Mortality and Incidents of the Great Plague.

The plague of 1665 was justly called the Great Plague, and is sometimes spoken of as “the plague of London,” as if it were unique. But it was not much more severe than those of 1603 and 1625 had been for the London of their generation; and there had been many plagues when London was a small capital, such as those of 1407, 1479, 1500, 1513 and 1563, which had cut off as large a proportion (one-fifth to one-sixth) of the population. The inhabitants in 1665 were not far short of half a million, nearly twice as many as in 1603, and about a third more than in 1625. The increased mortality in 1665 was somewhat more than proportionate to the increase of inhabitants, as the following table shows:—

Year Estimated
population		 Total
deaths		 Plague
deaths		 Highest
mortality
in a week		 Worst
week
1603 250,000 42,940 33,347 3385 25 Aug.-1 Sept.
1625 320,000 63,001 41,313 5205 11-18 Aug.
1665 460,000 97,306 68,596 8297 12-19 Sept.

Reckoned from the christenings and burials in the bills of Parish Clerks’ Hall, the population in 1605 would have been 224,275, and in 1622, 272,207. But in those years (and until after 1636) certain of the newer parishes (known as the Seven Parishes), including Stepney and Westminster, kept separate bills, of which some figures for 1603 and 1625 are given at p. 477 and p. 511. The population of the Seven Parishes appears to have been about one-ninth of the whole metropolis in 1603, and about one-seventh in 1625, while Graunt, a contemporary, makes it one-fifth in 1662. These fractions have been added in the table, so as to make 1603 and 1625 comparable with 1665. In 1603 and 1625, the highest mortality in a week does not show the deaths in those parishes (Westminster, Stepney &c.) which did not send their returns to the general bill until 1636, but their figures have been included in the totals for those years. It will be seen that the plague of 1665 fully kept pace with the increase of population. The old City within the walls had 15,207 deaths in the year from all causes. It had become crowded since the beginning of Elizabeth’s reign by its gardens and churchyards being built upon, and its mansions turned into tenement-houses for a poorer class; and yet in 1563 the mortality from plague and other causes in the City and its Liberties, with a population hardly exceeding that of the City alone in 1665, was 20,372. The enormous total of 1665 was largely made up from the populous suburbs of Cripplegate, Whitechapel, Stepney, St Martin’s in the Fields, St Giles’s in the Fields, Southwark and Westminster, which would have contributed but little to the total down to the middle third of the sixteenth century.

The following tables will show the progress of the epidemic from week to week, the weekly deaths from all causes and from plague, and the incidence upon the several parts of London. The so-called ordinary deaths are much in excess of the average, and must have included many that were really cases of plague. Part of the excess, however, was due to the great prevalence of fever and spotted fever, which made a heavy mortality in the early months before the plague began. Bowel complaint also is credited with a good many deaths. The other more important items in the bills are consumption and infantile troubles. Boghurst, however, says: “Almost all other diseases turned into the plague. For five or six months together there was hardly any other disease seen but the plague and a few casualties, whatever the Bills say; and Thucydides says the same of the plague at Athens.” As to the total of deaths in the year from all causes (97,306), Hodges thinks that it does not show the whole mortality. The largest number of burials in one week is 8297; but he thinks that 12,000 were buried in that week, and that 4000 were buried in one day and night. But there seems to be no reason to set aside the tally of the sextons to that extent; the returns were made weekly from one hundred and forty parishes, and might easily have been exact to within a few in each.

Bill of Mortality of the Plague-year 1665 in London.

Week ending Christened Buried Plague
Dec.27 229 291 1
Jan.3 239 349 0
10 235 394 0
17 223 415 0
24 237 474 0
31 216 409 0
Feb.7 221 393 0
14 224 462 1
21 232 393 0
28 233 396 0
Mar.7 236 441 0
14 236 433 0
21 221 363 0
28 238 353 0
Apr.4 242 344 0
11 245 382 0
18 287 344 0
25 229 398 2
May2 237 388 0
9 211 347 9
16 227 353 3
23 231 385 14
30 229 400 17
June6 234 405 43
13 206 558 112
20 204 615 168
27 199 684 267
July4 207 1006 470
11 197 1268 725
18 194 1761 1089
25 193 2785 1843
Aug.1 215 3014 2010
8 178 4030 2817
15 166 5319 3880
22 171 5568 4237
29 169 7496 6102
Sept.5 167 8252 6988
12 168 7690 6544
19 176 8297 7165
26 146 6460 5533
Oct.3 142 5720 4929
10 141 5068 4327
17 147 3219 2665
24 104 1806 1421
31 104 1388 1031
Nov.7 95 1787 1414
14 113 1359 1050
21 108 905 652
28 112 544 333
Dec.5 123 428 210
12 133 442 243
19 147 525 281
9,967 97,306 68,596

Incidence on Parishes of the Plague in 1665.

