War-typhus in Oxfordshire and Berkshire.
It was in the spring and summer of 1643 that England had a first experience of the war-typhus which had been familiar to the continent of Europe for a century and a half, having reached perhaps its greatest prevalence in the Thirty Years’ War. It is only in the sense of war-typhus that Shakespeare’s boast, put into the mouth of John of Gaunt, holds good:
“This fortress, built by nature for herself,
Against infection and the hand of war.”
The medieval civil wars in England do not seem to have bred infection among the people, unless, perhaps, during the anarchy of Stephen’s reign: there is reason to think that the faction-fights of York and Lancaster had no such result. But the wars of the Parliament against the Royalists produced war-sickness in its most characteristic form, and that too, at the very beginning of the struggle.
The existence of sickness in 1643 among the troops of the Parliament in Berkshire and Oxfordshire, under the earl of Essex, is briefly stated by Rushworth. But, for the first time in the history, we find a medical account of the type of sickness, of its circumstances, and of the extent of its prevalence, which is not without interest even for the military history. It happened that the afterwards celebrated Dr Thomas Willis, chemist, anatomist, physiologist and physician, was at Christ Church, Oxford, in 1643, being then aged twenty-one, and intending to enter the Church. In 1659 he published at the Hague his first medical essays, one on Fermentation and the other on Fevers[1073]; and in the latter he recalls many particulars of what he had seen in his earlier years in and around Oxford. The sickness of 1643 was also the subject of a tract published that year in Oxford, by his majesty’s command, by Sir Edward Greaves, physician to the king, which appears to have been in sufficient request in the town to be reprinted within the year[1074].
The preceding events may be briefly summarized[1075]. In November, 1642, the king moved from Oxford with his army towards London and seized Brentford. The forces of the Parliament, under Essex, concentrated round the capital, where they were joined by the trainbands of the City, so that the king recrossed the Thames at Kingston and retired upon Reading and Oxford. All through the months from January to April 1643, tedious negociations went on for a treaty, the details largely relating to the places to be occupied by the Parliamentary troops on the one hand (around Windsor) and by the Royalist troops on the other (in Oxfordshire and Bucks). In April the negociations fell through, and Essex came before Reading on the 15th, with an army of 15,000 foot and 3000 horse. The king and prince Rupert attempted to raise the siege by a march from Oxford, but were stopped at Caversham bridge, and on the 26th April, Reading was surrendered to the Lord General, the garrison marching out the day after.
The siege had lasted only eleven days; the Royalist commandant was sentenced to death at Oxford for betraying the town, but was pardoned. When Essex entered Reading he found the place “infected,” and a great mortality ensued among his men, who were discontented at the want of plunder and of pay. In June he moved his troops across the chalk downs to Thame, on the borders of Bucks; but the weather being wet and unseasonable in the early summer, and afterwards hot, the sickness so increased among them that “he judged the design upon Oxford impracticable” (Rushworth), and on July 9, wrote to the Parliament advising a peace. In his letter, Essex explained that it was impossible to keep the counties from being plundered, “so that they must suffer much wrong, and the cries of the people are infinite.” Eventually he brought what remained of his army to the neighbourhood of London, and having received 2000 recruits from the City, he held a muster on Hounslow Heath, when his whole force amounted to 10,000 men. With his recruited army he marched to the relief of Gloucester[1076], raised the siege, and on September 20 won the (first) battle of Newbury.
The realities of that inactive summer at Reading and Thame may be conceived from what Willis tells us of the state of things within the Royalist lines in Oxfordshire. These things, he says, “fell under our own observation,” he being then at Christ Church and not yet entered on the physic line.
In the spring of 1643, Reading being held for the king,
“In both armies there began a disease to arise very epidemical; however they persisting in that work till the besieged were forced to a surrender, this disease grew so grievous that in a short time after, either side left off and from that time for many months fought not with the enemy, but with the disease; as if there had not been leisure to turn aside to another kind of death....
Essex’s camp moving to Thame, pitched in the places adjacent, where he shortly lost a great part of his men.
But the king returned to Oxford, where at first the soldiers, being disposed in the open fields, then afterwards among the towns and villages, suffered not much less. For his foot (which it chiefly invaded) being pact together in close houses, when they had filled all things with filthiness and unwholesome nastiness and stinking odours (that the very air seemed to be infected) they fell sick by troops, and as it were by squadrons. At length the fever, now more than a camp fever, invaded the unarmed and peaceable troops, to wit, the entertainers of the soldiers, and, generally, all others: yet at first (the disease being but yet lightly inflicted) though beset with a heavy and long languishment, however, many escaped. About the summer solstice this fever began also to increase with worse provision of symptoms, and to lay hold on the husbandmen and others inhabiting the country, then afterwards spread through our city and all the country round for at least ten miles about. In the mean time they who dwelt far from us in other counties remained free from hurt, being as it were without the sphere of the contagion. But here this disease became so epidemical that a great part of the people was killed by it; and as soon as it had entered a house it ran through the same, that there was scarce one left well to administer to the sick. Strangers, or such as were sent to help the sick, were presently taken with the disease; that at length for fear of the contagion, those who were sick of this fever were avoided by those who were well, almost as much as if they had been sick of the plague.
