Clinical: The Top 10 Scariest Medical Diagnoses Throughout History

The Top 10 Scariest Medical Diagnoses Throughout History

Osmosis Team
Published on Oct 9, 2023. Updated on Oct 24, 2023.

Navigating the spooky realm of viruses and bacteria can be hair-raising! While many of these conditions have become at least treatable, if not curable, many of them still scare even the bravest souls. Join us on this spine-tingling journey as we uncover history's top ten scariest medical diagnoses! 

The Black Death: A Plague That Struck Fear

The Black Death, or the Bubonic Plague, struck fear into the hearts of millions of Europeans and Northern Africans, killing one-third of the population of Europe, around 25 to 30 million people, at its peak between 1346 and 1353. The plague spread from infected rats to fleas and ultimately jumped to humans who came in close contact. Symptoms included high fevers, pain in legs, abdomen, and arms, and large swollen pus-leaking lumps in the lymph nodes, known as bubobes.

Many superstitions surrounded the spread of the black death. These ranged from punishments from God, allowing foreigners to follow different religions, poisoned wells, and “bad air” to the (mis)alignment of the planets. It wasn’t until 1894 that Alexandre Yersin discovered what actually causes the plague: the bacterium Yersinia Pestis. The impact of the plague was far-reaching. Although wars were temporarily halted, so was trade. Families lost their breadwinners and were devastated, as were landowners who lost laborers. 

Leprosy: Social Stigma and Isolation

To suffer leprosy in early times was the pathway to the life of a social outcast, such was the stigma associated with the disease and the severe disfigurement and deformity it causes. Leprosy was something concealed and feared. In early times, colonies were created to isolate sufferers from society. The irony is leprosy is not, in fact, very contagious. Although today, leprosy, also known as Hansen’s Disease, is curable with 6 to 12 months of multi-drug treatment, there’s still a stigma associated with the disease. Early diagnosis is the key to successful treatment, but many people find it difficult to get the medical help they need due to the stigma associated with the disease.

Leprosy is caused by Mycobacterium leprae. It impacts the peripheral nerves, skin, eyes, and respiratory tract and is spread by droplets from the nose and mouth. The impact of leprosy is far-reaching. Aside from the mental and social isolation, households are pushed into poverty due to the loss of income and high treatment costs.

An illustration of a smallpox virus

Smallpox: A Global Scourge

Smallpox has a unique place in medical history. It remains the only infectious disease that has ever been totally eradicated. However, prior to the discovery of a vaccine, smallpox had a 30% mortality rate. The disease caused a distinctive skin rash (pox), fever, and, in some instances, blindness, resulting in those that survived often disfigured from the scars.

The vaccine was developed from the observation of Edward Jenner, who noted that milkmaids who developed cowpox didn't seem to get smallpox. The last natural outbreak of smallpox occurred in 1977. Despite the first vaccine being developed in 1796, it still took nearly 200 years to eradicate the disease. 

Tuberculosis: The White Plague

Tuberculosis still affects 10 million people yearly; despite being preventable and curable, 1.5 million die annually. In the late 1800s, tuberculosis accounted for one in every seven deaths in the US and Europe. Referred to as the White Plague due to the pale pallor resulting from severe weight loss, fatigue, and general debilitation, tuberculosis is an airborne disease caused by the bacteria Mycobacterium tuberculosis. It most commonly affects the lungs with symptoms including a bad, long-lasting cough, expelling bloody sputum, and chest pain. 

Before antibiotics, isolation, and good nutrition were considered the key to managing tuberculosis. The first significant breakthrough in treatment came with the Bacille Calmette-Guérin (BCG) vaccine in 1921. Antibiotics were the key, and between 1951 and 1966, a new four-drug cocktail was developed that cured tuberculosis. 

Notwithstanding these advances, the cost of treatment is very high due to the increase in new, drug-resistant strains that require DNA testing to identify the strain before treatment, along with a significant shortage of health professionals and clinical resources, making tuberculosis an ongoing health crisis for less developed countries.

An illustration of syphilis bacterium.

Syphilis: The Hidden Epidemic

We’ve dated syphilis as a transmissible STI to around 3000 BC when it spread due to lowering temperatures in Europe and the rest of the world. The first recorded syphilis outbreak was in 1495, rapidly moving from military circles into the general population.

Infection begins with a painful sore, often in the genital area, progressing to a rash on the soles of the feet or palms, possibly after the sore has healed. Untreated syphilis has a mortality rate of 8% to 58% but is easily treatable with one to three doses of penicillin and preventable with the use of safe sex practices. It’s usually accompanied by flu-like symptoms, eventually dissipating and entering a latent stage that can last for many years. For the unlucky few, however, it ultimately enters what’s known as the tertiary stage, where it has the potential to impact most of the systems in the body. Despite knowing how to prevent and cure it, the WHO estimates there are 7.1 million cases of syphilis each year. 

