Smallpox in the 17th Century.

The gradual rise of smallpox to prominence in England about the end of the Elizabethan period and in the first years of the Stuarts cannot fail to strike anyone who is occupied with the English records of disease as a whole. Smallpox and measles may have been, and almost certainly were, observed in England in the earlier part of the 16th century; but they make no such figure in the records, domestic and other, as they do from the beginning of the 17th century onwards. Perhaps the first mention of smallpox, in English literature proper, occurs in a collection of lyrical poems published in 1602[904]. In some verses “Upon his Ladies sicknesse of the Small Pocks,” the poet, Th. Spilman, apostrophises the “cruel and impartial sickness” and asks,—

Are not these thy steps I trace
In the pure snow of her face?
Th’ heavenly honey thou dost suck
From her rose cheeks, might suffice;
Why then didst thou mar and pluck
Those dear flowers of rarest price?

In two letters of Dr Donne, dean of St Paul’s, written probably a few years before his death in 1631, reference is made to the smallpox in London. In the one he says:

“At my return from Kent to my gate, I found Peg had the pox: so I withdrew to Prickham and spent a fortnight there. And without coming home, when I could with some justice hope that it would spread no farther amongst them (as I humbly thank God it hath not, nor much disfigured her that had it), I went into Bedfordshire” etc.

This dread of smallpox infection is quite unlike anything that we meet with in the earlier 16th-century domestic memorials; in them it is only the infection of the plague that comes in. Donne’s other reference is to the sickness of my lord Harrington: “a few days since they were doubtful of him; but he is so well recovered that now they know all his disease to be the pox and measles mingled[905].”

Cases of smallpox among the upper classes are occasionally mentioned in the letters written by Chamberlain to Carleton in the reigns of James I. and Charles I.[906]. On December 17, 1612, “The Lord Lisle hath lost his eldest son, Sir William Sidney, by the smallpox, which were well come out.” On December 31, the same year, Carleton, writing from abroad, mentions that the duke of Mantua had died of the smallpox about three weeks since, of which he buried his only son not three weeks before. Also on December 31, Chamberlain writes to him, that the Lady Webbe was sick of the smallpox, of which, he says in another letter, she died: “She was grown a very proper woman, but loved the town too well, which in a short time would have drawn her and her husband dry as well in purse as in reputation.” It is the year 1614 that is given (by Horst) as the worst season of smallpox all over Europe and the East; England is mentioned by the foreign writer as among the countries affected, but there is no trace of an epidemic in our own records. On April 20, 1616, Chamberlain mentions the case of the duke of Buckingham, the favourite; “he hath been crazy of late, not without suspicion of the smallpox, which, if it had fallen out, actum est de amicitia. But it proves otherwise.” Buckingham’s illness, for which he took much physic, produced an imposthume on his head (an effect which followed in the more notorious illness of Wolsey), and he is elsewhere said to be suffering from the morbus comitialis. The suggestion of smallpox appears to be the same euphemism which was resorted to in the cases of other exalted personages.

On August 21, 1624, having written of the great mortality from fevers, Chamberlain adds: “Lady Winwood, hearing that her only daughter was fallen sick of the smallpox at Ditton and that they came not out currently,” had gone to her. On December 18, 1624, “the Lady Purbeck is sick of the smallpox, and her husband is so kind that he stirs not from her bed’s feet.” In the first week of June, 1625, the famous composer Orlando Gibbons died at Canterbury, not without suspicion of the plague[907], but according to another opinion of the smallpox[908].

With the year 1629, the causes of death in London began to be published by Parish Clerks’ Hall in a rough classification, smallpox being a regular item from year to year. For the first eight years the deaths from “flox, smallpox, and measles” were as follows:

1629 72
1630 40
1631 58
1632 531
1633 72
1634 1354
1635 293
1636 127

The greatest epidemic, it will be seen, was in 1634[909]. For the years 1637-1646, the figures are lost (owing to Graunt’s omitting them in his Table of 1662, for want of room). But it is known from letters that the autumn of 1641 was a season of severe smallpox as well as plague. Thus on August 26, “both Houses grow very thin by reason of the smallpox and plague that is in the town, 133 dying here this week of the plague, and 118 of the smallpox, 610 in the whole of all diseases.” On September 9, a letter from Charing Cross says: “Died this week of the plague 185, and of the smallpox 101.” The plague mortality continues to be mentioned in subsequent letters, but the references to smallpox cease[910]. On July 16, 1642, one excuses his attendance on some State business because he is sick of the smallpox[911].

About the Restoration the references to smallpox become more numerous[912]. A letter of January 4, 1658 (1659), speaks of “much sickness in the town [London], especially fevers, agues and smallpox.” On February 7, 1660, the earl of Anglesey is dead of the smallpox. In September, 1660, Lord Oxford had a severe attack and recovered; at the same time the duke of Gloucester, on the 8th September, was diagnosed by the doctors to have “a disease between the smallpox and the measles; he is now past danger of death for this bout, as the doctors say.” However he died on 14th September, in the tenth day of the disease, with remarkable evidences (post mortem) of internal haemorrhage, having bled freely at the nose a few hours before his death. The eruption had “come out full and kindly” at the beginning, so that it was not the ordinary haemorrhagic type. On the 20th December, 1660, the princess Henrietta goes to St James’s for fear of the smallpox. On the 16th January, 1660 (? 1661), “the princess is recovered of the measles.” Letters from a lady at Hambleton to her husband in London, May 26, 1661, speaks of smallpox raging in the place, and in the house of her nearest neighbour, her own children having the whooping-cough. In the bills of mortality of those years the deaths in London from smallpox and measles were as follows:

1647 139
1648 401
1649 1190
1650 184
1651 525
1652 1279
1653 139
1654 832
1655 1294
1656 823
1657 835
1658 409
1659 1523
1660 354
1661 1246
1662 768
1663 411
1664 1233
1665 655
1666 38

These figures bring us down to the period of Sydenham, who was the first accurate observer of smallpox in London. With his writings, and with those of Willis and Morton, we begin a new era in the history of epidemics in England. We find, for the first time in the history, an adequate discussion of the epidemiological and clinical facts by the ablest men in the profession. But, as the new era is at one and the same time marked by the cessation of plague and by the enormous increase of various fevers, as well as of smallpox, it falls without the limits of this volume, making, indeed, the appropriate beginning of the new kind of epidemic history which is characteristic of England from the Restoration and the Revolution down to the end of the 18th century. It is clear, from the instances above given, that smallpox was already at the beginning of the 17th century becoming a pest among the upper classes. But to anyone who studies the history over continuous periods it is equally clear that its prominence was then something new and that the horror and alarm which it caused became greater as the 17th century approached its close. And so as not to leave the history of smallpox at this point with a wrong impression of its general virulence, it may be added that Dr Plot, writing of Oxfordshire in 1677, says: “Generally here they are so favorable and kind, that be the nurse but tolerably good, the patient seldom miscarries[913].”