Ninety-seven Parishes within the Walls.

All deaths Plague deaths
97 City parishes 15,207 9,877

(The parishes with heaviest mortalities were St Anne’s, Blackfriars; Christ Church, Newgate; St Stephen’s, Coleman St; St Martin’s, Vintry; Allhallows Barking, the Great, and in-the-Wall; St Andrew’s, Wardrobe).

Sixteen Parishes without the Walls and in the Liberties.

St Giles’s, Cripplegate 8069 4838
St Botolph’s, Aldgate 4926 4051
St Olave’s, Southwark 4793 2785
St Sepulchre’s 4509 2746
St Saviour’s, Southwark 4235 3446
St Andrew’s, Holborn 3958 3103
St Botolph’s, Bishopsgate 3464 2500
St Bride’s, Fleet Street 2111 1427
St George’s, Southwark 1613 1260
St Botolph’s, Aldersgate 997 755
St Dunstan’s in the West 958 665
St Bartholomew the Great 493 344
St Thomas’s, Southwark 475 371
Bridewell Precinct 230 179
St Bartholomew the Less 193 139
Trinity, Minories 168 123
Pesthouse 159

Twelve Out-parishes in Middlesex and Surrey.

Stepney 8598 6583
Whitechapel 4766 3855
St Giles’s in the Fields 4457 3216
St Leonard’s, Shoreditch 2669 949
St Magdalen’s, Bermondsey 1943 1362
St James’s, Clerkenwell 1863 1377
St Mary’s, Newington 1272 1004
St Katharine’s, Tower 956 601
Lambeth 798 537
Islington 696 593
Rotherhithe 304 210
Hackney 232 132

Five Parishes in the City and Liberties of Westminster.

St Martin’s in the Fields 4804 2883
St Margaret’s 4710 3742
St Clement’s Danes 1969 1319
St Paul’s, Covent Garden 408 281
St Mary’s, Savoy 303 198
Pesthouse 156

The Great Plague brought back all the familiar incidents of 1603 and 1625, and revealed no new feature. As before, all that could afford to do so made their escape at the outset. Sydenham, who fled with the rest, says that two-thirds of the population left; which may be true of the City proper, but certainly not of the populous Liberties and suburbs on both sides of the water, as Defoe points out. The poorer classes were left stranded, and bore the brunt of the calamity, as they had always done. Flight was, doubtless, the best step to take, the motive being to get “into clean air,” as cardinal Wolsey expressed it in 1515. Those that were left behind knew that they were in bad air, and knew that it mattered little whether they came into contact with the sick or not[1205]. Their employments and wages mostly ceased as the plague extended from suburb to suburb and to the City, so that with starvation on the one side and plague on the other, they held their lives cheaply and bore themselves with an unconcern which was strange to the rich. Their desperate case explains, as Defoe correctly saw, the ease with which the mayor could always get men to undertake for pay the disagreeable and risky work of day and night watchmen to the multitude of shut-up houses, of bearers of the dead, of buriers, of nurses, and distributors of the public charity. As soon as any fell in these humble ranks, others were willing to take their place; so that at no period of the epidemic was there any break-down in the work of expeditious burial or any failure in good order and decency. To carry the poor through the great crisis much money was needed; Defoe says that it was forthcoming from all parts of England and he estimates the distribution of relief at thousands of pounds weekly, although he failed to find the exact accounts, which, he thinks, had been destroyed in the fire of 1666. A thousand pounds a week, he says, was given from the king’s purse. The whole of this great system of relief was under the direction of the Lord Mayor, Sir John Lawrence, who proved himself worthy of the best traditions of his office. In the out-parishes there were Justices of the Peace who discharged the like duties.

The regular clergy for the most part left the town, but two are honourably mentioned as having stayed with the plague-stricken people, Dr Anthony Walker, of St Mary Aldermanbury, and Mr Meriton[1206].

