A History of Epidemics in Britain, Volume 1 (of 2) / From A.D. 664 to the Extinction of Plague

by Charles Creighton

Review of Fever in England to 1643.

Of the prevalence of malignant fevers in England in the earlier years of the 17th century we have only occasional glimpses. Thus, in London in November, 1612, there were several deaths of prominent personages. Prince Henry, eldest son of James I., died of a fever in the course of that month, the illness being thus referred to by Chamberlain in one of his letters to Carleton, written on November 12 from London:

“It is verily thought that the disease was no other than the ordinary ague that hath reigned and raged almost all over England since the latter end of summer, which, by observation, is found must have its ordinary course, and the less physic the better, but only sweating and an orderly course of keeping and government. The extremity of the disease seemed to lie in his head

Sir Theodore Mayerne, the king’s physician (who had been driven from Paris by the intolerance of the Galenists towards those who used antimony and other Paracelsist remedies), was a good deal blamed because he had purged the patient instead of bleeding him.

Writing again on the 19th November, Chamberlain says: “On Friday Sir Harry Row, our alderman died, and, same morning, Sir George Carey, master of the wards, of this new disease.” Chamberlain’s statement that an epidemic fever, which he calls “the ordinary ague,” had raged all over England from the end of summer, 1612, is supported by Short’s abstracts of the parish registers for that year, while the following year, 1613, stands out as still more unhealthy. The next unwholesome year in Short’s tables is 1616; and of that sickly time we have one great personal illustration. Shakespeare died on April 23 at Stratford-on-Avon, after three days’ illness of a fever (but possibly of a chill) having just completed his 52nd year. So far as is known, he was not in failing health. It is a singular coincidence that he made his will on March 25 preceding, the first day of the year, old style; but the customary phrase, “in perfect health and memory (God be praised!),” would have been perhaps varied a little if illness had been creeping upon him. Now the year 1616 is the most unhealthy in Short’s tables from the beginning of the century; the parish registers do not bear witness again to so much sickness until 1623, which, as we have seen, was a year of typhus. The winter of 1615-16 was altogether exceptional: warm and tempestuous south-westerly and westerly winds prevailed from November until February; on the 8th February, there were East Indiamen lying in the Downs, which had been at anchor there for ten weeks waiting for a change of wind to take them down the Channel. The warm winds brought “perpetual weeping weather, foul ways and great floods,” and brought also an early spring. In the last week of January the archbishop found a nest of young blackbirds in his garden at Lambeth, and had “another sent to him from Croydon about four days after.” That was proverbially the kind of Christmas to make a fat churchyard; but it is impossible to say whether one type of sickness, such as fever, predominated, as in the preceding sickly years, 1612-13, and in the next following 1616, namely 1623-24. The following figures from Short’s tables will prove, at least, that there was excessive mortality.

In the year 1616, twenty-one parish registers out of eighty-eight examined, showed excessive mortality, the burials being 601 and the baptisms 417, the year 1617 showing a somewhat improved state of health. In the market towns for the same two years, the excessive proportion of burials to christenings is equally striking: of sixteen town registers examined, ten showed a bad state of health in 1616 (714 burials to 568 baptisms), and in 1617, nine towns had 786 burials to 652 baptisms. But neither in town nor country do the years 1616-17 stand out so unhealthy as the years 1623-24. Those two biennial periods are the only very conspicuous ones in Short’s list for the first quarter of the 17th century, the year 1613 coming next in unhealthiness.

Let us now seek for any causes such as unwholesome conditions of living upon which these epidemic fevers might have depended. One of the most notorious forms of typhus in the 18th century was the ship-fever. The problem how to destroy its infection in the hulls of transports and ships of war occupied the attention of the men of science, Stephen Hales among the rest. Parliament, eager for any cure of so disastrous a pest, voted some thousands of pounds to a projector whose method, when tried, resulted in nothing but the burning of three ships to the water’s edge. This ship-fever became notorious early in the 17th century, having occurred before in 1588. If the Elizabethan naval annals in Hakluyt’s collection were less engrossed than they are with adventures and doughty deeds, we should probably have had more glimpses of an unwholesome state of things in the ’tween-decks. At all events there is no doubt that fever infested the shipping of England as well as of France about the year 1625. The conditions on board ship are, of course, special; there might have been ship-fever, when there was no gaol-fever, workhouse-fever, or domestic typhus in general. But what happened on board ship was no bad index of what was happening on shore. The nation, both on sea and on land, was expanding far beyond its old medieval limits, with very crude notions of the elbow-room that it needed. The ideas of cubic space, ventilation, and the like, with which we are now so familiar, had then no existence. A few facts about the shipping, gaols and houses will serve to illustrate this statement.

