zone

Brown [phlegm from] inflammation of the lung, peripneumonia (hard to breathe with hacks and coughs), pleurisy, causes stubborn blockages (i.e. mucus plugs, due to asthma, allergies), gives people bad vision, worsens rheumatism, causes malignant or fatal pox.

Occasional: Skin diseases, scorbutus – epidemical

Frequent (endemic): Epilepsy, Hypochondria (rabies), Lunacy, scrophula,

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Moderate Zone

Winter – Sniffles, Bronchitis, Lung inflammation with peripneumonia, asthma complaints, constipation, chronic rheumatism,

Spring – the healthiest time of the year . . . bronchitis, burning of the skin, mental confusion or disorder, hypochondria

Summer – Browning, Ear Inflammation/Otitis, gastroenteritis, sporadic cholera, typhus, 3 types of ___ fever, gangrene, carbuncle, tetanus

Fall – quartan fever, volvulus, rheumatism, catalepsy, lunacy, asthmatics,

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Hot Zone

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Berghaus’s Biography Link

(same in German, with portrait)

See also:

http://cartographymaps.tumblr.com/page/22