How Art Has Documented Global Disease Since the First Century

Throughout history, people have turned to art to express emotions about events. This is no different for disease as outbreaks, epidemics, and pandemics have ravaged the world for centuries. Covered below are many global disease outbreaks that have had art created about them. The art may be graphic to some and death is discussed.

It’s important to distinguish the difference between an outbreak, epidemic, and pandemic. An outbreak of a disease is “a sudden rise in the number of cases of a disease. An outbreak may occur in a community or geographical area, or may affect several countries. It may last for a few days or weeks, or even for several years.” An epidemic is an occurrence of cases of a rapidly spreading infectious disease beyond what is normally expected in a geographical area. A pandemic is a disease outbreak that has spread across many countries and has affected a large number of people.

There was a series of epidemics in Europe prior to the 14th century that were not well documented. As a result, the art pool from these illnesses is small, and much of it was created in later centuries.

Antonine Plague — 165 A.D.

the Plague of Rome engraving by Levasseur after Jules-Elie Delaunay

This plague is known to have emerged in the Hunnic Empire, later spreading to the Germans and the Roman Empire. Symptom descriptions have led scientists to believe it was an early form of smallpox. It had a death toll of 5 million. This engraving is done in extreme detail, showing an angel of death striking down a door in Rome, presumably to take another person's life in the face of disease.

Japanese Smallpox Epidemic — 735

An acute viral disease, smallpox had devastated up until its eradication in 1979. One extremely devastating epidemic occurred in Japan in 735–737. Fiscal reports from these years have led to estimates that smallpox killed a third of the Japanese population in this time. There is little art dated to this period, but there are several pieces of Japanese art about smallpox, including symptom diagrams and pieces where smallpox is depicted as gods or demons.

Minamoto no Tametomo Punishes Smallpox Gods, created in 1892 based on Japanese history that describes Tametomo punishing the two smallpox gods variola major and variola minor.

Leprosy — 11th Century Onward

Clerics with leprosy receiving instruction from the Bishop. Omne Bonum illuminated manuscript (James le Palmer)

Leprosy, also known as Hansen’s disease, is a slow-developing bacterial disease that causes sores and deformities in the human body. There was a wide outbreak of leprosy in 11th-century Europe. Given that it was different than previous diseases and there was little known about it, many believed leprosy to be a punishment from God that ran through families. This belief led to extreme moral judgments and ostracization of victims, as most did not suffer quick mortality. This desire to keep them out of the public eye, where they might pose a social threat, has caused stigma to this day. Leprosy still affects tens of thousands each year and can be fatal if not properly treated. A large portion of art pieces about leprosy from the 11th century, or around, have a shared emotion of isolation as art pieces have clear, or underlying, themes of shunning and judgment.

A Nigerian mask believed to represent disfigurement caused by leprosy (Left), Elderly Couple with Leprosy illustration (Center), A 14th Century manuscript depicting a person with Leprosy and his warning bell (Photo taken by Peter Richards, The Medieval Leper, 2000) (Right).

The Columbian Exchange — 15th, 16th, and 17th Centuries

While not technically a pandemic, the Columbian Exchange was still disastrous.

The Columbian Exchange was when Europeans colonized the Caribbean and the Americas. This process is known as an “exchange” because both the native peoples and the Europeans gained new resources from each other in the process of colonization. The most deadly of these exchanges is that of disease, which was a near one-way exchange from Europe to Native civilizations (with the exception of Syphillis) that started in the Caribbean in 1492. Native peoples were not accustomed to countless diseases such as typhus, smallpox, and measles that spread through the Caribbean, Hispanola, the Aztec Empire, and Native American populations. Since they weren’t accustomed, they couldn’t properly fight off or treat these diseases. Throughout the long period of exposure, diseases brought over by the Columbian Exchange killed millions, including around 16 million in the Aztec empire and some 56 million Native Americans in the 16th and 17th centuries alone.

“A drawing by Spanish missionary and Aztec archeologist Father Bernardino de Sahagún from the mid-sixteenth century that depicts smallpox victims at different stages of the disease.”

The Plague

Justinian Plague — 541 A.D.