The fleet which sailed from Plymouth to make war on Spain in the autumn of 1625 consisted of 90 sail, and carried 10,000 men. Whether there was overcrowding would depend, of course, on the size of the ships; and it may be safely said that the largest ship of the fleet was not a fourth part the size of a transport that would be allowed to carry five hundred men today. The expedition came back in a few weeks broken by sickness and mutiny, just as the expedition of Mansfeld for the relief of the Palatinate had fared. The wretched state of the thirty ships which arrived at Plymouth in November, 1625, has been mentioned already. At the same date we read of French ships of war also throwing overboard two or three dead men every day. There are some more precise figures for French ships in 1627, to be given in the next chapter, which will enable us to measure the provocation to ship-fever afforded by the conditions of a transport service in those years.

Besides ship-fever, in the great typhus period of the 18th century, there used to be named gaol-fever, and workhouse-fever. Of the gaol-fever one hears little in these years. It was severe in the Queen’s Bench prison in Southwark in March, 1579; a petition of that date complains that the prison held double the usual number, that “the sickness of the house” was rife, and that near a hundred had died of it there during the previous six years, many more having been sick[1059]. “The sickness of the house” is a name suggestive of what was usual. These events of prison life made little stir unless they involved the health of classes far removed from the prison-class, as in the three memorable instances of the Black Assizes at Cambridge, Oxford and Exeter. But it is not certain that even such cases have been all recorded, or that instances of gaol-fever spreading to those outside may not have been more frequent than appears. Whitmore in his book of 1659 on fevers in London and the country, quotes Bacon’s remarks upon the Black Assizes of the Tudor period and adds: “and within this eight or nine years there happened the like at Southwark, as I am credibly informed.” That would have been in the King’s Bench prison some time about 1650, which is not far from the date we have brought the history down to[1060].

The overcrowding of the ships and of the gaols had its counterpart in the dwelling-houses of London and other towns such as Portsmouth. The proclamations against the erection of houses on new sites within three miles of the city gates continued to be issued to the time of Cromwell. The effect of them was merely to call into existence a class of poor tenements in odd corners or to overcrowd the existing houses. Thus, on June 27, 1602: “The council have spied an inconvenient increase of housing in and about London by building in odd corners, in gardens and over stables. They have begun to pull down one here and there, lighting in almost every parish on the unluckiest, which is far from removing the mischief[1061].” Again, on February 24, 1623, certain inhabitants of Chancery Lane were indicted at the Middlesex Sessions for subletting, “to the great danger of infectious disease with plague and other diseases[1062].” Again, in May, 1637, there were found in one house eleven married couples and fifteen single persons; in another the householder had taken in eighteen lodgers[1063]. The monstrous window-tax, which did more than anything else to breed typhus and perpetuate smallpox, was not imposed until after the Revolution; but there was enough in the London of the Stuarts to explain the great increase of those diseases.

We have already had evidence of the wide prevalence of spotted fever in 1624, even in the houses of the rich. In the harvest of 1625, Mead, of Cambridge, heard of much sickness which he calls “ague,” about Royston and Barkway, localities by no means malarious; so many were ill that the people wanted help to gather the harvest out of the fields. The nature of these “agues” is a question of great difficulty. The intermissions or remissions of the country fevers are clearly enough asserted by Willis and others, whatever they were; at the same time the general characters of the disease, or diseases, are not those of intermittent malarial fever; and “influenza” does not help us. Chamberlain calls the fever of 1624 “the spotted fever,” and Sir Theodore Mayerne, physician to James I., in a long opinion upon the king’s state of health and the treatment, dated Aug. 20, 1624, introduces a paragraph “Ad Febrem Purpuream,” which, he says, was prevalent that year, “not so much contagious as common through a universal disposing cause,” seizing upon many in the same house, and destroying numbers, being most full of malignity etc. These various accounts for town and country point to a form of typhus; and we find that diagnosis confirmed for the country fevers which were again widely prevalent a few years later, about 1638.

Among other statistics in Graunt’s essay of 1662 we find the figures from the register of “a parish in Hampshire” from 1569 to 1658. There were several years of excessive mortality in that period just as in Short’s tables, but the worst were 1638 and 1639—the years of high mortality (not plague) in London also. Of that mortality in the Hampshire parish Graunt has given a brief account, which he seems to have based on first-hand information. The parish contained about 2700 inhabitants, and enjoyed average good health during the period of 90 years covered by the figures, the births exceeding the deaths by twelve on an average in the year. In the year 1638 the deaths were 156 and the births 66 (about the average); in 1639 the deaths were 114 and the births 55. The cause of this great excess of mortality in a country parish was, says Graunt, not plague, “but a malignant fever raging so fiercely about harvest that there appeared scarce hands enough to take in the corn; which argues, considering there were 2700 parishioners, that 7 might be sick for one that died; whereas of the plague more die than recover. They lay longer sick than is usual in plague,” and there were no plague-tokens.

