Smallpox in England in the 16th Century.
The earliest references to smallpox in England, apart from the probably incorrect one by Gaddesden early in the 14th century, occur in letters of the years 1514 and 1518. Another letter of 1514 will serve to bring out the ambiguity of the names given to diseases at the time. On June 30, 1514, Gerard de Pleine writes from London to Margaret of Savoy that he had been asked by the bishop of Lincoln why the marriage between the princess Mary and Louis XII. had been broken off (it took place shortly after), and by another great peer whether Louis XII. “avoit eu les pocques,” which last sentence has a marginal note in the printed collection of letters: “c’est la petite verole[895].” But les pocques in a letter written from London in 1514 did not mean the smallpox. In a letter of March 3, 1514, Peter Martyr writing in Latin from Valladolid to Ludovico Mendoza, says that the King of England has had a fever, and that the physicians were afraid it would turn to the pustules called variolae, but he is now well again and rises from his bed[896]. This illness of Henry VIII. happened at Richmond previous to 7th February. Although in the letter quoted there was only a fear that the illness might have turned to the pustules called smallpox, yet in the instructions of Henry VIII. to Spinelly, English ambassador in the Low Countries, sent in February, the twelfth item instructs him to say that the English king has lately been visited by a malady “nommée la petitte verolle[897].”
Four years after, on July 14, 1518, Pace writes to Wolsey from Wallingford, where the court then was, that the king was to leave next day for Bisham “as it is time; for they do die in these parts in every place, not only of the small pokkes and mezils, but also of the great sickness[898].”
These are the earliest known instances of the use of the words pocques, variola, petite verolle, “small pokkes and mezils,” as applied to particular cases of sickness, in correspondence from or relating to England. The remarks to be made upon the early usage are: first, that the word pocques, as used by one writing in French from London in 1514, did not mean smallpox, but pox; second, that the first authentic mention of smallpox happens to have been in the French form—“une maladie nommée la petitte verolle;” third, that, in the political gossip of the time the opinion of the physicians regarding the illness of the young king is given as of a fever which they feared might have turned to the pustules called “variolae;” and fourthly, that in the very first mention of the disease variola by an English name “small pokkes,” the name is modelled on the French, being coupled with the old English name “mezils.” It is impossible to infer from these references anything as to the amount of smallpox in England at the time, or even to be sure of the correctness of the diagnosis. The lax usage as between “pox” and “smallpox” is shown in a book of the year 1530 called ‘Prognosticacions out of Ipocras and Avicen,’ in which a brief reference to variola in the Latin original is translated “to prognosticate of the pockes.”
In Sir Thomas Elyot’s Castel of Health, published in 1541, children after their first infancy are said to suffer from a number of maladies, and in “England commonly purpyls, meazels and smallpockes.” That is perhaps the first use of the terms in a systematic work on medicine, not indeed by one of the faculty, but by a layman. About the same time we hear of smallpocks in an infant of noble family: a letter of May 26, 1537, from Charles duke of Suffolk to Cromwell, written from Hoxun in Suffolk, excuses his not repairing to Lincolnshire, as the king had ordered, on the ground that “his son fell sick of the smallpox and his wife of the ague[899].” “His son” was Henry Brandon, born September 18, 1535, so that he was then an infant of some twenty months; he is the same that died, with his younger brother, of the sweating sickness in July 1551.
The reference to smallpocks and meazels by Elyot in his Castel of Health is repeated in the almost contemporary Book of Children by Thomas Phaer. Whether Phaer translated that also “out of the French tongue” as he did the Regiment of Life, with which it is bound up in the edition of 1553, we have nowhere any information. In a list of forty infirmities of children, the 32nd in order is “small pockes and measels.” A later passage in the Book of Children shows how much, or how little, intelligent meaning Phaer attached to these terms: “Of smallpockes and measels. This disease is common and familiar, called of the Greeks by the general name of exanthemata, and of Plinie papulae et pituitae eruptiones. It is of two kinds:—varioli, ye measils; morbilli, called of us ye smal pocks. They be but of one nature and proceed of one cause. The signs of both are so manifest to sight that they need no farther declaration;”—but he does add some signs, such as “itch and fretting of the skin as if it had been rubbed with nettles, pain in the head and back etc.: sometimes as it were a dry scab or lepry spreading over all the members, other whiles in pushes, pimples and whayls running with much corruption and matter, and with great pains of the face and throat, dryness of the tongue, hoarseness of voice, and, in some, quiverings of the heart with sownings.” He then gives the four causes, three of them being intrinsic states of the humours, and the fourth “when the disease commenceth by the way of contagion, when a sick person infecteth another, and in that case it hath great affinity with the pestilence.” The treatment is directed towards bringing out the eruption; all occasions of chill are to be carefully avoided. More special directions are given for cases in which “the wheales be outrageous and great;” also, “to take away the spots and scarres of the small pockes and measils,” a prescription of some authors is given, to use the blood of a bull or of a hare.
The whole of Phaer’s section on smallpox and measles bears evidence of a foreign source, namely the same stock chapter from which Kellwaye drew most of his section upon the same two diseases appended to his book on the plague in 1593. Not only does Phaer speak of smallpox and measles conjointly as leaving spots and scars, but he actually renders variolae by measles, and morbilli by smallpox. Phaer was more of a literary compiler than a physician with original knowlege of diseases and their pathology. But he is not singular among the Tudor writers in taking measles to be the equivalent of variolae. William Clowes, of St Bartholomew’s Hospital, one of the most experienced practitioners of his time, does the same. His Proved Practice for all Young Chirurgeons has an appendix of Latin aphorisms “taken out of an old written coppy,” to each of which aphorisms Clowes has added an English translation: in the aphorism on variolae, that term is translated “measles,” the name of “smallpox” nowhere occurring in the book. Clowes’s translation is exactly in accordance with the English-Latin glossary of the time by Levins (1570). Levins was an Oxford fellow who had graduated in medicine and afterwards become a schoolmaster, just as Cogan, of The Haven of Health, had done. He wrote the Pathway of Health, and also compiled the Manipulus Vocabulorum. His definitions in the latter may be taken, therefore, to stand for the medical usage of the time. In this glossary, “ye maysilles” is rendered by variole, while the name of “smallpox” is omitted altogether, “a pocke” having its Latin equivalent in phagedaena, and “ye French pocke” in morbus Gallicus. In the Elizabethan dictionary by Baret, “the maisils” is defined as “a disease with many reddish spottes or speckles in the face and bodie, much like freckles in colour;” and that was the disease which the English profession then understood to be the same as the variolae of medieval writers.
I leave readers to draw their own conclusions, whether there was much or little smallpox or measles in England in the Tudor period. They may be reminded that Pace, dean of St Paul’s, in a letter from Berkshire in 1518, asserts the fatal prevalence of “smallpox and mezils,” and that the duke of Suffolk called the illness of his infant son by the name of smallpox in 1538. They may be farther helped to a conclusion by the following curious instance which has been recorded by John Stow.
Among the miscellaneous collections of that antiquary preserved in the Lambeth Library[900], there is a narrative of the troubled conscience of Master Richard Allington, esquire, a gentleman who appears to have lent money at high interest. Believing himself to be dying on November 22, 1561, he summoned to his bedside at eight in the evening the Master of the Rolls (“Sir John of the Rolls”), two doctors of the law and two other lawyers.