How was Fever Interpreted
before the advent of Germ
theory?
And what lessons can we learn
from it?
By Patrick Long
Student reference number:
91028278
Modern Germ Theory
In 1890 Robert Koch made four statements
which are considered the basis or modern
medical understanding of the germ theory of
disease.
He said that for a germ to be blamed for a
disease it needed to show that: -
The germ must be found in every case of that
disease.

The germ should captured and grown in a lab.

If the germ if given to anouther person or
animal it should cause a disease.

This disease should be the same disease as before.

Today we tend to classify a body
temperature over 37.50C as a Fever.
Fever
However the thermometer is a
modern invention and the
concept of fever has existed
throughout antiquity.
In ancient Egyptian and Greek civilisation fevers were
interpreted as madness of possession and sufferers were left
by family on the street for strangers to offer help if they
could.

Hippocrates and humors
Hippocrates is
considered the
father of modern
Medicine.
He was one of the
first people to
attribute disease to
physical processes
rather than
through divine
action.
Hippocrates and humors
Hippocrates
described a
persons health
as a balance
between four
“humors”
These “humors”
could be interpreted
also by their four
elements
1.
Hot
2.
3.
Dry
Wet
4.
Cold
Disease was caused when these “Humors” went out of balance with each
other.
Humorism and Epidemics
The Presence of
Epidemics was
a threat to the
theory of
Humorism. It
couldn’t
explain why a
large group of
people’s humors
would become
unbalanced all
at the same
time.
We can see this dilemma being played out in Thomas
Fuller’s book – Exanthematologia (1707)
Physicians at
the time
reconciled this
by theorizing
that the areas
where the
disease was
localized was
likely to be
corrupted in
some form. Some
argued that the
people
themselves were
innately
corrupted.
Girolamo Fracastoro
Suggested that fever was
instead caused by passage of
small bodies from one individual
to another

This challenged humorism and
initiated the contagion view of
fevers.

Fever as a state of excitement
Regardless of
Fracastoro’s
ideas other
theories also
propagated.

We can see an example of
this in a book by John
Brown (1787) who believed
that fever was caused by
excess excitability of the
body.
How did this manifest in the
treatment of fevers.
Humorism resulted in odd practices such as of blood letting and
emetics.

“the general view that
physicians…nothing can
be more uniform than
they, in their practice
in bleeding” – John
Brown (1787)
However progress in
chemistry at the time
also resulted in
various concoctions
becoming produced.
Moses Griffith’s on how to treat
Fevers
What Type of
Fever is it?
Hectic Fever
Slow Fever
Give Four times a day:
Salt of Wormwood,
Myrrh
Salt of steel (most likely
magnesium)
Waters of Alexandria
Did it
Work? No?
Give the other
medicine!
Salt of Wormwood (larger
dose)
Myrrh (smaller dose)
Chamemel - flower
Nitrous.
Compared to a modern
treatment algorithm
for children alone!
Case Study Example
"A poor woman of a thin and tender habit,
had an immoderate flux of the menses, and,
long after its being stopped, continued very
weak, faint, and low-spirited, with unquiet
sleeps, and a slow hectic fever. I ordered her
this medicine, and after she had taken about
fifteen doses of it, became perfectly well.“ –
Moses Griffith
Conclusions – What can we
lessons can be learnt?
Dogma – The story
shows how
previously held
beliefs can impede
progress.
Holistic
approach in
the face of the
unknown
Dealing
With
Uncertainty
Scientific
Process – Focus
on objectivity
and scientific
rigor.
Acknowledgement
Acknowledgments to the Plymouth Medical Soceity and Discovery
Library for access to the Historical Collection.

All images obtained from Wikipedia Creative Commons
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References
Gian Franco Gensini, Andrea A Conti. The evolution of the concept of ‘fever’ in the history
of medicine: from pathological picture per se to clinical epiphenomenon (and vice versa).
Journal of Infection 2004; 49(2): 85-87.

Fuller, Thomas. Exanthematologia: or, an attempt to give a rational account of eruptive
fevers, especially of the measles and small pox. : ; 1707.

Griffith, Moses. Moses Griffith's on fevers. : ; 1776.

Griffith, Moses. Practical Observations on the cure of hectic and slow fevers, and the

pulmonary consumption: to which is added, a method of treating several kinds of internal
hemorrhages. . : ; 1776.
Reid, Thomas. an essay on the nature and cure of the phthisis pulmonalis . : ; 1787.

Brown, John. Observations on the principles of the old system of physic, exhibiting a
compend of the new doctrine: the whole containing a new account of the state of medicine
from the present times, backward, to the restoration of the Grecian learning in the western.
England: ; 1787.

5. NICE. Feverish illness in children overview.
http://pathways.nice.org.uk/pathways/feverish-illness-in-children (accessed 21/03/2014)
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