This considerable epidemic of fever, which must have affected some hundreds of people, occurred in a Hampshire parish. In the very same season (autumn and winter of 1638) we hear of what is obviously the same sickness being epidemic all over the county of Monmouth. On April 23, 1639, the sheriff of Monmouthshire thus explained his delay in executing the king’s writ for an assessment: “In January last I sent forth my warrants for the gathering and levying thereof, but there has been such a general sickness over all this country, called ‘the new disease,’ that they could not possibly be expedited.... Besides, the plague was very hot in divers parts of the county, as Caerleon, Abergavenny, Bedwelty, and many other places[1064].” Here the sheriff uses the same name as Greaves put on his title-page five years after, and he distinguishes clearly between the fever and the plague. The mayor and others of Northampton, in a memorial to the Recorder, dated May 1, 1638, touching the exclusion of Northampton tradesmen from fairs in the vicinity owing to suspicions of the plague in their town, had been informed by the physicians that some cases were of the plague, and some of “the spotted fever[1065].” The same distinction had been made at Norwich, in 1636: in October there was a suspicion of the plague, “but the physicians say it is some other contagious disease which die with the spots[1066].” At Northampton, the coexistence of plague and some other sickness is asserted also by the sheriff (Sept. 18, 1638), who had to excuse himself, like so many other sheriffs, for his failure to remit the ship-money: he himself and his servants had had sickness, and the plague was so great and so long in Northampton that the county still allowed £148 a week for relief of the sick. The deaths in that epidemic from March to September were 533[1067]. The sheriff of Montgomery, making a like excuse on October 25, 1638, speaks of the plague only: “It pleased God to visit a great part of the county with the plague, and three of the greatest towns, Machynlleth, Llanidloes and Newton[1068].” The sheriff of Radnorshire, in his excuse to the Privy Council, on November 14, says he could not collect the ship-money at Presteign “by reason of the plague, which continued there for two years together, and did not cease until the latter end of April last[1069].” We may take it, then, that there was a great deal of plague in Wales about 1637 and 1638, that there was also “the new disease,” or spotted fever, all over Monmouth and probably other Welsh counties, that the same two forms coexisted at Norwich and Northampton, just as they coexisted in London, and that Graunt’s parish in Hampshire in 1638 had probably the fever only.

Short’s statistical tables again bear out the concrete history. In 1638, nineteen country parishes, out of ninety-four examined, had 699 burials to 542 baptisms, and in 1639, eighteen parishes had 585 burials to 386 baptisms. In the market towns the unhealthy period (which may have been due to plague in great part) is a year earlier. In 1637, ten towns out of twenty-four whose registers were added up, show 1474 burials to 1008 baptisms, the proportion in 1638 for the same number of unhealthy towns being 1438 to 1025.

It would have been one of the country epidemics of those years that Boghurst brings into his account of the plague of London in 1665: “I was told by an ancient woman that in Somersetshire the spotted fever was very epidemical, so that whole families died; but being told that plantan [plantain] was very good, all of them almost took it, which wrought an admirable change, for very few died that took it, whereas before they died very fast.” He thinks plantain was as likely to have effected a cure as “higher priced medicines.” We shall find a corresponding prevalence of fever described by a competent physician, Whitmore, for rural parts of Cheshire and Shropshire in 1651 and 1658. Thus we have a remarkable epidemiological phenomenon, somewhat new to England unless, indeed, we bring all those spotted fevers and the like under the generic name of influenza. It was in country districts in 1612-13 and from 1623 to 1625, it was extensively prevalent in 1638 in places as far apart as Hampshire, Monmouth and Northampton, it appeared in Berkshire and Oxfordshire in 1643 in connexion with the military movements of the Royalist and Parliamentary armies, it caused a disastrous loss of life in Tiverton within a few weeks of Essex’s army passing through the town in 1644; it is heard of again in Shropshire and Cumberland in 1651-52, and in the same parts in 1658, as well as in Somerset, and in London steadily from year to year.

It was in its steadiness from year to year in the poor quarters of towns, as well as in its more frequent recurrences as a country epidemic, that the spotted fever deserved the name of “new disease” in the reign of Charles I. But more than one epidemic fever had been called a “new disease” in England before; and no fewer than five epidemics were so called from 1643 to 1685, of which only one or two can be classed among the influenzas.

