Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Gin And Tonic—Cultural Footprints of Disease


To mitigate incorrect assumptions about patients who have been infected with COVID-19, we must work to spread truths and to minimize inaccuracies—particularly those that may be shameful or demeaning.

Humans have faced pandemics for millennia. As the nature and cures of these scourges were unknown, they left indelible imprints on human lives primarily driven by culture, practices, or superstition. Here are some examples of commonly used phrases that have origins that can be traced back to pandemics. Not all of them are positive and it’s worth reflecting on how patients suffering from these diseases were often subject to adverse social beliefs and stigmas.


1. “God bless you” or “Bless you”

Use of this expression when someone sneezes is quite ubiquitous. It’s attributed to Pope Gregory I who suggested this prayer in the hope that it would protect them during the bubonic plague in Europe around 590 CE. Sneezing was thought to be a sign of a person falling ill. There were similar expressions in other cultures whose meanings ranged from “live long,” to “be healthy,” or “thanks to the Lord.” The bubonic plague also gave rise to several terms like “avoid him like the plague” which likely led to social ostracization.



2. “Ring o ring o roses”

This nursery rhyme and game is still sung and played in many parts of the world. One of the theories about the origin dates to the Great Plague of England around 1665. A “rosy” rash was thought to be a symptom, “posies” of herbs were carried to help cure, and “ashes, ashes we all fall down” meant death—all captured in this seemingly innocent rhyme.



3. “Gin and tonic”

This expression dates back to early 19th century India when malaria was exacting a heavy toll on the British East India company. British officers added gin, water, sugar, and lime to quinine to make it more palatable. The popularity of the drink has only increased over time.



4. “Consumption”

This was a common word used to describe the wasting away of patient suffering from tuberculosis. Unfortunately, the care of the patients was often shifted to “sanatoriums” where patients spent many months or years (often final) away from their families.



5. “Untouchable”

There have been several treatises written on the social impact and negative stigmas that originated from outbreaks of leprosy and stretched on for millennia. The phrases that referred to sufferers as unclean, impure, or “untouchable” have diminished as science and subsequent cures helped defeat the disease.



6. “Cooties”

This was a term originally used for diseases caused by lice or other parasites and it’s somehow morphed into a North American elementary school game. It’s now thought to represent an imaginary disease that can be caught by touching or bodily contact with a person typically of the opposite sex. Unfortunately, it’s also a way children bully or reject others when the labeled individual is perceived as physically or behaviorally different.


As healthcare professionals, we should be mindful about social impacts when we label a patient as suffering from a pandemic disease. It disrupts their lives within their homes and communities where they might be treated as outcasts. We have a responsibility to spread knowledge and awareness and work to mitigate incorrect assumptions. Clear communication, education, and supporting families and communities is key and will be the true “shot in the arm” for public welfare during pandemics.



This piece expresses the views solely of the author. It does not represent the views of any organization or institution, including CLOSLER and Johns Hopkins Medicine.