Sometime in August Lord Arlington wrote to the bishop of London that the king was informed of many ministers and lecturers being absent from their posts during this time of contagion, and that nonconformists had thrust themselves into their pulpits to preach seditions and doctrines contrary to the Church. His majesty wishes the bishop to prevent such mischiefs to Church and State[1207]. The bishop replied, from Fulham, 19 August, that the sober clergy remain, that he had refused some that offered to supply vacancies, suspecting them to be of the factious party, though they promised to conform, that most of his officers had deserted him and gone into the country, but he could not learn that any nonconformists had invaded the pulpit[1208]. The bishop, however, was not likely to hear much within his garden walls at Fulham of what was passing at Aldgate. There can be no question that Church pulpits were occupied during the plague by ministers who had been ejected in 1662. Chief among them was Thomas Vincent, formerly minister of St Magdalen’s, Milk Street, who preached in St Botolph’s, Aldgate, Great St Helen’s, and Allhallows Staining[1209]. Vincent says that it was the opportunity of irregular practitioners both in the Church and in medicine, and he is disposed to say a good word for the latter from a fellow feeling with them. Besides Vincent, says Richard Baxter[1210], there were “some strangers that came thither since they were silenced, as Mr Chester, Mr Janeway, Mr Turner, Mr Grimes, Mr Franklin, and some others.” These all became prominent in London Nonconformity; and Baxter clearly traces their subsequent power to the opportunity that the plague gave them:

“But one great benefit the plague brought to the city, that is, it occasioned the silenced ministers more openly and laboriously to preach the Gospel to the exceeding comfort and profit of the people; in so much that to this day [1670] the freedom of preaching which this occasioned, cannot, by the daily guards of soldiers, nor by the imprisonments of multitudes be restrained. The ministers that were silenced for Nonconformity had ever since 1662 done their work privately.”

Baxter knew of none among the Nonconformist ministers remaining in London who fell victims to the plague, except “Mr Grunman, a German, a very humble, holy, able minister, but being a silenced Nonconformist, was so poor that he was not able to remove his family.” Two others of the sect, who fled, lost their lives—“Mr Cross, flying from the plague into the country died with his wife and some children as soon as he came thither, in the house of that learned worthy man, Mr Shaw, another silenced minister,” and Mr Roberts, “a godly Welsh minister, who also flying from the plague, fell sick as far off as between Shrewsbury and Oswestry and died in a little straw, but none durst entertain him.” Baxter himself found refuge in the house of the Hampdens, in Bucks[1211], leaving his family, as he says, in the midst of plague at Acton. Defoe draws from the incident of the Nonconformists in Church pulpits a somewhat sentimental moral; he sees nothing aggressive in it, but merely the levelling of differences by affliction, and a short-lived prospect of reconciliation.

The irregular practitioners of physic would appear to have been in great force, just as in former plagues, when their bills were on every post. Defoe professes to give specimens of their advertisements, which he might have adapted from actual advertisements in the news-sheets, the ‘Intelligencer’ and the ‘Newes.’ The empirics were of both sexes, and of foreign extraction as well as native.

Among the regular physicians who practised for a time, at least, in the plague were the famous Professor Glisson, Dr Nathan Paget (an intimate friend of Milton and cousin of Elizabeth Minshull whom the poet, in 1664, had married for his third wife), Dr Wharton, of St Thomas’s Hospital, a distinguished anatomist, Dr Berwick or Barwick, Dr Brooke, Dr Hodges, and Dr Conyers. The last was one of two of his order who died of the plague. Two Paracelsist or chemical physicians, Dr Dey and Dr Starkey, died of it: and Dr George Thomson says that he survived three several attacks of the buboes, the first sore lasting for four months. A considerable number of chirurgeons and apothecaries are said (by Defoe) to have fallen victims. Pepys says that at the first meeting of Gresham College (the Royal Society) since the plague, held on January 22, 1666, Dr Goddard “did fill us with talk in defence of his and his fellow physicians’ going out of town in the plague-time,” his plea being that their particular patients were out of town, and they left at liberty. But that excuse ignores the fact that the time was a great emergency, and puts the defence upon the wrong ground.

