European Smallpox in the Middle Ages.
The present extensive prevalence of smallpox among the Arabs may or may not date from the Elephant War of A.D. 569. Its prevalence also in Abyssinia, so widely in modern times that almost everyone bears the marks of it, may have no continuous history from the return of Abraha’s expedition. But the history of smallpox in the West comes to us through the Saracens, and there can be no question that the disease is at the present day peculiarly at home in all African countries, and most of all in the upper basin of the Nile, where, as Pruner says, “it appears as the one great sickness[874].” It is a remark of Freind, whose erudition and judgment should carry weight, that “the Saracens first brought in this distemper, and wherever their arms prevailed, this spread itself with the same fury in Africa, in Europe, and through the greatest part of Asia, the eastern part especially[875].” Our inquiry here does not extend beyond England, so that the extremely disputable question of the amount and frequency of smallpox in the European countries conquered or invaded by the Saracens in the Middle Ages need not be raised[876].
So far as concerns England, smallpox was first brought to it, not by the Saracen arms, but by Saracen pens. The earliest English treatise on medicine, the Rosa Anglica of Gaddesden, has the same chapter “De Variolis [et Morbillis]” as all the other medieval compends—in substance the same as in the earlier work of Gilbert, and in all the other Arabistic writings earlier or later. The Rosa Anglica was a success in its day, partly, no doubt, by reason of its style being more boisterous than that of Gilbert’s or Gordonio’s treatises, partly, also, on account of its blunt indecency in certain passages. Guy de Chauliac, of Avignon, one of the few original observers of the time, had heard of the Rosa Anglica, and was curious to see it; but he found in it “only the fables of Hispanus, of Gilbert, and of Theodoric,” and he rather unkindly fixed upon it the epithet of “fatuous.” What de Chauliac had probably heard of was Gaddesden’s occasional claims to originality; and these we shall now examine so far as they concern smallpox.
One of Gaddesden’s variations from the stock remarks on smallpox is his explanation of why the disease was called variola: it is called variola, says he, because it occurs in diverse parts of the skin (quia in cute diversas partes occupant). This is an ingenious improvement upon Gilbert, who says that it is called variola from the variety of colours (et dicitur variola a varietate coloris)—sometimes red, sometimes white, or yellow, or green, or violet, or black. Another remark attributed (by Häser at least) to Gaddesden as original, is that a person may have smallpox twice; but Gaddesden, in a later paragraph, shows where he got that from: “And thus says Avicenna (quarto Canonis), that sometimes a man has smallpox twice—once properly, and a second time improperly.” The most famous of Gaddesden’s originalities is his treatment by wrapping the patient in red cloth; for that also Häser ascribes to him. But Peter the Spaniard, the Hispanus of de Chauliac’s reference given above, is before him with the red-cloth treatment also, while he is candid enough to quote Gilbert: “Any cloth dyed in purple,” says Hispanus, “has the property of attracting the matter to the outside.”
Gilbert’s reference is as follows: “Old women in the country give burnt purple in the drink, for it has an occult property of curing smallpox. Let a cloth be taken, dyed de grano.” Bernard Gordonio, also, says: “Thereafter let the whole body be wrapped in red cloth.” There was probably Arabic authority for that widely diffused prescription, as for all the rest of the teaching about smallpox. But Gaddesden does improve upon his predecessors in boldly appealing to his own favourable experience of red cloth:—“Then let a red cloth be taken, and the variolous patient be wrapped in it completely, as I did with the son of the most noble king of England when he suffered those diseases (istos morbos); I made everything about his bed red, and it is a good cure, and I cured him in the end without marks of smallpox.”
With reference to this cure, it has to be said, in the first place, that the object of the red cloth was to draw the matter to the surface[877], and that it had nothing to do with the prevention of pitting. The means to prevent pitting was usually to open the pustules with a golden needle; that is the Arabian advice, and all the Arabists copy it. Gaddesden among the rest copies it, but he does not say that he practised it on the king’s son. If he had said so, we might have believed that the disease was actually one bearing pustules which could be opened by a needle. What he says, in the earliest printed text (Pavia, 1492) is that, while the king’s son was “suffering from those diseases,” he caused him to be wrapped in red cloth, and the bed to be hung with the same, and that he cured him without the marks of smallpox. Gaddesden was not altogether an honest practitioner; on the contrary he was an early specimen of the quack in excelsis. According to the learned and judicious Dr Freind, “his practice, I doubt, was not formed upon any extraordinary knowledge of his faculty;” and again, “He was, as it appears from his own writings, sagacious enough to see through the foibles of human nature; he could form a good judgment how far mankind could be imposed upon; and never failed to make his advantage of their credulity[878].” The opportunity of diagnosing variola in the king’s son, and of curing it by red cloth, so as to leave no pits, was one that such a person was not likely to let slip. “It is a good cure,” he says; and we may go so far with him as to admit that it must have been impressive to the royal household to have heard some sharp sickness of the nursery called by the formidable name of variola, and to have seen it cured “sine vestigiis.”