Picardy sweat

The Picardy sweat was an infectious disease of unknown cause and it was the only disease that bore any resemblance to the English sweating sickness. The Picardy sweat is also known as the miliary fever, suette des Picards in French,^[1] and picard'scher Schweiß, picard'sches Schweissfieber, or Frieselfieber in German.^[2] It appeared in the northern French province of Picardy in 1718. The Picardy sweat was mainly confined to the northwest part of France, particularly in the provinces of Seine-et-Oise, Bas Rhin, and Oise.^[3] Although the Picardy sweat began in Northern France, outbreaks also occurred in Germany, Belgium, Switzerland, Austria, and Italy. Between 1718 and 1874, 194 epidemics of the Picardy sweat were recorded.^[4] The last extensive outbreak was in 1906, which a French commission attributed to fleas from field mice.^[5] A subsequent case was diagnosed in 1918 in a soldier in Picardy.^[6]

There were two types of the Picardy sweat, a benign form that was similar to nephropathia epidemica and a more severe form that resembled the English sweat. The disease was similar to the English sweat but differed in some symptoms and in its course and mortality rate. Additionally, the more severe type of Picardy sweat is believed to be more benign than the English sweating sickness. The rate of sickness was anywhere from 25% to 30% of the population and the mortality rate is estimated to have been between 0% and 20%.^[7] Similar to the English sweat, the more severe Picardy sweat was characterized by intense sweating, but the symptoms were less fatal. Some of the symptoms were high fever, rash, and bleeding from the nose. Other symptoms include intense sweating, headaches, suffocation, precordial pain, anxiety, and "passion of the heart" or palpitations. Additionally a miliary rash followed by desquamation, or peeling of the skin, is a fresh feature that was brought on with this variant of the English sweating sickness would typically appear three to four days after infection.^[8] Many victims died within two days.^[9]

André Chantemesse

The Picardy sweat occurred in limited epidemics, usually for a short duration during the summer months. Additionally, this disease spread predominately in rural villages and communities. André Chantemesse, a French bacteriologist, presented a detailed epidemiological account of the outbreak. Chantemesse argued against human-to-human transmission by discussing specific visits of ill individuals in visits of ill individuals to nearby villages. Additionally, he believed that those who slept on or near the ground were more likely to be infected. Chantemesse called the Picardy sweat, "the virus that came from the fields." Although symptomatology did not match, he believed that this disease was transmitted through flea bites and predicted that the virus came from rodents invading homes after flooding.^[7]

Related Illnesses

The English sweating sickness, also known as Sudor Anglicus, caused five major epidemics between 1485-1551. The location, duration, and violence differed with each respective outbreak. This sickness, named after the devastation it induced in England, had a mortality rate of 30% to 50%. A Noteworthy mention is the English sweating sickness did not attack the younger or the older individuals, but rather the middle-aged individuals in the population. Additionally, these individuals were typically active, wealthy, and white males.^[7] The Picardy sweat appeared over 150 years later, in 1718, in France. This outbreak was considered to be much less fatal in comparison to the English sweating sickness. Although there is much speculation about the similarities between the Picardy sweat and the English sweating sickness, it is unknown rather or not the two were derived from one another. Given the two sicknesses have different geographical regions and over a century of time between outbreaks, many speculate that the two are not related. However, other speculations say that both could be a form of what we know today as hantavirus infections. A hantavirus infection is one that is spread mainly through rodents, insectivores, and bats and cause varied disease syndromes. Each type of hantavirus is carried by a specific host species and phylogenetic analysis revealed that the relationships between hantaviruses generally parallel the phylogeny of their rodent hosts.^[7]

Treatment

The Picardy sweat disease was previously believed to arise from a leaven or a poison that would directly contaminate the blood. Due to this, physicians during this time suggested expelling the disease through sudorifics, cordials, ptisans, and heavy bedclothes.^[10] Sudorifics were suggested because they are medicines that induce sweating. Sweating would then allow the disease-causing agent to have the ability to exit the blood via the sweat glands. Heavy bedclothes were proposed because they would also induce sweating, thus resulting in the expulsion of the disease while the infected patient was asleep. Drinking cordials was presented to infected individuals because cordials were believed to sterilize the body and blood due to the low alcohol content found in cordials. Additionally, ptisans, or warm teas, were recommended in hopes that the herbs within the ptisan would have healing agents that would aid in the expulsion of the disease.

Around 1773, the treatments for the Picardy sweat disease changed when other means of curing the disease were introduced. Venesection procedures, mild lukewarm drinks, small doses of hypnotic medicine, and withdrawing practices on the hands and feet were suggested as more efficient ways of treating the Picardy sweat disease.^[10] Venesection procedures, or more commonly known today as phlebotomy procedures, would directly remove blood from the body and essentially the disease along with it. The blood is drawn through a small incision or a puncture of the skin. Venesection would have been most efficient in the early stages of infection before the disease has had the opportunity to spread throughout the body. Mild lukewarm drinks were opposite of the warm ptisans that were suggested prior to 1773. Hypnotic medicines were suggested to aid in sleeping and provide some relief during the night. Withdrawing practices on the hands and feet were performed to generate rashes, which usually soothed the pains of the disease. An example of how they did this includes bathing the hands and feet in mustard water which irritates the area, therefore, drawing blood and disease to those regions of the body.^[10] Essentially, the goal of this was to intensify pain in particular regions of the body by inducing rashes to make the pain caused by Picardy sweat disease feel less extreme. Counter-irritation was important for providing relief and was especially necessary when the lungs or head became congested.

Another treatment for the Picardy sweat disease during this time was quinine sulfate. Physicians would prescribe doses of 3 grams or less of quinine sulfate to affected patients.^[7] Quinine sulfate was later used as a treatment against a disease caused by parasites called malaria. This disease typically enters the body via the bloodstream due to mosquito bites from parasites carrying the malaria disease. This disease is similar to that of the Picardy sweat disease because both pathogens enter the human body by infiltrating the bloodstream. Quinine sulfate was a suggested form of treatment because it was assumed to expel the disease through the drug's side effects. Quinine sulfate can be responsible for inducing sweating and causing easy bleeding.^[11] These side effects would fundamentally expel the disease from the human body.

See also

• Sweating sickness

References

External links