Goddard had attended Cromwell in the Irish and Scottish campaigns as physician to the army. For a short time he had been a member of the Council of State, and for several years was master of a College at Oxford. He was Gresham professor of physic, and one of the original council of the Royal Society. This eminent man of science was the inventor and proprietor of “Goddard’s drop,” the secret of which he sold to Charles II. for a large sum, said to have been £6000. Dr Martin Lister says that the king showed him the receipt, and that the drops were nothing more than the volatile spirit of raw silk rectified with oil of cinnamon, and no better than ordinary spirit of hartshorn. Another writer says that the drops contained also skull of a person hanged and dried viper. According to Sydenham, Goddard’s drops were preferable to other volatile spirits for the particular purpose, namely, the recovery of people from faintings of various kinds. Even if Dr Goddard had remained in town, he would have been a trafficker in nostrums as much as the empirics; nor is it probable, from all that we know, that he could have brought epidemiological principles to bear upon the management of the epidemic among the poor. The best teaching of the time counselled that which he himself practised, namely, flight.

Defoe says that the Lord Mayor (Sir John Lawrence), the Sheriffs (Sir George Waterman and Sir Charles Doe), the Court of Aldermen and certain of the Common Council, or their deputies, came to a resolution and published it, viz.:

“That they would not quit the City themselves, but that they would be always at hand for the preserving of good order in every place, and for the doing justice on all occasions; as also for the distributing the public charity to the poor; and, in a word, for the doing the duty and discharging the trust reposed in them by the citizens to the utmost of their power.”

The minutes are extant of numerous meetings of the Mayor and Council, with the orders made (on May 11, June 17, 19, and 27, July 12, and at short intervals thereafter)[1212]. Two of the Aldermen died of plague.

It appears to be admitted by all, that good order was kept, the dead buried expeditiously, day and night watchmen provided for an immense number of infected houses (until, as Vincent says, the infected houses became so many that there was no use shutting them up), bearers of the dead and grave-diggers engaged to fill the places of those who died, and applications heard for relief. One of the things that justly excited the admiration of Defoe was the abundant supply of all the markets, and the almost unvarying weight of the penny wheaten loaf, which is given every week at the foot of the bill of mortality. The Parish Clerks brought out their bill regularly, although Hodges says that the sextons failed at length to keep an accurate account of the number of corpses. All the dead were buried at first in coffins and with full ceremony; but when the infection became hottest in August and September, especially in the crowded East-end and in Southwark, the bodies are said to have been brought to the pits in cartloads and thrown in, sometimes without even a covering[1213]. That is alleged by the writers on the plagues of 1603 and 1625, and the same must have happened to some extent in 1665, but whether to the extent that Defoe’s graphic account implies may be doubted.

The burials took place over night until, as Vincent says, “now the nights are too short to bury the dead.” This was a reversal of the order, first issued in 1547 and probably carried out in the plague of 1603, that no burial was to take place between six in the evening and six in the morning. Even at the worst time, coffins would seem to have been got for most. Vincent says, “Now we could hardly go forth but we should meet many coffins,” and he mentions one woman whom he met with a little coffin under her arm. Evelyn enters in his diary on September 7, the worst week of the epidemic: “I went all along the City and suburbs from Kent Street to St James’s, a dismal passage and dangerous, to see so many coffins exposed in the streets now thin of people.” Defoe’s weird description of the Aldgate plague-pit at midnight, with seven or eight lanterns set on the heaps of earth round the edge, and of the constant journeys to and fro of the dead-carts, has probably made the most of the realities of the case.

A letter of Pepys to Lady Carteret, written from Woolwich on September 4, gives us a glimpse of the state of the City:

“I having stayed in the city till about 7400 died in one week, and of them above 6000 of the plague, and little noise heard day nor night but tolling of bells; till I could walk Lumber-Street and not meet twenty persons from one end to the other, and not fifty upon the Exchange; till whole families, 10 and 12 together, have been swept away; till my very physician, Dr Burnet, who undertook to secure me against any infection, having survived the month of his own being shut up, died himself of the plague; till the nights, though much lengthened, are grown too short to conceal the burials of those that died the day before, people being thereby constrained to borrow daylight for that service.” The butcheries are everywhere visited, his brewer is shut up, and his baker dead with his whole family.

On September 20, he writes in his diary:

“But Lord! what a sad time it is to all: no boats upon the river, and grass grows all up and down Whitehall Court, and nobody but poor wretches in the streets.”