Saint Sebastian Interceding for the Plague Stricken (Josse Lieferinxe, c. 1497–1499)

This plague originated in both Palestine and the Byzantine Empire before spreading through the Mediterranean. It’s often considered the first major outbreak of the bubonic plague, and caused massive economic upheaval and panic within Emperor Justinian’s reign. Reoccurrences of the plague over the next two centuries claimed the lives of 50 million people, which was about 26% of the world’s population. This painting depicts St. Sebastian pleading with Jesus to spare the life of a gravedigger impacted by the plague. Thought it was painted centuries later than the pandemic, it still holds the chaotic, terrified emotion of those affected.

The Black Death — 1347

One of the earliest known drawings of the plague. (1349)

The Last Judgement (detail) (Taddeo di Bartolo)

The Black Death, also known as the Black Plague, the Pestilence, the Great Plague or the Bubonic Plague, was a devastating global pandemic of the 14th century. It was inflicted on a person by fleabites and was mostly carried by rats. The plague itself, which transferred easily from one person to the other if they were close enough, was gory, painful, and sometimes extremely quick to kill. Streets were filled with bodies, both dead and alive. It was a common belief that the plague meant pestilence, one of the four horsemen of the apocalypse, was arriving, signifying the end of the world. European art from this period showcases the terror citizens felt. It often features subjects such as the ill, people transporting the dead, and the chaos in the streets. The Black Death was also often considered a punishment from God, similar to previous epidemics, and it caused widespread religious persecution. Some paintings depict the burning of Jews, who were held at cause for the plague.

The black death epidemic of the 14th century killed one-third of the world population, which was equivalent to about 200 million people.

Triumph of Death (Brugel the Elder) (left), “…residents of a town stricken by the plague burn Jews, who were blamed for causing the disease.” (Gilles li Muisis, 1340s) (middle), sculpture of a man with plague symptoms (right)

Drawing from a medical pamphlet (left), The Dance of Death (Danse Macabre) (Michael Wolgemut, 1493) (right)

Italian Plague — 1629

This outbreak of the plague lasted until 1631. Having been one of the more drastic outbreaks since the black death, this pandemic spread through towns in Italy at a rapid pace. From this outbreak came a number of detailed works, as well as the famous plague doctor mask.

Engraving (Melchiorre Gherardini, 1630) (left), Drawing of the Great Plague in Milan (right)

Italian Plague of 1629–1631 (Mikkal Noptek) (left), 16th Century Plague Doctor Mask (German Historical Museum, Berlin) (right)

The Great Plague of London — 1665

“Dunstall, a 17th-century engraver, created nine woodcuts showing the effects of the plague on the citizens of London, including both the victims and those who treated them, and the wealthy who escaped the City.”

Similarly to previous plague epidemics, this outbreak of the plague in 1665 London spread quickly. As soon as the first cases were confirmed, anyone who had the resources to flee left the city. All trade with London and any other plague towns was stopped and the borders to England closed. The plague was most rampant in areas filled with waste and killed around 100,000 people. The art of the London plague, from 1665–1666, is less graphic and chaotic than previous plague artwork, likely because this outbreak was much better contained. Art was realistic as to the state of the common citizen, the state of the city, and how society was running in London at the time.

An Incident in The Great Plague of London (Alexander Christie) (left), “Bring Out Your Dead” illustration (right)

The Great Plague of Marseille — 1720

Contemporary Engraving of Marseille During the Great Plague (Michel Serre)

Marseille, a port city of southern France, faced a deadly outbreak of both bubonic and pneumonic strands of the plague in 1720. This outbreak ravaged the city and killed an estimated 100,000 people. Paintings of the 1720–1722 epidemic display the chaos and fear seen in previous plague paintings, but remains realistic. A large portion of paintings on this outbreak are from a great distance, allowing the viewer to see a large part of the city.

Marseille during the plague outbreak (left), Scène de la peste de 1720 à la Tourette (Marseille) (Michel Serre) (right)

The Third Plague Pandemic — 1855

A makeshift hospital in a factory building, Hong Kong (1894) (left), Liverpool men dipping rats in buckets of petrol in an attempt to kill any fleas. (1900–1920) (right)

Images from Visual Representations of The Third Plague Pandemic, descriptions here

The Third Plague Pandemic began in Yunnan, China in 1855. This third pandemic of the bubonic plague spread from China to India, and later to cities like Rio de Janeiro, Sydney, and San Fransisco around the world. While accounts vary, this pandemic is said to have killed upwards of 12 million people. The height of the pandemic lasted until the end of the century. Given the technology developments since the previous plague pandemics, there is less traditional art (paintings, etc) and more photography to be found. An excellent source for photography from this pandemic can be found in Visual Representations of the Third Plague Pandemic from the Cambridge University database.

