The evidence as to the wide prevalence of the pox in high and low becomes abundant in the writings and memorials of the reign of James I. The effects of the disease, as they would have been commonly remarked at this period, are summed up in a well-known passage in Timon of Athens. It would serve no purpose to collect the numerous references from Puritan sermons, moral and descriptive essays, plays, and letters of the time. An anonymous work of the year 1652 actually couples “the plague and the pox,” and shows “how to cure those which are infected with either of them[852].” One more piece of evidence may be given for London in the year 1662, or the beginning of the Restoration period,—a date which brings us down a century and a half from the epidemic invasion with which we are more immediately concerned; but the information for 1662 will serve to show how the existence of the disease was still viewed sub rosa, and it may help one to realize what its prevalence and its serious effects on the public health must have been continuously in the generations before, and most of all in the generation which experienced the full force of it as an epidemic[853].
The London bills of mortality, setting forth the several causes of death, were first printed in 1629. The entry of the French pox is in them from the beginning, and the annual total of deaths set down to it is considerable, approaching a hundred in the year. But according to Graunt, who made the bills of mortality the subject of a critical study in 1662[854], they were defective or incorrect in their returns of deaths due to the pox:—
“By the ordinary discourse of the world, it seems a great part of men have, at one time or other, had some species of this disease ... whereof many complained so fiercely, etc.” He then explains, with reference to the deaths entered as due to it in the bills of mortality: “All mentioned to die of the French pox were returned by the clerks of St Giles’ and St Martin’s in the Fields only, in which place I understand that most of the vilest and most miserable houses of uncleanness were; from whence I concluded that only hated persons, and such whose very noses were eaten off were reported by the searchers to have died of this too frequent malady”—the rest having been included under the head of consumption.
Origin of the Epidemic of 1494.
The French pox, as it was called in England (also the great pox and simply the pox), or the Spanish pox, as it was called in France, or the sickness of Naples, or the grandgore, is one of the epidemic diseases concerning which it seems fitting to say something of the antecedents, in addition to what has been said of its arrival as an epidemic in this country, and of its prevalence therein. But this will have to be said very briefly, and without entering upon the pathology or ultimate nature of the disease.
The numerous foreign writings upon it during the first years of its spread over Europe are all singularly at a loss to account for its origin. One of the earlier guesses was that it arose out of leprosy, as if a graft or modification of that medieval disease, replacing it among the maladies of the people. The occasion of that hypothesis seems to have been the lax diagnosis of leprosy itself, a laxity which goes as far back as Bernard Gordonio and Gilbert, if not farther back. Many things were called lepra which were not elephantiasis Graecorum, and among those things the lues venerea in the Middle Ages was undoubtedly included. At a time when true leprosy was disappearing or had already disappeared from Europe, a new form of disease, which came suddenly into universal notice although by no means then first into existence, seemed to be the successor of leprosy, evoked out of it, and even caught from the leprous by contagion. That is the view of Manardus, in a passage quoted in the sequel,—that syphilis began in certain most particular circumstances at Valencia, in Spain, the source of all the subsequent contamination of Europe having been a certain soldier of fortune who was elephantiosus or leprous. In the infancy of a science it is natural to assign to some such single and definite source a new phenomenon which was really called forth by a concurrence of causes[855].
Another guess of the same kind was the famous theory, which found a truly learned defender in Astruc last century and has had supporters more recently, that the lues venerea came from the New World with the returning ships of Columbus. There never was any considerable body of facts, consistent as regards times and places, in support of that theory; and, on antecedent grounds, the objection to it was that it is as difficult, to say the least, to conceive of the origin of such a disease among the savages of Hispaniola as among the natives of Europe. “Here or nowhere is America” is the proper retort to all such visionary theories put upon the distant and the unknown. The American theory is now hopelessly dead; the more that the New World became known, the less did syphilis appear to be indigenous to it: indeed the disease followed the track of Europeans, and those parts of the American continent, north and south of the Isthmus, which were longest in being reached by the civilisation of the Old World, were also longest in being reached by the lues venerea[856].
The name “sickness of Naples,” which occurs in the Aberdeen records as early as 1507, indicates the common opinion of the laity as to the origin and means of diffusion of the strange malady. In the passage above quoted from Jones’s Dyall of Agues, it will be seen that he refers it to “the besiegers of Naples.” The besiegers of Naples were the mercenaries of Charles VIII. occupying it in the beginning of the year 1495, although there was no real siege. The new disease was at the time, rightly or wrongly, traced to them while they occupied Italy, and its diffusion over Europe was justly traced to their dispersion to their several countries at the end of the campaign. There is medical testimony that the malady appeared in 1495 among the Venetian and Milanese troops which were banded against Charles VIII. at the siege of Novara. Marcellus Cumanus, of Venice, who was surgeon to the forces, thus speaks of the event, in certain Observationes de Lue Venerea which he wrote on the margin of Argelata’s work on Surgery[857]:
“In Italy, in the year 1495, owing to celestial influences, I have myself seen, and do testify that, while I was in the camp at Novara with the troops of the Lords of Venice and of the Lords of Milan, many knights and foot-soldiers suffered from an ebullition of the humours, producing many pustules in the face and through the whole body; which pustules commonly began under the prepuce or without the prepuce, like a grain of millet-seed, or upon the glans, attended by considerable itching. Sometimes a single pustule began like a small vesicle without pain, but with itching. Being broken by rubbing, they ulcerated like a corrosive formica, and a few days after, troubles began from pains in the arms, legs and feet, with great pustules. All the skilled physicians had difficulty in curing them.... Without medicines, the pustules upon the body lasted a year or more, like a leprous variola.” He then gives many other details of symptoms and treatment.
For the year after, 1496, two German writers, who were not surgeons but occupied with affairs of state, Sebastian Brant (author of the Ship of Fools) and Joseph Grünbeck, have described the disease, apparently in connexion with the troops serving in Italy under Maximilian I. against the invading army of Charles VIII. Thus, there is sufficient evidence that the malady in its first two or three years of epidemic prevalence, was associated with a state of war on Italian soil, in the persons of French troops (and mercenaries of all nations), of Venetian and Milanese troops, and of the German troops of the Emperor.