Some three weeks later (October 11) Evelyn writes in his diary: “Went through the whole city, having occasion to alight out of the coach in several places about business of money, when I was environed with multitudes of poor pestiferous creatures begging alms. The shops universally shut up.” Vincent says that he would meet “many with sores and limping in the streets,” (from the suppurating buboes in the groins). Again:

“It would be endless to speak what we have seen and heard of:—some in their frenzy rising out of their beds and leaping about their rooms; others crying and roaring at their windows; some coming forth almost naked into the streets”

—the delirium being sometimes of the gentle or foolish kind, and sometimes violent. These incidents are much enlarged upon by Defoe, who makes out the cries and groans (mentioned by Dekker and others for the earlier plagues) to have been from the pain of the hard and tense buboes. Boghurst says that the treatment by actual cautery and other escharotics caused more pain than the buboes.

As a set-off to the more horrible picture given by Defoe of the inmates of a house all dying together, their bodies being found by the watchmen and taken away in the dead-cart, we may turn to Vincent’s plain account of what happened in the house where he lodged, probably in the neighbourhood of Aldgate or Bishopsgate, when he came up from Islington to minister to the sick.

“We were eight in the family—three men, three youths, an old woman and a maid; all which came to me, hearing of my stay in town, some to accompany me, others to help me [he was a celebrity in the religious world with a large following]. It was the latter end of September before any of us were touched.... But at last we were visited.... At first our maid was smitten; it began with a shivering and trembling in her flesh, and quickly seized on her spirits.... I came home and the maid was on her death-bed; and another crying out for help, being left alone in a sweating fainting-fit. It was on Monday when the maid was smitten; on Thursday she died full of tokens. On Friday one of the youths had a swelling in his groin, and on the Lord’s day died with the marks of the distemper upon him. On the same day another youth did sicken, and on the Wednesday following he died. On the Thursday night his master fell sick of the disease, and within a day or two was full of spots, but strangely recovered.... The rest were preserved.”

The two boys appear to have been conscious to the end, and to have died in the placid mood that often came on in the last hours of plague, as in other prostrating infections such as yellow fever and cholera. In those two weeks at the end of September and beginning of October the burials in all London were 6460 (of plague 5533) and 5720 (of plague 4929).

The chief preventive measure which the mayor had to give effect to was the shutting-up of infected houses. Defoe says that he carried out that odious policy considerately. The policy was a traditional one, and may or may not have had its origin in medical prescription. It was practised, as we have seen in a former chapter, early in the reign of Henry VIII., if not even before that. The doctrine underlying it was the contagiousness of plague, which was much more a doctrine of the faculty than of the people, and was most of all a doctrine of the Court. Originally the dogma of contagiousness, in all its rigour, had been made for the persons of the Tudor monarchs, and as late as 1665 it was in the atmosphere of the Court that the contagion of plague was invested with the most powerful properties. The common people of London gave no heed to it, because they saw every hour that it was a matter of indifference; the middle classes held it in a qualified way, knowing that there was less to fear from plague-bodies than from plague-infected ground; but kings took the comprehensive view of it, allowing no exceptions or scientific reservations, and the Court doctors, such as Mead in the 18th century, at length succeeded in making the high doctrine of plague-contagion to pass current. Two instances are known from extant petitions, of its rigorous application upon Court servants in 1665: one in the case of a trumpeter of the king, and the other in the case of the barber to the household. In the latter case, apparently when the Court was at Salisbury in the autumn, a stranger supposed to be visited with the sickness ran into the barber’s tent in his absence; whereon the tent and all his goods and instruments of livelihood were burnt, he himself confined, and his servants sent away, according to the orders for the preservation of the Court, “so that he lost his trade and was utterly ruined[1214].”