An illustration of a polio virus

Polio: The Crippling Disease

The summers of the early 1950s were known as the “summers without children” when parents isolated their children, fearing they would succumb to polio. Due to the lack of knowledge about the disease, some children ended up paralyzed, while others spent time in iron lungs trying to stave off the infection. Fear was at an all-time high.

Poliomyelitis is a viral disease that’s typically transmitted via the fecal-oral route. It consolidates in the intestinal system, invading the nervous system, potentially resulting in complete paralysis. In 1952, over 3,000 kids in the US died of polio; nearly 60,000 were infected, many left partially paralyzed. It took Jonas Salk, at the University of Pittsburgh, to develop a vaccine that halted the endemic.  Since then, polio has effectively been eradicated. The last US case was in 1979, but it’s still causing outbreaks in the border areas of Afghanistan and Pakistan.

An illustration of the yellow fever virus

Yellow Fever: A Deadly Outbreak

The bite from an infected mosquito carrying the yellow fever virus results in 200,000 cases and 30,000 deaths yearly. The virus damages the internal organs, in particular the liver. As the name suggests, the prominent symptoms are yellowing skin and fever, accompanied by other flu-like symptoms. If the disease progresses, it causes viral hemorrhagic fever.

Endemic in 44 tropical countries in Africa and South America, there’s no cure for yellow fever, just supportive measures. The answer lies in vaccination, which has been available for eighty years and provides lifelong protection with just one vaccination. Despite being introduced as part of the childhood vaccination schedule in at-risk countries, it’s estimated that just 45% of the population received the vaccination, leaving a significant portion of the population without immunization against the disease.

An illustration of influenza variants

Spanish Influenza: The Global Pandemic

Despite its name, Spanish Influenza, as it’s sometimes referred to, did not originate in Spain. It’s believed to have originated in the US, carried to Europe by soldiers headed to Europe to fight in World War I. Keen to keep the losses secret, the military withheld the death rate from the public. The uncensored press in Spain broke the story, leading to an attribution of the origin to Spain. It’s estimated that 50 million people globally succumbed to the Spanish flu.

The symptoms of Spanish Influenza included muscle and joint pain, fever, and chest pain. It struck in rural and urban areas, although poor hygiene and cramped living conditions among soldiers may have contributed to its spread. Victims often died within a few hours of experiencing symptoms. We’re still debating the science from the lessons learned from Spanish Influenza.

An illustration of the HIV virus.

HIV/AIDS: A Modern Epidemic

Initially recognized in 1981, it took another three years to pinpoint HIV as the cause of AIDS. There are estimates that 100,000 to 300,000 individuals were already living with HIV prior to 1980. Little was known about its transmission, leading to rising discrimination against the gay community and intravenous drug users, who were disproportionately affected. This era witnessed significant fear and stigma surrounding those with HIV. 

Education played a significant role in reducing this stigma, along with the support of various celebrities, including Princess Diana, who publicly shook hands with an HIV-positive man and the death of icons like Rock Hudson and Freddie Mercury. Introduced in 1987, AZT was the first, but not especially effective, treatment due to rapid viral mutations. The first significant breakthrough came with the HAART antiretroviral treatment regime in 1995, which resulted in a 47% reduction in deaths the following year. According to the WHO, “The estimated 630,000 people dying from HIV globally in 2022 were 69% fewer than in 2004 (the peak) and 51% fewer than in 2010 despite a period of substantial population growth in many high-burden countries.” Treatments for HIV/AIDS continue to be refined, along with the development of effective prophylactic medications like PrEP, showing that HIV is no longer a death sentence but a managed condition that 39 million people live with globally.

An illustration of cholera bacteria

Cholera: The Deadly Waterborne Disease

Cholera has been around for several centuries, with multiple major outbreaks. In 1845, British physician and epidemiologist John Snow confirmed that poor sanitation and lack of clean water supply were the sources of cholera through his research. While most patients have mild diarrhea or limited symptoms, cholera also has the potential to kill within hours, especially among the young and vulnerable population. There are between 1.3 and 4 million cases each year, with up to 143,000 deaths annually. 

Three vaccines have been developed, with 20 million doses administered globally, typically in areas experiencing an outbreak. One of the major difficulties is that the treatment efficacy remains around the 50% mark, and the extent of vaccine coverage is relatively unknown. The focus now is on prevention by expanding access to clean water sources, educating the public to adopt hygiene practices, and increasing sanitation in areas where cholera is still rampant.

On Past and Present Diagnoses

Although these are arguably the top ten scariest medical diagnoses throughout history, many of them are now curable or treatable, lessening their effect. However, it’s essential to understand the threat of diagnoses like these and the impacts at the time. Why? Understanding the past is often the key to unlocking the future and can provide direction on where research and resources are best directed. Staying up-to-date and understanding the past while informing yourself about current medical developments is often the key to preventing and treating diseases effectively. 

References & Resources