The Fourth Rider of the Apocalypse is mounted on a pale horse; he is pestilence; he is disease. He has wiped out legions, annihilated armies, brought down nations, destroyed empires. He has created worlds of untold suffering and horror. He is to be feared; he is to be respected. He was with Humanity at Humanity's beginning: he could be Humanity's end.
The coronavirus plague that is sweeping the world is, simply and sadly, a new twist on the old, old story. That story concerns Humankind's failure to deal with its own waste and refuse and the consequent pollution of the environment.
Most human beings ever born have died before their 15th year. Even in Victorian times, the average life span was less than 20 with slightly fewer than 30% of the population reaching their 40th birthday. Today, this still holds for many parts of the world; even in the 1950s the average life span in Latin America was less than 10 years. Although the position is much improved today, particularly in the affluent Western world where most can expect to live into their 70s, times are a-changing.
The whole history of Humankind could be written solely in terms of disease and reaction to illness. The Fourth Horseman has allies beyond number in the hordes of bacteria that surround us. Bacteria have been on this planet for at least three billion years – against which Homo Sapiens can, at best, boast about 150,000 or so. Bacteria are the most successful life form ever.
For the most part, they are benign and even helpful; in fact we could not exist without them. They break down waste, clean the water and purify the air. There are more of them in a spade of soil than there are humans on Earth. They live on us; they live in us; they are at the highest height; they are at the lowest depth.
But they mutate; contact with cosmic rays, chemicals and energy sources can instigate changes within them and their close kin, such as fungi and viruses. These changes are mainly harmless but, as we know well, not always.
Early man was a hunter-gatherer. This meant that he exercised well, ate natural foods and left his waste behind him as he travelled following the herds. If this life sounds ideal, there were many disadvantages. People often went hungry and infirmity of any sort was an almost certain death sentence – and infanticide was the only method of keeping the mouths down. There were pressures therefore to establish control over both animals and crops.
Farming probably began some 10,000 years ago in the valley of the Euphrates. It had immediate advantages: old folk could be fed and cared for and the fruits of their experience passed on; dependency on the risky business of hunting was reduced; the greater availability of food meant that all were reasonably nourished and all children could be raised. Also, a settled community allowed for greater areas of specialisation of effort to the gain of all.
But there were considerable drawbacks, most not appreciated until the last century. Farming introduced humans to a whole new range of bacteria. In greater intimacy with the soil and with their animals, and living huddled in a static society with greater communal waste problems, humans met up with some entirely new bugs. The cow brought tuberculosis and the plough teased anthrax out of the soil – and, as their nests were ripped apart as the earth was churned, mice, rats and other creatures found new, warm and luxurious accommodation in living with Mankind.
The first plagues were not documented although the Bible echoes to their far-off groans. God was often blamed! When they happened to your enemy, it was because your enemy was a thoroughly bad lot and was simply being dished his just deserts; when they happened to you, it was of utmost importance you made reparation to the offended God – and a human sacrifice or two often helped.
The concept of illness being due to natural causes was, however, recognised in Greece around the fifth century BC. Hippocrates noted that a doctor needed to be: 'skilled in Nature and must strive to learn what Man is in relation to food, drink and occupation, and what effect each of these has on the other'.
It was also in Greece that the first truly documented plague broke out in 429 BC. This was during a war between Sparta and Athens, and thousands of refugees swarmed into Athens. In the cramped and unhygienic conditions, deadly illness broke loose. Athens was still strong enough to fight on – but the die had been cast. Sparta never lost the upper hand and the possibility of a Mediterranean world run on democratic lines never materialised. Athens faded; democracy died; and the way was clear for Rome – and malaria.
A famous tale tells of Humankind being tried by all the other animals and, being found a considerable liability, faces condemnation unless two other creatures can be found to support the Human Race. The servile dog steps forward calling humans the 'masters' but no other beast moves. All is lost, but then, at the last moment, the mosquito swoops in: how dare the other creatures condemn his favourite food! Humans are reprieved.
Malaria is credited with killing half of all who have ever lived. It still does good business. Appropriately, it has forced some of the greatest changes upon society. Rome had risen by the Tiber and by the nearby Pontine Marshes; the marshlands were a superb breeding ground for the Anopheles mosquito, the only mosquito to carry malaria.
As Rome grew and became more powerful, so also did this human-loving insect. As the disease scoured the city with regularity, the wealthy and educated classes moved out taking their skills with them. Over time, the fertile farmlands of the surrounding countryside became denuded of farmers; the men who had been the backbone of the Roman legions disappeared as the Italo-Roman birth rate dwindled.
The Roman Empire did not fall; it merely fizzled out. Malaria altered the shape of the New World as well. It virtually wiped out the indigenous natives around the coastal plains as well as those living in the Caribbean. This stimulated the slave trade as hundreds of thousands of Africans, who had more immunity to the disease, were forcibly brought over to labour on the plantations. The European owners of these lands suffered a high death rate (about one-third) and this ensured a swift turnover in estates where the owners' interest lay only in making money fast and then escaping. Thus, the Caribbean suffered all the evils of mismanagement and exploitation.
Smallpox rivalled malaria. Along with TB, typhus, plague and a variety of other nasties, it marched with the Europeans. With no natural resistance to such biological weapons, millions of Native Americans died. North American numbers have been estimated at around 15 million before Columbus landed, whereas today, there are only a little over four million Native Americans. It was not the guns of the US Cavalry that did for them; it was simply the flu.
However, all these diseases pale in comparison to what was termed 'The Great Disease'. And that was Leprosy.
Leprosy has probably been with humans since the beginning. In the Bible, Leviticus outlines control procedures: isolate the infected and burn their garments. The disease reached epidemic proportions in the Middle Ages; over 7,000 Lazar Houses (leper retreats) were established in France alone.
The ceremony separating a leper from the healthy world took the form of a bizarre funeral mass where the officiating priest would pronounce the leper as legally dead. Macabre as this was, there existed an underlying humanity. In effect the leper's relatives were told to mourn the victim as dead – and then get on with their own lives. It also freed the leper's spouse to remarry.
However, the medieval attitude to leprosy was ambiguous. In a world of filth and appalling sanitation, the Church taught that the leper was unclean, and this was easy to believe when the physical symptoms of leprosy included a variety of disfiguring ailments – noses eroded, lips and tongues swelled, hair fell out, and hands and feet assumed claw-like shape. It no doubt salved the conscience of the wholesome to believe that lepers had brought the disease upon themselves and thus could be righteously and indignantly spurned.
The French writer, Jean Bodel, wrote movingly about the beginnings of leprosy on his body in the year 1202. He described trying to hide the marks by wearing extra clothing but a leper he explained, can hide 'not even his despair'. At least he was better treated than he would have been in China or India, where he would have been killed outright. Even in Scotland, lepers were hanged if they were found outside the leper house. Perhaps the most famous victim of leprosy was Robert the Bruce – whilst his equally famous adversary Edward the First had a penchant for burying lepers alive.
The great wave of leprosy that washed over Europe had at least one good outcome; the establishment of hospitals. Although Europe is clear of leprosy today, as the bacterium responsible for that disease is not so virulent now and it can be cured, its half-brother, tuberculosis, looks like making an unwelcome return.
But if all these diseases – leprosy, typhus, malaria, smallpox, tuberculosis and umpteen others – have spread fear, suffering and anguish, there is still one that tops all; the Black Death.
Part 2 of 'Cometh the fourth horseman' will appear in next week's edition
Bill Paterson is a writer based in Glasgow