The more discriminating of the profession knew and taught that the seeds of plague could lurk in a bundle of clothes, or of bedding, or in other effects, or in bales of goods, and that they became the more virulent through the fermentation that goes on in these circumstances. The contagion was understood to be per fomitem and per distans; on the other hand, experience was rather against a contagion from the exhalations of the sick: the immunity of nurses was as striking as it has been in many other contagions. The people were instinctively right in their belief that they mostly caught the plague because the infection was in the air of the place; so long as they were living on a plague-stricken spot, they were exposed to the risk; and if there were any difference in safety between dwelling-houses, and the streets, markets or shops, the preference seemed to lie with the former. The traditional or official doctrine, however, was that the plague-stricken were the sources of contagion, that all who had come near them were suspect, and that the safety of the well depended upon the rigorous shutting-up of the sick and the suspected together. The experience of epidemic after epidemic might have shown that this theoretical reasoning, so attractive to the “thorough” order of mind, was worthless in practice. A great plague pursued its course until the infected houses became too many for shutting up; if many plague-years did not develop epidemics of the first degree, that was in accordance with some epidemiological law, and not because the preventive measures were one year effective and another year ineffective. However, a traditional doctrine will always survive a good deal of adverse experience; and the shutting-up of houses, which had signally failed in 1563, 1593, 1603, 1625 and 1636, was resorted to once more in 1665, and perhaps with more rigour than ever so as to give it a fair chance. Defoe has stated with great fairness the hardships of it, and he follows Hodges and Boghurst in pronouncing it a mistake and a failure. Most of the horrible incidents of the plague came from the shutting-up of houses; those which Defoe introduces in that connexion do not exceed probability. It is hard to say whether the condemnation of shutting-up, which found wide currency during and immediately after the plague of 1665, would have at length made any difference to the traditional doctrine and practice. The occasion did not arise again in London except for a few months in 1666, when the old practice seems to have been enforced. The corresponding doctrine and practice that arose in its place, was quarantine against foreign importation; that rested firstly upon the sophistical assertion of the all-powerful Mead, that plague had been an exotic to England, and secondly upon the doctrine of plague-contagion in its most comprehensive and least discriminating form. But the quarantine law dates really from the Queen Anne period, and the curious history of its rise, progress, and overthrow belongs to another part of this work.

The other general preventive measure besides the shutting-up of “visited” houses was the burning of fires in the streets, which was also a tradition from Tudor times. The mayor loyally carried out that also; until in the beginning of autumn a concurrence of things made an end of the practice. These adverse influences were first, the heavy showers of rain, which put the fires out; secondly, the differences in medical opinion whether coal-fires or wood-fires were the better, and whether fires were to be recommended at all; and thirdly the popular perception that the fires made no difference to the progress of the epidemic.

In the way of individual protection and treatment, the College of Physicians issued a tract full of directions and prescriptions, which Boghurst says were all old, being taken from De Vigo († 1520). It is not necessarily against methods of practice that they are old; but one cannot fail to observe how closely the medieval teaching about plague, cause and cure together, was followed to the last in England: for two centuries the writers on plague reproduced the chapters and paragraphs almost without change that we find in the treatise of the bishop of Aarhus, which circulated in manuscript in England in the 15th century and was first printed about 1480. The most popular preventive was something “to smell to,” not sweet but aigre. Hence the use of civet-boxes, pouncet-boxes, and pomanders, which were made to suit all purses. There were also plague-waters, one of which, “the plague-water of Matthias,” figures among the prescriptions of the College of Physicians both in a cheap and in an expensive form. The College’s prescription “to break the tumour” is as follows:

“Take a great onion, hollow it, put into it a fig, rue cut small, and a dram of Venice treacle; put it close stopt in a wet paper, and roast it in the embers; apply it hot unto the tumour; lay three or four, one after another; let one lie three hours.”

The Paracelsist or chemical physician, Thomson, gives a prescription which brings out the mystical tendencies of that otherwise meritorious sect. It relates to a method of curing plague by means of a toad.

“The great difficulty to bring this animal to a true Zenexton lies in an exquisite preparation of it, the manner whereof that great investigator of verity, Van Helmont, hath thus delivered, as he received instructions from Butler, an Irishman who (to Helmont’s knowledge) had cured some thousands of the pest in London. He gave directions that a large Bufo, taken in the afternoon in the month of June, should be hung up by the legs, nigh the fire, over a vessel of yellow wax” etc.

Tobacco, smoked or chewed, came into great vogue in 1665 as a preservative from the plague. Hearne, the antiquary, says:

“I have been told that in the last great plague at London [1665] none that kept tobacconists shops had the plague. It is certain that smoaking it was looked upon as a most excellent preservative; in so much that even children were obliged to smoak. And I remember that I heard formerly Tom Rogers, who was yeoman beadle, say that when he was that year, when the plague raged, a schoolboy at Eaton, all the boys of that school were obliged to smoak in the school every morning, and that he was never whipped so much in his life as he was one morning for not smoaking[1215].”

The best medical details of the Great Plague come from Boghurst, who claims that the observations were all his own.

