Smallpox in London in 1694: the death of the Queen.
The epidemic of smallpox in London in 1694 was made memorable by the death of the queen. On 22 November Evelyn notes, “a very sickly time, especially the smallpox, of which divers considerable persons died”; on 29 December: “the smallpox increased exceedingly, and was very mortal,” the queen having died of it the day before. Queen Mary came of a stock to which smallpox had been peculiarly fatal, a brother and sister of her father, James II., having died of it at Whitehall in 1660. Some of the particulars of her illness and death come from bishop Burnet[859], who saw her in the first days of the attack and was about the Court until the end of it; the authentic medical details are by Dr Walter Harris, one of the physicians in attendance, who published them, by leave of his superiors, in order to meet the censures passed on the doctors “by learned men at a great distance[860].”
The symptoms of illness on the first day did not prevent the queen from going abroad; but, as she was still out of sorts at bedtime, she took a large dose of Venice treacle, a powerful diaphoretic which her former physician, the famous physiologist Dr Lower, had recommended her to take as often as she found herself inclined to a fever[861]. Finding no sweat to appear as usual, she took next morning a double quantity of it, but again without inducing the usual effect of perspiration. Up to that time she had not asked advice of the physicians. To this severe dosing with one of the most powerful alexipharmac or heating medicines, the malignant type of the ensuing smallpox was mainly ascribed by Harris, who was a follower of Sydenham and a partizan of the cooling regimen. On the third day from the initial symptoms the eruption appeared, with a very troublesome cough; the eruption came out in such a manner that the physicians were very doubtful whether it would prove to be smallpox or measles. On the fourth day the smallpox showed itself in the face and the rest of the body “under its proper and distinct form.” But on the sixth day, in the morning, the variolous pustules were changed all over her breast into the large red spots “of the measles”; and the erysipelas, or rose, swelled her whole face, the former pustules giving place to it. That evening many livid round petechiae appeared on the forehead above the eyebrows, and on the temples, which Harris says he had foretold in the morning. One physician said these were not petechiae, but sphacelated spots; but next morning a surgeon proved by his lancet that they contained blood. During the night following the sixth day, Dr Harris sat up with the patient, and observed that she had great difficulty of breathing, followed soon after by a copious spitting of blood. On the seventh day the spitting of blood was succeeded by blood in the urine. On the eighth day the pustules on the limbs, which had kept the normal variolous character longest, lost their fulness, and changed into round spots of deep red or scarlet colour, smooth and level with the skin, like the stigmata of the plague. Harris observed about the region of the heart one large pustule filled with matter, having a broad scarlet circle round it like a burning coal, under which a great deal of extravasated blood was found when the body was examined after death. Towards the end, the queen slumbered sometimes, but said she was not refreshed thereby. At last she lay silent for some hours; and some words that came from her shewed, says Burnet, that her thoughts had begun to break. She died on the 28th of December, at one in the morning, in the ninth day of her illness.
The case of Queen Mary was one of discrete smallpox turning to the haemorrhagic form; and it had from first to last the most striking resemblance to that of her uncle, the Duke of Gloucester, in September, 1660[862]. The smallpox, says Burnet, came out, but the pustules “sunk so that there was no hope of raising them”; and in sinking they turned to livid spots or blotches. It is quite possible that the repeated doses of Venice treacle at the outset, which failed in their usual effect of inducing sweat, may have had something to do with the result, as Dr Harris certainly believed and afterwards publicly said with the leave of his superiors. But the queen, with eminent qualities of mind and heart, was not physically of good constitution. She was one of those children of James II. whom Willis had brusquely pronounced, some twenty-five years before, to be affected with mala stamina vitae; and her father’s brother, the Duke of Gloucester, who was not treated in the same way, and, by one account, not treated at all, died in exactly the same kind of haemorrhagic smallpox[863].