In Ambroise Paré’s references to smallpox there occurs one singular line of remark which will serve to bring us back to etymology and to the great pox[917]. The petite vérole, he says, has a resemblance to the grosse vérole as sometimes attacking the bones. He had seen that in smallpox cases not only in 1568 but on other occasions: and he gives the details of two cases of smallpox, apparently with periostitis and necrosis, which he compares to cases of the great pox. To express in one word the meaning of such cases, he says, the smallpox and rougeolle, not having been well purged, give rise to various troublesome accidents, as the great pox does. One cannot read Paré’s chapters on the grosse vérole and the petite vérole without detecting an inclination to compare them or class them together in nosological characters. The comparison or classification is by no means explicit; but it seems to be in his thoughts, and he would seem, accordingly, to have held until a late period of the 16th century a view of the two diseases which was not unusual at the beginning of that century (as in the treatise of Pinctor and in the accounts of the dreadful mortality of Indians in Hispaniola and Mexico[918]), and was expressed in the popular names given to each disease in France and in England.
CHAPTER X.
PLAGUE, FEVER AND INFLUENZA FROM THE ACCESSION OF THE STUART DYNASTY TO THE RESTORATION.
The last period of plague in England, from 1603 to its extinction in 1666, was as fatal as any that the capital, and the provincial towns, had known since the 14th century. The mortalities in London in 1603, 1625, and 1665 are the greatest in the whole history of the City’s epidemics, not, perhaps, relatively to the population, but in absolute numbers. The capital was growing rapidly, having now become the greatest trading community in Europe. The dangers which were foreseen in the proclamation of 1580, of an extension of the City’s borders beyond civic control, had been realized. The old walled city, like Vienna down to a quite recent date, remained both the residential quarter and the centre of trade and commerce: the original suburbs, which were in the Liberties or Freedom of the City, were the slums—the fringe of poverty covered by the poorest class of tenements, unpaved and without regular streets, but penetrated by alleys twisting and turning in an endless maze. The City was not, indeed, without a good deal of building of the same class, especially in the parish of St Stephen, Coleman Street, the most populous parish within the walls. But what was an occasional thing in the City where gardens and other open spaces had been built upon, was the rule in the parishes beyond the walls. It was in the Liberties and outparishes that the plague of 1603 began; its origin in 1625 is less certain; but there can be no question as to the gradual progress of the Great Plague of 1665 from the west end of the town down Holborn and the Strand to the City, to the great parishes on the north-east and east, and across the water to Southwark. From one point of view we may represent the later plagues as incidents in the transition from the medieval to the modern state of the capital—a transition which proceeded slowly and is still unfinished so far as concerns the forms of municipal government. The history of the public health of London is, for nearly two centuries, the history of irregular and uncontrolled expansion, of the failure of old municipal institutions to overtake new duties. Perhaps if Wren’s grand conception of a New London after the fire of 1666 had been taken up and given effect to by Charles II., the Liberties and suburbs might have been joined more organically to the centre and have benefited by the municipal traditions of the latter. The history of the public health in London during the latter part of the 17th century and the whole of the 18th might in that case have been a less melancholy record. That history falls within our next volume; but as it began with the expansion of London under Elizabeth and the Stuarts, this is the place to review the growth of the City from the time when it broke through its medieval limits.
The Growth of London in the Tudor and Stuart Periods[919].
The accession of James I. to the English crown in 1603 corresponds in time with the pretensions of London to be the first city in Europe. “London,” says Dekker, in The Wonderfull Yeare, “was never in the highway to preferment till now. For she saw herself in better state than Jerusalem, she went more gallant than ever did Antwerp, was more courted by amorous and lustie suitors than Venice (the minion of Italy); more lofty towers stood about her temples than ever did about the beautiful forehead of Rome; Tyre and Sydon to her were like two thatcht houses to Theobals, the grand Cairo but a hogsty.” That is, of course, in Dekker’s manner; but it can be shown by figures that London took a great start in the end of Elizabeth’s reign and grew still faster under James.
From Richard I. to Henry VII., London was the medieval walled city, as Drayton says, “built on a rising bank within a vale to stand,” with a population between 40,000 and 50,000. Without the walls lay a few city parishes or parts of parishes, including the three dedicated to St Botolph outside Aldgate, Bishopsgate and Aldersgate, respectively, and St Giles’s without Cripplegate, all of these being at the gates or close to the walls. On the western side, however, lay an extensive but sparsely populated suburb, which was erected in 1393 into the Ward of Farringdon Without; it extended westward from the city wall as far as Temple Bar, Holborn Bars and West Smithfield, and was divided into the four great parishes of St Sepulchre’s without Newgate; St Andrew’s, on the other side of Holborn valley, St Dunstan’s in the West (about Chancery Lane and Fetter Lane), and St Bride’s, Fleet Street.
The earliest known bills of mortality, in 1532 and 1535, from which a population of some 62,400 might be deduced, show that the St Botolph parishes, St Giles’s without Cripplegate and the four great parishes in the western Liberties (or, more correctly, in the ward of Farringdon Without) had one-third of the whole deaths, and presumably about one-third of the whole population. In the few memoranda left of the plague-bills of 1563, we find evidence that the population had increased to some 93,276, of which about a sixth or seventh part, or some 12,000 to 15,000 was in the “out-parishes,” or in the parishes not only beyond the walls, but beyond the Bars of the Freedom. The most valuable series of statistics for Elizabethan London are those which give the christenings and burials for five years from 1578 to 1582; from those of the year 1580, which was almost free from the disturbing element of plague, a population of some 123,034 may be deduced by taking the birth-rate at 29 per 1000 living and the death-rate at 23 per 1000, or in each case at a favourable rate corresponding to the large excess of births over deaths.