Masterman,
E. "Hygiene and Disease in
Public Domain.
Digitally prepared by Ted Hildebrandt (2004)
HYGIENE AND DISEASE IN
AND IN
BIBLICAL TIMES. (Part I)
By Dr. E. W. G. MASTERMAN.
INTRODUCTION.
THE
subject of the diseases mentioned in the Bible has always been a
difficult one and it is not expected that this
present effort to elucidate
it will have anything of finality about it. The
writer will be content
if he clears up some obscure points, and if
incidentally he is able to present
to his readers a considerable mass of facts which
have not hitherto been
co-ordinated. The basis of any
correct views on the subject must be our
knowledge of the conditions of life in
Testament times. Though doubtless much
may be gathered from
literature it is reasonable to suppose that the
physical environment of
the modern peoples of this land as regards climate,
food, houses and
mode of life being probably much the same as of old,
a study of these will
be likely to prove at least as important. Then the
diseases rife in the
land to-day may also be considered. It is quite
possible that some
diseases have changed their type or even become
extinct, and it is certain
that some diseases occur which were unknown before
the Middle Ages,
but as some popular information on the modern
diseases of
be opportune at this time, this section will be
complete in itself, though
necessarily brief. Twenty years' residence in
various parts of the Holy
Land
in actual medical practice enables the writer to treat this part of the
subject with the authority of experience, and he
does so with greater
assurance, inasmuch as he has discussed various
points here mentioned
with other practitioners in the land, both
personally and in conferences.
The literature of this subject was until
recently extraordinarily scanty,
but in the last few years a number of medical
papers from those practising
or making researches in the land have been
published which do much to
add to our knowledge. This is notably the case with
regard to tropical
13
14 HYGIENE AND DISEASE IN
diseases in which, thanks to the researches of
the workers in the "Inter-
national Health Bureau," established in
scientific reports of the greatest value. Although
a full Bibliography will
be published at the conclusion of these papers1
I may mention here a few
recent papers which give information about diseases in
modern
in a fuller manner than will be possible here:--
T. HARRISON BUTLER.--"Clinical Features, Bact., and Treatment of
Acute Oplithalmia in
the East,"
"Some
aspects of Ophthalmology in
1915),
published by Birmingham Medical Review,
1915.
J. CROPPER.--"The Geographical Distribution
of Anopheles and
Malarial. Fever in
Malarial
Diseases of
1905.
Dr. HUNTEMULLER.--a Neuartige
Parasitenbefunde bei der
beule," Centralblatt fur
E. W. G. MASTERMAN.-" Notes on Some
Tropical Diseases in
Parasites
in
Prof. P. MUHLENS.--"Bericht
uber eine Malariaexpedition nach
HANS MUCH.--Eine Tuberkuloseforschungsreise nach
With regard to using modern scientific medical
literature it must
however be always remembered that from the point
of view of old
writings it is less helpful than might be hoped,
as the scientific recognition
of many specific diseases is comparatively modern
and until quite recently
such general terms as "fever,"
"consumption," "palsy," were used in
a broad and general sense, and each included what
we now know to be
many varieties of disease. Perhaps more help will be
found from study--
such as will be attempted here--of the primitive
ideas of disease and its
cure, such as is still to be found abundantly among
the people of the land.
Some light on the conditions of life and health
in early times, which. may
be gathered from the results of
subject of a special chapter.
Finally, an endeavour
will be made to get as near as possible to the true
meaning of the various terms used in the
description of disease and to
investigate the actual relation of the Mosaic laws
to health. Here then
is a considerable body of Biblical and theological
literature to which
reference will be made in the Bibliography.
1 The author would be grateful for any
references to medical or Biblical
papers bearing on the subject.
HYGIENE AND DISEASE IN
CHAPTER I.
Race, Habit, and Food as bearing on Disease.
It is not necessary to discuss here the very
complicated ethno-
logical relations of the various and mixed races
inhabiting
and
distinct classes of people distinguished by such
special habits of life
as to have a somewhat different liability to
disease. These are
(1)
the nomads or bedawin, who
dwell in tents all the year round
and live a pastoral as contrasted with an
agricultural life; (2) the
peasants or fellahin, who are primarily
agriculturalists; and (3) the
town dwellers or hader,
whose occupations are various. Each class
shades off into the other. Thus, some of the local bedawin live in
rough houses or old ruins in the winter, and do a
certain amount
of primitive agriculture, housing their cattle and
stores of tibn
in the winter; and a considerable number of the
fellahin, particu-
larly in recent years, though
making their homes in their villages,
spend so much of their time in occupations in the
towns as to
expose them to all the disease-risks of the townsfolk.
(1) The bedawin are
popularly credited, on account of their
entirely open-air life, with great soundness of
constitution, but it
cannot be said that this is the case with the nomads
of
They
are exceedingly scantily clad, the poorest in actually nothing
but a shirt, and their skins are exposed to all the
extremes of heat and
cold; their goat-hair tents are but little
protection from the heat of
summer or the cold and wet of winter; while, during
the latter
season, the atmosphere of their dwellings is commonly
saturated
with the irritating smoke from wood or dung. It
might be supposed
that the smoke would at least afford some protection
from insect
pests, but the truth is that, under such conditions,
lice, mosquitoes,
and other insect pests are found in abundance.
