I believe that the date in the “Pied Piper of Hamelin” is that of the dancing neurasthenia when it attacked that town; the rat episode is a distorted recollection of some rat-legend attributed to Hamelin but which may have referred to other places; the theft of the children refers to the German branch of the Children’s Crusade, whose Hamelin members crossed the Koppelberg to reach Cologne.
And the leader’s name was Nicholas—Old Nick?
Some Epidemics of Social Importance
There is some reason to believe that Hippocrates himself, our professional father, who drew up that oath by which all modern doctors measure their conduct, knew the bubonic plague when he saw it, though he never went through a plague epidemic. The first epidemic of which we have detailed knowledge is the great plague of Athens in the Peloponnesian War about which there can be very little doubt, for it was described by one of the greatest literary artists of Greece, who saw it all with his own eyes, and suffered from it. Thucydides was not a doctor, but like Cervantes he had the eye and mind of a doctor; and he could describe a disease so plainly that many other ancient and even mediæval historians have taken their descriptions of their own epidemics straight from his with never an acknowledgment. And in Thucydides’ account of that plague we get the invariable conditions of all epidemics—the ungovernable terror of the people, the powerlessness of the doctors, the abandonment of all moral laws, the wild accusations of poisoning by enemies, the selfishness, cowardice, and ignorance of man in a panic, the hysterical dancing in the shadow of the tomb. From this one learn all.
I give a translation of Thucydides’ description of the symptoms, by C. Foster Smith. It must be remembered that Athens was being besieged and the Athenians had brought all the farmers into Athens so that the Spartans should find no food for the Lacedæmonian armies; the device of an already beaten nation.
“The disease began in Ethiopia and then descended into Egypt and Libia. Then it suddenly fell upon the Piræus and city of Athens, so that people at first said that the Peloponnesians had put poison into the cisterns. Afterwards it reached the upper city also, and from that time the mortality became greater. I have had the disease myself and seen others sick of it. Suddenly men were seized first with an intense heat of the head and redness and inflammation of the eyes, and the parts inside the mouth became bloodshot and exhaled an unnatural and fœtid breath. In the next stage sneezing and hoarseness came on and in a short time the disorder descended to the chest attended by severe coughing and sneezing. There was severe vomiting of every kind attended by great distress; and in most cases ineffectual retching producing violent convulsions which sometimes abated directly, sometimes not very long afterwards. The body was not very hot to the touch; it was not pale, but reddish, livid, and breaking out into small blisters and ulcers. Patients could not bear to have on them the slightest covering or linen sheets, but wanted to be quite uncovered and would have liked best to throw themselves into cold water—indeed, many who were not prevented did so. Most of them died on the seventh or ninth day from internal heat, but had still some strength left. After the crisis the disease sometimes attacked the privates and fingers and toes, so that many patients lost these, though some lost the eyes also. Immediately after recovery there was often loss of memory, so that many failed to remember either themselves or their friends. The most dreadful thing was the despondency of the victims.”
I am glad to say that I personally did not serve in the Balkan campaigns, but many doctors who did tell me that Thucydides’ description might, with a little imagination, be stretched to include that plague which proved so distressing to Dr. Elsie Inglis and her gallant band. In other words, Thucydides was describing typhus fever, which has always been the enemy of besieged cities, especially in hot and dirty surroundings. Dr. Crawfurd states that we may look upon it as almost certain that the plague of Athens was typhus fever, though he discusses at considerable length the academic question whether it might not have been bubonic plague or smallpox. At least we can say for certain that the plague of Athens showed more of the symptoms of typhus fever than of any other known disease; and if Dr. Crawfurd is wrong he had made a very shrewd guess. From my own experience of typhus, which is small, I should certainly be inclined to support him. But typhus nowadays is a thing almost of the past except in times of war. That we owe simply to washing ourselves and our clothes better than of old. It is a remarkable thing in clinical experience that typhus frequently accompanies bubonic plague, because they are both diseases of primitive civilisations like India and China to-day.
Passing over the innumerable ancient attacks of pestilence upon mankind, we come to the great plague of the Antonines which was probably the real cause of the decline and fall of the Roman Empire, for it is extremely doubtful whether the Empire ever recovered from it. To most of us this plague is remarkable for the fact that Galen, the Roman Hippocrates, ran away from it, and has left us an account of it which seems to have been drawn second-hand from Thucydides. In the Roman Empire many of the physicians were Greek slaves and had the slave mind. Though Galen himself was not a slave, still he was a man of his time, and it was not then thought imperative that a doctor should, in Dr. Crawfurd’s words, be “captain of his soul.”[17] Dr. Crawfurd gives many instances of honoured names whose owners ran before the onset of plague; and it was not till the Black Death that we find the real true silent courage that we now expect from the medical profession as a matter of course.
The plague of the Antonines seems to have varied in different parts of the Empire and at different times of its devastating career.[18] Occasionally it seems to have taken the appearance of smallpox, sometimes of typhus, and perhaps at times an infusion of bubonic plague may have thrust in its frightful form. It would be much easier for after generations to guess at the truth if only poor Galen had not taken wing and fled; for he was an acute clinician. At its first onset he fled to Campania and, finding no safety there, took ship to Pergamos. Thence, after two years’ absence, he returned at the urgent summons of the emperor, Marcus Aurelius Antoninus, and after a brief stay in Rome rejoined him again at Aquileia. But there was no rest for his weary soul; again pestilence pursued him. The thing would be comic if we could forget the frightful misery of mankind when the foundations of civilisation were crumbling before the assaults of micro-organisms. Man was engaged in one of his greatest battles to the death against the wild; and the rat, the body-louse, and the direct infection of smallpox were apparently leagued in an assault upon his works. It is a dramatic thing to stand before the great statue of Marcus Aurelius at the head of the Capitoline steps in Rome, near the smell of the caged wolves, and to ponder that the real enemy of that somewhat tedious emperor was, not the Quadi or the Marcomanni, but, unknown to himself, if Dr. Crawfurd is right, the ignoble body-louse and the squeaking, fighting, greedy Mus Decumanus.[19] And yet he sits there so proudly upon his wonderful horse, looking every inch an emperor yet unable to cast even a moral maxim at his ignoble foes.