If it had been possible to keep in mind the history of sicknesses from century to century or even from generation to generation, the “new disease” might have been recognised as not unlike the type that overran England in 1087, that was described by William of Newburgh in 1196, by Matthew Paris in 1258, and by Trokelowe in 1315-16. The conditions producing it or favouring it were not, indeed, the same in all particulars in the medieval period, in the Tudor period, and in the Stuart period. In the medieval period, the extreme want and misery which brought epidemic sickness were due to occasional sharp famines at long intervals, from failure of the crops. In the Tudor period epidemics were still so occasional (so far as is known) that something more special will have to be blamed for them than the swarms of vagrants and criminals all over England, which made the reign of Henry VIII. notorious, and were still a source of trouble until late in the reign of Elizabeth; the four chief periods were in 1540, 1557-8, 1580-82, and 1596-97 so that some special cause would have to be assumed in those years to account for their peculiar “epidemic constitution.” Almost from the beginning of the Stuart period, the seasons of fever (to say nothing of flux and smallpox), seem to come in quicker succession; they are heard of in 1612-13, 1623-25, 1638, 1643-44, 1651, 1658-9, and 1661-65, and heard of in those years over wide tracts of rural England as well as in London and other towns. It was from such experiences that the doctrine arose, so unintelligible to us now, of an “epidemic constitution of the air,” which may be traced, indeed, to much earlier writings than those of the 17th century, but finds its most frequent applications in the latter. The fevers were in part contagious and not contagious; contagion could not explain them all, and yet there was an undoubted infective element in them. The universality or generality of their incidence was accounted for by assuming, on the one hand, something common in the state of the air and, on the other hand, some common predisposition in the bodies of men, which might itself have had seasonal causes. We have now only one name for such common infection of the air, namely influenza; and it is significant that the catarrhal influenzas of 1658 and 1659 were regarded by some at the time as only the appropriate vernal form of the fever which in the hot weather of 1657 and 1658 had prevailed almost in the same general way as influenza, but with the symptoms of typhus. One thing which should not be overlooked, is that plague was still in the country, not always at the same time as the fever, and perhaps not usually coincident with it. Another thing, which will come out in its due order at a later part of the history, is that after the extinction of plague, fever became far more steady in the towns from year to year, and in certain years was not less prevalent in influenza-like epidemics all over the country. One might offer some suggestions as to the meaning of these epidemiological phenomena; but it will perhaps be more convenient that critics who have a speculative turn or a craving for generalities should exercise the one or gratify the other at their own risk.

Along with the prevalence of plague in 1637-38 in many towns of Wales, we may associate the outbreak of 1638 in Gloucester on the one side and in the small Salopian town of Clun on the other. From a letter of the Privy Council to the justices of Gloucestershire, it appears that a rate in aid of the plague-stricken in the city had been imposed upon the county in December, 1637, and that the infection still continued in Gloucester in September, 1638. Contributions made in Bridgenorth for the relief of the visited in Clun appear to belong to the same year. At Reading a tax for the “visited” had been collected once or oftener between 1638 and 1641. In 1641 the town of Leicester was put to some expense (£46. 8s. 7d.) in watching to keep out the sickness which prevailed in Thurmaston, Birstal, Whetstone and Oakham. The very severe plague in Stamford the same year would have been the most intense part of the epidemic in that corner of England; “Camden,” quoting from bishop Sanderson’s manuscript, says that it began at St James’s tide, 1641, and ended in March following, whereof are said to have died between 500 and 600 persons[1070].

Another centre of plague in 1641 was Congleton, in Cheshire, if we may trust the accuracy of the date given in a manuscript written some time after and seemingly based upon tradition[1071]. The infection was traced to a box of clothes which had belonged to one dead of the plague in London and were sent to the dead man’s relations at North Rede Hall. The family who received the box “caught the infection and died.” It spread “all over the country,” and came to Congleton, where it made dreadful ravages. The traditions which the anonymous narrator has put on record are, indeed, those of a plague of the greater degree—stories of corpses that no one would bury, of the sick left to their fate, of money dropped into water before it changed hands. This somewhat doubtful narrative ends with the statement that “the greatest part of the inhabitants died.”

The period from 1643 to 1650 contains all the outbreaks of plague that remain, whether in London or the provinces, until we come to the final explosion of 1665. In London the plague continued at a low endemic level from the outburst of 1636 until 1648, the deaths in 1647 reaching the considerable figure of 3597. This series of plague-years has no other interest than as showing how regularly every season the infection increased from a few cases in May or June to a maximum in September or October. One incident, out of many, may find a place. In August, 1647, Sir Philip Stapleton, one of the Eleven Members, leaders of the Presbyterian party, who were accused of treason by the Army, went over to Calais with five more of the accused, and died of the plague almost as soon as he landed. The people of the house where he died made the rest of the party pay them £80 before they would let them come forth, for bringing the sickness into their house[1072].

The plagues in provincial towns were in those years much more serious relatively than those in London. All of them occurred in towns that were besieged, or had been besieged, or had been occupied by bodies of troops or by garrisons. At the same time most of them were towns which had suffered plagues before. But the first effects of the war in the way of epidemic sickness were not of the type of plague.