“An 1894 engraving from The Graphic, a British newspaper, shows a plague epidemic in Hong Kong, then still a British colony.”

The Great Plague of Manchuria — 1910

“A red-cloaked Grim Reaper ravages the landscape of Manchuria in a cover illustration from a 1911 edition of Le Petit Journal, a French newspaper.”

This plague epidemic is not one of bubonic plague, but of pneumonic plague. Since the plague was pneumonic and dealt highly with the respiratory system, it infected through the air and rapidly spread through Manchuria. This outbreak, which lasted until 1911, killed around 100,000 people and inspired many political cartoons, in addition to paintings and photographs.

A depiction of the grim reaper (left), A drawing on the importance on the Russian sanitary commission (right)

Cholera Pandemics

Cholera was commonly called the Blue Death because people who fell prey to it often developed a blue tint to their skin. This 1857 drawing depicts an American colonist with the Blue Death.

There have been seven major Cholera pandemics in the last 200 years. Cholera, a deadly bacterial disease of the small intestine, is painful and can kill in hours. The first pandemic, beginning in 1817, originated in India and continued to spread through southeast Asia, the Middle East, eastern Africa, and the Mediterranian coast. The second pandemic spread the disease worldwide: across western Asia to Europe, Great Britain, the Americas, China, and Japan. The second pandemic famously spread the disease to Russia, causing the first of many famous Cholera Riots.

L’Inhumation Precipitée [The Premature Burial], (Antoine-Joseph Wiertz, 1854). Wiertz, in a visit to cholera-ravaged Naples in 1837, found that people were so scared of catching the disease they were burying people infected who hadn’t yet passed away.

The third pandemic, often considered the most deadly, killed upwards of a million people in Russia, Great Britain, the rest of Europe, the Americas, Asia, and Africa. The fourth and fifth pandemics proved the most tame of the seven, but still killed thousands. The sixth pandemic devastated India, Russia, the Middle East, and Africa. The seventh pandemic, which hit its peak from 1961–1975 but is still present in the world today, originated in Indonesia before spreading to Asia, the Middle East, South America, and Africa.

Cholera did not have a confirmed source for a long time. It wasn’t until John Snow, a British physician, studied the cases of cholera in London in the midst of the deadliest year of the outbreak, 1854. In his investigation, he found that all confirmed cases connected to a contaminated water pump the people were in contact with. This was still a cause many didn’t believe in until much later, and the uncertainty of how the disease spread lit fear in the minds of many. This fear inspired satirists and artists alike to create an array of artwork, from cartoons and drawings to classical paintings.

Robert Cruikshank’s Random Shots (No 1 (left) and No 2 (right)) A Cholera Doctor, c1832 (colored etching). Both etchings spoke on the uncertainty the public had in doctors. As cholera kept spreading and becoming worse, people began to believe doctors were prescribing treatments that would prolong the disease for their own profit.

A symbolist depiction of the effect of cholera, represented as a human, on the globe. From an 1885 medical text. (left) An engraving from Barcelona that depicts cholera as a human, facing a group of women. (19th century) (right)

A piece depicting Death infecting the water people are drinking from, spreading the disease. (left), A drawing of Death bringing cholera to the people in a 1912 edition of Le Petit Journal. (middle), A political cartoon showing New York City’s efforts to keep cholera from entering the city via immigrant ships. Cholera, often called “King Cholera”, is perched on the ship’s bowsprit. (right)

An English cartoon showing the spread of cholera in the urban city (mid-19th-century) (left) Citizens burn smudge pots (an oil-burning device used typically to keep frost off of fruit trees) to combat cholera in 1832. Black smoke hangs over the city of Quebec in this painting by Joseph Légaré. (right)

French caricature from 1830. (left), It is Cholera to Blame (Pavel Fedotov, 1848) (right)

Death as a Cutthroat (Alfred Rethel). Inspired by an account of the 1832 cholera outbreak written by poet Heinrich Heine.