With regard to its incidence he says: “About the beginning most men got it with fuddling, surfeiting, over heating themselves, and disorderly living.” Again: “Those that married in the heat of the disease (if they had not had the disease before) almost all fell into it in a week or a fortnight after it, both in the city and in the country, of which most died, especially the men.” One of Dekker’s stories of the year 1603 is an illustration of the same thing. “It usually went through a whole kindred, though living in several places; which was the cause it swept away many whole families.... In some houses ten out of twelve died, and sixteen out of twenty.” Melancholy for the loss of friends predisposed to it, while cheerfulness and courage fortified some against it. Old people that had many sores upon them, especially carbuncles, almost all died. The natural constitution, disposition, or complexion “did much to make or mar the disease.” People with hollow eyes commonly died. Those who drank brandy and strong waters grew mad, looked about them wildly, and died quickly in two days. “All that I saw that were let blood, if they had been sick two, three, four or five days or more, died the same day.” Teeming women fared miserably; they were not more subject than others: but scarce one in forty lived (this is enlarged upon by Defoe). Many people had the spotted fever and the plague both together, and many the French pox and the plague both together, and yet both sorts commonly lived (someone says that men caught the French pox of purpose[1216]). All sorts died, but more of the good than the bad, more men than women, more of dull complexion than fair. “Of all the common hackney prostitutes of Luteners-lane, Dog-yard, Cross-lane, Baldwin-gardens, Hatton-garden and other places, the common criers of oranges, oysters, fruits etc., all the impudent drunken drabbing bayles and fellows, and many others of the rouge route, there is but few missing—verifying the testimony of Diemerbroeck that the plague left the rotten bodies and took the sound[1217].” It fell not very thick upon old people till about the middle or slake of the disease, and most in the decrease and declining of the disease. Cats, dogs, cattle, poultry, etc., were free from infection.

Some died in twelve or twenty days, but most in five or six. In summer about one-half that were sick, died; but towards winter, three of four lived. None died suddenly as stricken by lightning: “I saw none die under twenty or twenty-four hours.” After one rising, or bubo, was broke and run, commonly another and another would rise in several parts of the body, so that many had the disease upon them half a year; some risings would not break under half a year, being so deep in the flesh.

This explains Dekker’s statement in 1603 that some had buboes repeatedly, and that one person had eighteen sores. Dr Thomson himself had buboes thrice. Hodges, also, knew of many cases fatal at the third seizure, the later attacks being not relapses but new infections; some even fell at the fifth or sixth time, being before well recovered. In one of the earlier London plagues, that of 1563, Jones saw a case of a woman near Temple Bar that ended fatally at the third attack, the buboes having suppurated twice, but not at the third time. Boghurst goes on:

Of evil omen was “a white, soft, sudden, puffed up tumour on the neck behind the ears, in the armpit, or in the flank;” also a “large extended hard tumour under the chin, swelling downwards upon the throat and fetching a great compass” (the brawny swelling of the submaxillary salivary glands and surrounding tissues). Tokens came out after a violent sweat, which was often induced of purpose by nurses, who said, ‘Cochineal is a fine thing to bring out the tokens.’ Nurses often killed their patients by giving them cold drinks. Many also were killed by the shutting-up of houses, by wickedness (of nurses ?), by confident and ignorant mountebanks, by over-hasty cutting and burning of buboes. Servants and poor people removed to the pest-house or to other houses in their sickness, took harm therefrom. People using corrosives, actual cauteries and many intolerable applications put their patients to more pain than the disease did.

The botches, or buboes (swollen lymph-glands in the neck, armpits or groins), were the most distinctive sign of the plague, having given to it the old name of “the botch.” Besides these, there were the “tokens” (specially limited in meaning to livid spots on the skin), carbuncles and blains. Carbuncles, says Boghurst, commonly rose upon the most substantial, gross, firm flesh, as the thighs, legs, backside, buttock; they never occurred, that he saw, on the head among the hair, or on the belly. They were not seen until the end of July, were most rife in September and October, commonly in old people, never in children.

Hodges saw one carbuncle on the thigh, the size of two handbreadths, with a large blister on it, “which being opened by the chirurgeon and scarification made where the mortification did begin, the patient expired under the operation.” But most commonly carbuncles did not exceed the breadth of three or four fingers. Boghurst continues:

“Blains are a kind of diminutive carbuncle, but are not so hard, black, and fiery; sometimes there is a little core in them. Generally they are no bigger than a two penny piece, or a groat at the biggest, with a bladder full of liquor on the top of them, which, if you open but a little, will come out whitish or of a lemon or straw colour.” “Besides a blain there is a thing you may call a blister, puffing up the skin, long like one’s finger in figure, like a blister raised with cantharides; and such usually die.” The following experience is remarkable, but it is doubtful whether Boghurst has not taken it from Diemerbroek: “Towards the latter end of a plague, many people that stayed, and others that returned, have little angry pustules and blains rising upon them, especially upon the hands, without being sick at all. But such never die, nor infect others; and I remember Diemerbroeck saith, etc.” Can this be the meaning of “smallpox” following the plague, as in the 16th century books by Alphanus, Kellwaye and others?