Doubtless, in the
days when the bedawin
possessed considerable wealth of cattle,
camels, and horses, and were able both to feed well
and to keep
themselves in good physique by martial exercises,
they enjoyed
greater robustness, but now a large proportion
of the bedawin of
malarial fever, and even from pulmonary
tuberculosis (consumption),
from which it might bethought their out-door life would
save them.
16 HYGIENE
AND DISEASE IN
Even
their nomad habits do not deliver them from epidemics of
small-pox, typhus, enteric, measles and
whooping-cough; and the
mortality is very high, especially among the
young. While it is
probably true that the great desert tribes are
largely free from
venereal diseases, this is certainly not the case
with the mongrel
bedawin in the neighbourhood of the towns of
very low morals: syphilis and gonorrhoea
are extremely common
among them, and it is said that the same is the case
with some
of the nomads of Sinai. These same bedawin are described as being
peculiarly liable to rheumatism. No class are
greater fatalists, and
in the larger number of cases of illness the
patient is left uncared
for, even, as the writer has witnessed, when the
sick one is a cherished
son. The bedawin have
remedies of their own, but many appear to
be the result of the inspiration of the moment
rather than of any
tribal lore. The food of these nomads consists of
unleavened bread,
made of coarsely ground wheaten flour, burghul (bruised wheat,
boiled), rice, lebban (sour
milk), cheese, dates and fresh fruit when
they can be obtained; occasionally, as on a feast, a
sheep is killed
and there is a gorge of meat. A great number of
them suffer from
chronic dyspepsia, the pangs of which they
usually ascribe to
intestinal worms; these, it is true, they also have
in plenty. Child-
birth is, as a rule, accomplished with extraordinary
ease. Although
these nomads, in a remarkable manner, survive
injuries received in
their fights, their constitutions present very little
resistance to acute
diseases, particularly perhaps to pneumonia, and
they succumb to
what any soundly constitutioned
European would successfully resist.
(2) The fellahin are ethnologically a very mixed
race, and
distinctive physical characteristics are found in
certain villages or
groups of villages. In general, the poorest both in
physique and in
possessions are found in southern
fellahin--like the bedawin--are
nominally Moslems, but they know
but little of the religion which they profess, and
follow a cult of
traditional religious customs, often quite at
variance with their
orthodox belief. There is
a certain number of Christian villages
scattered about the land where, as a rule, the
houses and sur-
roundings are more comfortable
than in the villages of the Moslems.
In
northern
classes dwell side by side--Christians (in
several distinct sects),
Jews
(in “colonies”), Sunnite Moslems, and Metaweleh, Druzes,
Moslem Circassians, Turkomans, and Algerians. Even those
HYGIENE AND DISEASE IN
occupying villages within sight of each other will
often have but
little social intercourse. All over the land the
custom of inter-
marriage within the very narrow circle of a
single village, or of a
small group of villages, is the rule. This constant
interbreeding is
naturally prejudicial to health, and must greatly
concentrate the
tendency to inheritance of disease. The houses of
the fellahin are
usually constructed of very loosely built walls,
with flat mud roofs,
unprovided with parapets (Deut.
xxii, 8), and in many parts of the
land without even chimneys. These ill-made walls,
however, have the
advantage of allowing free ventilation even when,
as is the rule, all
windows and doors are closed at night. Most
dwellings swarm with
vermin. In some parts of the land (e.g., Hattin, Banias, etc.) the
inhabitants sleep in booths constructed on the roofs
during the
summer months, when the vermin are most active. A
witness to
the commonness of the presence of body lice is
supplied by the
exclamation frequently used in northern
remove them [i.e., the lice] from me!" because
the sudden departure
of these pests from anyone is considered a sign of
mortal sickness.
The
village streets are narrow and very irregular. Heaps of refuse
accumulate in corners, and a huge dung heap--the
breeding-place of
countless myriads of flies--dominates the
habitations. There are,
with very few exceptions, no sanitary arrangements,
and the whole
village is often surrounded by a narrow area of
human excreta
which the fellahin never take the trouble to cover
with earth,
and which, when the rains come, is, in many cases,
carried into
the source of the water supply. Although the native
of the land
has a keen appreciation of good water when he sees
it, and will
laud the virtues of fine springs in extravagant
language, he is
often very careless about his domestic supply. In
many places
water is very scarce over much of the year, and
little can be spared,
or is used, for personal cleanliness. On the other
hand, the young
lads, in many villages, bathe daily in the tank or
pool which
supplies water for domestic use. The
house-floors, being usually of
beaten earth, can never be properly cleansed and harbour the
accumulated filth of years. The fellah has the
advantage neither of
the nomad's periodical migration to a clean site
nor of the thorough
cleansing which the town-dweller is able to give periodically
to his
stone-paved floor. From want of personal cleanliness
and the
impregnation with sewage of the
food, especially the salads, intes-
tinal worms are exceedingly
common. The food of the villager,
18 HYGIENE
AND DISEASE 1N
in addition to the articles mentioned as eaten by
the nomad,
includes a large amount of fresh and dried
fruits, especially figs,
grapes, apricots and dates, and in their seasons,
fresh melons, gourds
and cucumbers. Cooked with meat he has rice,
vegetable marrows,
egg-plant (solanum), barmeyeh (Hibiscus esculentus),
tomatoes, etc.