Nor indeed did there a less mortality or slaughter of men accompany this disease; because cachectic and phthisical old men, or other ways unhealthful, were killed by it; also not a few children, young men, and those of a more mature and robust age. I remember in some villages that almost all the old men died this year, that there were scarce any left who were able to defend the manners and privileges of the parish by the more anciently received traditions[1077].”
Willis recalls how this epidemic disease changed its type as the season wore on. At first it was a “putrid synochus,” which seemed to be helped by a sweat or a looseness; a relapse or renewal followed the crisis. Later, it became a continual fever of six or seven days, with no crisis; when the fever ceased the sick kept their beds, sometimes raging, more often in a stupor, great weakness continuing, and sometimes convulsions ensuing. About midsummer “the disease betrayed its malignancy by the eruption of whelks and spots.” It would often begin with an insidious languishing, the strength being totally withdrawn. At length buboes appeared in many, as in the plague. At this time, during the dog-days, the disease began to be handled, not as a fever, but as a lesser plague—by vomits, purges, and sudorifics. The autumn coming on, the disease by degrees remitted its wonted fierceness, so that fewer grew sick of it, and of them many grew well. At the approach of winter the fever almost wholly vanished, and health was fully restored to Oxford and the country round about. Among the victims are mentioned “some belonging to the king’s and queen’s Court, with a few scholars[1078].”
Of the causes, Willis says that, so far as concerned the army, the evident causes were “errors in the six non-naturals.” The spring was very moist and “flabbery,” with almost continual showers, to which a hot summer succeeded. The tract upon the Oxford fever by Greaves, a short piece of some 25 pages, which was written for use in the city during the epidemic, bears out the account by Willis, without developing the doctrine of increasing malignancy. He is concerned to prove that it was not the plague “as the relations and hopes of your enemies, and the fears of others, have suggested.” One of his proofs is the insidious mode of invasion, which Willis ascribes to the sickness in its later type—great weakness without any manifest cause appearing, such as sweating or looseness, so that even strong men were prostrated, with a quick, weak and creeping pulse, sometimes intermittent, with pains in the head, vertigo &c. The most distinctive thing was the spots; “But what need we any farther signs than the spots, which appear upon half the number, at least, of those that fall sick?” Greaves seems to claim that Oxford had some immunity for a time: “God hath been most merciful to this city in sparing us heretofore, when our neighbours round about us were visited.”
Among the causes, he mentions putrid exhalations from stinking matters, dung, carcasses of dead horses and other carrion; “and were there care taken for the removing of these noisome inconveniences, and keeping the streets sweet and clean, it would doubtless tend much to the abatement of the disease.” The diet, also, may have had something to do with it; more particularly the brewers should dry their malt better, boil their beer longer, and put in a sufficiency of hops. But the great cause was the presence of the army.
“We need not look far for a cause where there is an army residing, which the Athenians called to mind in their calamity, or as Homer speaks of his Greeks:
εἰ δὴ ὁμοῦ πόλεμός τε δαμᾷ καὶ λοιμὸς ’Αχαιούς.
—it being seldom or never known that an army, where there is much filth and nastiness in diet, worse lodging, unshifted apparel, etc., should continue long without contagious disease.” Whole families were infected, “and seldom in any house where sick soldiers of either side are quartered, but the inhabitants likewise fall sick of the same disease.”
There appears to have been the almost inevitable doubt in some minds, whether the disease were contagious: “But if anyone be yet obstinate, and will not believe it contagious, let him go near and try.” Among the remedies, he mentions a favourite one of the empiric sort, “Lady Kent’s powder,” which Willis also refers to; but Greaves, as became an academical physician, would not admit that it had any advantage over medicines of known ingredients.
This widespread epidemic of typhus, perhaps not without some relapsing fever, and, according to what Willis says in one of his general chapters, complicated, in its diffusive form in the villages around, “with squinancy [sore throat], dysentery, or deadly sweat,” is the only one medically recorded of the Civil Wars. But there was certainly a renewal of it, in the same circumstances, next year at Tiverton; and it seems probable, from the heavy mortality which the parish registers witness to in that year (1644) that some kind of epidemic sickness had spread far and near. Thus, in Short’s abstracts of the burials and christenings in country parishes and market towns, the years 1643 and 1644, and especially the latter, stand out as the most unhealthy for a long time before and after, the next sickly period, as we shall see, being the years 1657-1659. In the year 1643, out of eighty-eight country registers examined, twenty-nine showed a sickly death-rate, although the disproportion of births to deaths does not appear great (821 to 847). That was the year of the epidemic fever in Berkshire, Oxfordshire and Bucks. Next year, which was the year of the Tiverton epidemic, there are again twenty-nine country registers indicating unusual sickness (715 baptisms to 938 burials). In nineteen out of twenty-four market towns, the same two years come out still more unhealthy (844 births to 1193 deaths in 1643 and 1008 births to 1647 deaths in 1644). The registers examined by Short were mostly from Northern and Midland parishes; but they included two or three from Devonshire, and among his market towns was Tiverton. We shall now see what these bald figures mean in that concrete instance.