Epidemic and population patterns in the Chinese Empire (243b.c.e. to 1911c.e.): quantitative analysis of a unique but neglected epidemic catalogue

Abstract

A catalogue of dates and places of major outbreaks of epidemic diseases, that occurred in the Chinese Empire between 243 B.C.E. and 1911 C.E., combined with corresponding demographic data, provides a unique opportunity to explore how the pressure of epidemics grew in an agrarian society over 2000 years. This quantitative analysis reveals that: (1) the frequency of outbreaks increased slowly before the 12th century and rapidly thereafter, until 1872; (2) in the first millennium of our era, the people of China lived for decades free of major epidemics; in the second millennium, major outbreaks occurred every couple of years, but were localized; (3) in the more recent centuries, these outbreaks were as common, but disseminated to more places. This evolution, closely matching the demographic growth, was similar in the north and south of China, and therefore may have been similar in other regions of the world.

Correspondence

“…Based on two sets of data, Professor Morabia reveals that demographic expansion closely matches the increasing number of outbreaks and epidemics [1]. The burden of epidemic diseases seemed to grow at the same rate as the population enumeration throughout the Chinese Empire.…”

Pandemics: past, present, future

“…Infectious chronic diseases such as osteomyelitis, leprosy, and tuberculosis occurred in humans in ancient time, but spread of infections as epidemics and pandemics was not possible because of the lifestyle of humans in ancient time as described by A. Morabia 2009 (1). The groups of humans were simply too small to sustain acute communicable infectious diseases because the sick patients either died or became immune and thereby further spread of the infections stopped (Fig.…”

“…The changed living conditions paved the way for epidemics and pandemics which were facilitated by long‐distance journeys, trade, and migration by ships or by horses. At the same time, animal domestication created favorable conditions for animal microbes to adapt to humans such as measles, tuberculosis, and smallpox from cattle, influenza from pigs and ducks, and pertussis from pigs and dogs (1). The growing population density in cities was likewise favorable for emergence of epidemics.…”

“…Epidemics occurred in ancient Sumer, Babylon, and Egypt around 2000 B.C. (1) whereas epidemics do not seem to have occurred in Central America in the Aztec empire where about 25 million inhabitants lived before the Spanish Conquest and where the capital Tenochtitlan (now Mexico City) was one of the largest cities in the world with about 200 000 inhabitants. The Aztecs, however, had only domesticated dogs and turkeys as food resources.…”

“…The Chinese administration’s enumeration of the population and the outbreaks showed a striking correlation between the growing population and the growing frequency of epidemics (Fig. 3) (1). Outbreaks were rare 100 B.C.…”