The tokens proper, according to Hodges, were spots on the skin “proceeding from extravasated blood.” The body of the youth dissected by Thomson was “beset with spots, black and blue,” some of which when opened “contained a coagulated matter.” The tokens, as the name implies, were made the most distinctive sign of the plague; but they were far from being so constant as the botches or buboes. Boghurst says that “tokens appeared not much until about the middle of June;” and, according to a letter of September 14, they must have been very variable even at the height of the plague: “The practitioners in physic stand amazed to meet with so many various symptoms which they find among their patients; one week the general distempers are blotches and boils, the next week as clear-skinned as may be, but death spares neither; one week full of spots and tokens, and perhaps the succeeding bill none at all[1218].”

The account of the dissection by Thomson, of a youth dead of the plague, is perhaps all the morbid anatomy that has come down to us. He found what appear to have been infarcts in the lungs; the surface was “stigmatised with several large ill-favoured marks, much tumified and distended,” from which, on section, there issued “sanious, dreggy corruption and a pale ichor destitute of any blood.” The stomach contained a black, tenacious matter, like ink. The spleen gave out on section an ichorish matter. The liver was pallid and the kidneys exsanguine. There were “obscure large marks” on the inner surface of the intestines and stomach. The peritoneal cavity contained a “virulent ichor or thin liquor, yellowish, or greenish.” There was a decoloured clot in the right ventricle, but “not one spoonful of that ruddy liquor properly called blood could be obtained in this pestilential body.” In all other cadavers that he ever dissected he had found that the right ventricle had blackish blood condensed, but this one had a pale clot “like a lamb-stone cut in twain,” which puzzled him greatly; perhaps it came, he conjectures, from a sumption of mere crude milk which an indiscreet nurse had given the boy not long before he died.

Among the symptoms of a fatal issue, Boghurst mentions the following: Hiccough, continual vomiting, sudden looseness, or two or three stools in succession, shortness of breath, stopping of urine, great inward burning and outward cold, continual great thirst, faltering in the voice, speaking in the throat and occasionally sighing, with a slight pulling-in one side of the mouth when they speak, sleeping with the eyes half-open, trembling of the lips and hands and shaking of the head, staggering in going about rooms, unwillingness to speak, hoarseness preventing speech, cramp in the legs, stiffness of one side of the neck, contraction of the jaws, the vomit running out from the side of the mouth, prolonged bleeding at the nose, the sores decreasing and turning black on a sudden.

It is to be remarked that Boghurst says very little of the gentle or the violent delirium, on which Defoe enlarges picturesquely; nor does he emphasize the extreme pain of the hard and tense buboes, which is another of Defoe’s themes. Hodges, however, says that “some of the infected run about staggering like drunken men, and fall and expire in the streets; while others lie half-dead and comatous.... Some lie vomiting as if they had drunk poison.”

The progress of the epidemic would seem to have been little influenced by the weather or by what was done, unless the shutting-up of houses had helped to intensify the virus. Boghurst says: “If very hot weather followed a shower of rain, the disease increased much;” and again: “If, in the heat of the disease the wind blew very sharp and cold, people died very quickly, many lying sick but one day.” We are told, however, by Hodges that “the whole summer was refreshed with moderate breezes,” and that “the heat was too mild to encourage corruption and fermentation.” The air itself, he says, “remained uninfected.” Rain fell from time to time in the end of summer, copious enough to put out the fires in the streets. There was at least one very hot day, near the beginning of the epidemic, the 5th of June, which Pepys says was “the hottest day that I ever felt in my life.” On September 20, however, he says that the increase of the plague could not have been expected “from the coldness of the late season.”

The plague lingered in London throughout the year 1666, causing 1998 deaths in all. In January 1666 it was still at as high a figure as 158 deaths in a week, and in the week ending September 18 it rose again to the exceptional height of 104 deaths. In the first three weeks of December, the deaths were 2, 4, and 3; and from that low level the plague never rose again in London. A few annual deaths continued to appear in the bills down to 1679, when they finally disappeared.