Influenza

1889–1890 Flu Pandemic

“The January 12, 1890, edition of the Paris satirical magazine Le Grelot depicted an unfortunate influenza sufferer bowled along by a parade of doctors, druggists, skeleton musicians and dancing girls representing quinine and antipyrine”

This influenza pandemic is often considered the first significant flu pandemic or the first “modern” flu pandemic. It’s occasionally called the Russian flu. It began in Russia before spreading worldwide, particularly to the rest of Europe and the US. It most drastically affected Russia, however, and dissipated relatively quickly. This outbreak is said to have killed as many as 1 million worldwide. Art pieces from this pandemic commonly show two extremes: those who understood the disastrous effects of influenza and those who believed the disease was temporary. This art from this pandemic was mostly produced in the form of drawings and engravings.

Le Petit Parisien, 1890. This cover spread shows how France was responding to the influenza epidemic, from tents to separate the infected (top left), to a setup hospital (middle), to street performers and passing out clothes to families of the ill (bottom). These seemingly lighthearted measures against the disease, particularly the image in the middle, showcases how people believed influenza was a casual virus that would quickly pass, not a deadly epidemic.

The Illustrated Police News, 1892 (left), The Prevailing Epidemic (engraving by J. Leech) (middle), “The Dutch minister Bergansius and Hendrik Pieter Tindal visit an influenza hospital populated with representations of the countries of Europe. Reproduction of a lithograph by J. Braakensiek, 1889.” (right)

Spanish Flu — 1918

Germicide Rush, 1918 Influenza Pandemic (Chas Reese, 1919)

This is often considered the most severe pandemic in recent history. This strand of influenza infected an estimated 500 million people, or roughly one-third of the world population, between 1918–1919. This pandemic caused upwards of 50 million deaths. With little effective public health measures against influenza, as well as a common belief that the disease was a temporary virus (as seen in the 1889 pandemic), the disease spread rapidly. Influenza was commonly represented as a monster or skulls in Spanish Flu art. This strand, which arose from birds and can be referred too as an avian flu, found it’s strongest symbolism in birds.

Self Portrait with the Spanish Flu (Edvard Munch, 1919)

A monster, representing influenza, hits a man over his head while he sits in an armchair. (Ernest Noble) (left), North Carolina cartoon (right)

(R. W. Harrison) A family mourns as death takes some of their loved ones, who had been killed by the Spanish Flu. (left), “ Throughout history, birds have been linked to death. As omens of death in folklore, feared as carriers of deadly viruses, or in popular songs and rhymes like ‘In Flew Enza.’” (right)

Vintage poster for the epidemic in the U.S. (1918) (left), The Family (La famiglia) (Egon Schiele) Sciele and his family died of the Spanish Flu (right)

Swine Flu — 2009

This outbreak of influenza, originating from pigs, swept worldwide through 2009 and 2010. An estimated 151,700–575,400 people died from the swine flu in that time. Being an outbreak in the rise of digital media, there is a large array of digital artwork about swine flu.

Swine Flu Over the Cuckoos Nest, chalk art (Imag Obegi, 2009) (left), Conceptual swine flu clip art (middle), A street art piece from Beijing, 2009 (right)

Ebola Epidemic — 2014

Ebola Virus Disease (EVD) is a deadly disease that primarily affects the African continent. It’s transmitted via bodily fluid and animals and has had reoccurring small outbreaks several times since the disease’s discovery in 1976. From 2014 to 2016, the disease ravaged through Guinea, Liberia, and Sierra Leone, infecting over 28,000 people and killing over 11,000. Much of the art from this period is centered on education, particularly in infected areas. A large percentage of this artwork is also found in the form of contemporary paintings.

Murals about the symptoms of Ebola, as well as prevention methods, were made to spread awareness of the disease in Liberia, one of the countries most infected by it. (Mural on the left: Stephen Doe, 2014)

Ebola (Susi LaForsch, 2014) (left), HOW CAN I UNDERSTAND THIS WORLD; EBOLA VIRUS (Robert Roelink) (right). Photos of health care workers in Africa, dressed in hazmat clothes, were a symbol of the epidemic.

Ebola Burial Team — Sierra Leone (Mudiama Kammoh, 2015) (left), Ebola (Mia Weiner, 2009) (middle), Keeping the Message Alive (Leslie Lumeh) (right)

HIV/AIDS Epidemic — First identified in 1981

“HIV stands for human immunodeficiency virus. It harms your immune system by destroying the white blood cells that fight infection. This puts you at risk for serious infections and certain cancers. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV.”