Eggs,
chicken, and meat in general are eaten more commonly than
with the bedawin, and in
certain districts fish is also a usual article
of diet; but the majority of the villagers never
touch it. As with
the bedawin, so with
these people, there is a great prevalence of
dyspepsia, due partly to the common custom of
making but one
large meal daily, in which half-cooked bread and
unripe fruit largely
figure, partly to the over-eating which occurs at
feasts, and perhaps
most of all to the perpetual over-drinking of water
(a habit in itself
often due to dyspepsia), which distends the stomach
and dilutes
the gastric juices. This last is even more true of
the bedawin, who
have often to wait for a long time before getting a
satisfactory
drink. The fellahin suffer much from the cold and wet
in winter,
the majority make but little change of raiment, and
those who can do
so cower over their small charcoal fires during
the long, heavy, rains
of the winter months. They need sunshine for their
natural life,
darkness and wet are things to be got through as
well as possible--
preferably in slumber.
(3) Then we turn to the hader,
or townsfolk. It is necessary to
distinguish to some degree between the Moslems, the
Christians and
the Jews, and, in the case of the last two, to
differentiate between
the true Orientals and the more or less orientalized Europeans,
because each class has different social customs
and modes of life,
leading to a different liability to disease. For
example, venereal
diseases are distinctly rare among the Jews of
Palestine, not very
common among the oriental Christians, but fairly
common among
the more well-to-do Moslems. This is said to be
increasingly true
the nearer we approach to
high percentage of the people, according to the late
Rev. Canon
they, as a class, are much held in check by
religious motives. Public
vice is uncommon everywhere, but on the other hand a
large pro-
portion of the more notorious “public women,”
especially in
are deplorably common, and they are viewed by the
rank and file
HYGIENE AND DISEASE IN
with but little horror. The kidnapping of boys for
vile purposes is
done in some of the larger Moslem centres in broad daylight, and
the victims, not uncommonly native Jews, have but
little redress.
The
writer has had many such cases under his care.
As a whole the towns-people enjoy better houses,
better clothes
and better food than the fellahin; and perhaps, as
a class, oriental
Christians
know best how to live comfortably. Food is much the
same as with the fellahin, with the addition of
great quantities of
sweets and nuts, sweet sherbets and coffee, the first
mentioned,
particularly, leading to rapid decay
of the teeth. The villager with
his coarse food has usually excellent teeth, but a
few months of
town life leads to rapid deterioration. Milk is, by
a long-standing
instinct, always boiled--a custom which doubtless
saves many lives
from Malta fever, enteric and tuberculosis. In the towns,
dyspepsia
is also somewhat common, much of it being due to
the habit of
cooking food with oil, olive or sesame, instead
of, as with the
fellahin, with semen (boiled butter). The
orthodox Jews, always,
and the native Christians, at fast seasons, are
obliged to cook
their meat and vegetables in this way, and experience
shows that
food so prepared is not easily digested.
The sanitary arrangements of all the towns are
still extremely
primitive. Drain traps are practically unknown,
except in European
houses and institutions. The “waterclosets"
are usually in close
proximity to the front door, or the kitchen, or
both; and the
entrance to the main drain or cesspool, where
there is often an
accumulation of years, being quite untrapped, the effluvia is at
times almost unbearable. In
easily drained, a water-carriage system of main
drainage has been
made, ancient sewers being utilized, but as there is
no system of
flushing these badly constructed, stone-built
channels, sewage
stagnates in them during the whole dry season,
poisonous gases
make their way freely into the houses and streets,
and the liquids
impregnate the surrounding soil for a considerable
distance, and,
without doubt, in places reach the neighbouring cisterns. When
the heavy winter's rains fall, the accumulation of
months is carried
down the main sewer, emerges in the valley of the Kedron just
below the village of Silwan,
and flows down the valley in close
proximity to the Bir Eyyub (Job's well--the ancient ' en-Rogel),
the
water of which is carried to the city for many
domestic purposes.
Much
of the fresh sewage is distributed over the gardens to the
20 HYGIENE
AND DISEASE 1N
south of the city, in which are grown quantities of
the salads,
cauliflowers, and other vegetables
supplied to the city. One effect
of these and such-like arrangements is the
universal occurrence of
“round worms " among the native population, and here too
we have
all the necessary antecedents for the propagation
of enteric fever and
cholera.
(To be continued.)
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