HIV/AIDS has been around for centuries, but its cause was identified in 1983. The disease is spread through bodily fluids, and is most commonly transmitted via unprotected sex, sharing needles used for drugs, and birth. HIV arrived in the United States in the 70s, but the Centers for Disease Control and Prevention (CDC) soon reported on five men who had contracted a rare form of pneumonia. At the same time, reports of men contracting a rare form of cancer emerged, concerning the public as these diseases were never contracted unless the person had a compromised immune system. AIDS, which seemed to infect mainly gay men, was soon labeled GRID, or gay-related immune deficiency. Despite CDC releasing reports on how AIDS could infect women, AIDS continued to be considered a gay disease or the “gay plague”. By 1999, despite several resources coming out, including AZT, at-home testing, and other medical resources, AIDS was the fourth biggest leading cause of death worldwide. There have been an estimated 75 million people infected and 32–35 million people killed from HIV/AIDS. Art from the HIV/AIDs epidemic and movement focuses on a variety of topics: from education to depictions of and commentary on the discrimination against those infected, the lack of governmental help, silence, and gay symbolism. Art and symbolism in the HIV/AIDs movement was a rallying point for the ACT UP and LGBTQ+ movements of the late 1900s and early 2000s, showcasing both the fear and injustice felt in those communities.

“Democracy” ( David Wojnarowicz, 1990) (left), Die you HIV Scum (Copy Berg, 1991) (right)

The Reagan Administration concerned many AIDs activists, as they were not taking any actions against the disease and opposed sex education, worsening the spread of HIV/AIDs overall. This poster, inspired by the president's lack of effort and the death of the artist's friend due to AIDs, showcases these concerns. He Kills Me (Donald Moffett, 1987) (left), Against AIDs (Larry JaBell, 2002) (middle)

Vibrantly Alive (Elton Tucker, 2005) (left), We Are All HIV+ (Kevin Wesley, 2003) (middle), Two Men and a Woman (Hugh Steers, 1992) (right)

Retrovir, (AZT) Miracle Drug? (Kurt Reynolds, 1990) (left), NAMES Project AIDs Memorial Quilt (right)

Q (David McDairmid, 1994), (David McDairmid)

AIDS wallpaper (General Idea, 1989) (left), AIDS is Not Over (Edith Alvarez, 2012) (middle), AIDS #5 (Marc Lida, 1983) (right)

Silence = Death is a saying from the ACT UP movement against AIDs that is meant to encourage people to spread awareness about the disease. The pink triangle symbolizes Nazi persecution of LGBTQ+ people in the 1930s and 40s. Ignorance = Fear (Keith Haring, 1989) (left), Silence = Death (Kieth Haring, 1989) (middle), Silence = Death (SILENCE = DEATH Project (Avram Finkelstein, Brian Howard, Oliver Johnston, Charles Kreloff, Chris Li))

COVID-19 Pandemic — 2020 (Current)

The current pandemic of Coronavirus disease has been rapidly spreading through the world since the start of the year. This respiratory disease, similar to the flu, has put much of the world into a shutdown, canceling travel, events, and causing mass self-quarantine. As of 3/23/2020, there are upwards of 372,000 confirmed cases worldwide and upwards of 16,300 deaths. Artwork is steadily emerging in the face of this pandemic, and all of it demonstrates the fear people are feeling as this pandemic continues to escalate. COVID-19, having thought to have originated in China, has resulted in a drastic spike of racism against Asians.

“Here’s a mural by Italian street artist Laika, which features Sonia, the owner of the Hang Zhou restaurant in the Esquilino district, best known as the Chinatown of Rome. The mural tackles the ignorance and xenophobia surrounding Covid-19. Sonia, dressed in white surgical costume and face mask, has a speech bubble which reads (in Italian): ‘There’s an epidemic of ignorance going around… we must protect ourselves!’”

Grafitti in Munich, Germany (left), Glass sculpture, Coronavirus-COVID 19 (Luke Jerram) (right)

Statues have been dressed, particularly with masks, worldwide in the face of COVID-19 outbreaks (Daegu, South Korea)

General Sources

Pandemics That Changed History

Outbreak: 10 of the Worst Pandemics in History - MPH Online

Visualizing the History of Pandemics

6 Devastating Plagues