The first medical essay upon the malignant fever which got the name of typhus at the beginning of the 19th century, was that of a physician, Sir Edward Greaves, published at Oxford in 1643 in connexion with the sickness in that city while the king and the Royalist army lay there, and with the sickness in the Parliamentary army of the earl of Essex which lay at Reading. Greaves describes the unmistakable characters of spotted fever or typhus, and calls it, in his title “Morbus Epidemicus Anni 1643, or the New Disease.” In his text he speaks of “this so frequently termed the New Disease.” The name of “New Disease” was used also for influenza; but there can be no doubt that typhus did become common in England during the Civil Wars, between the Royalists and the Parliamentarians, which were the first and also the only sieges and campaigns on English soil that really touched the life of the nation.
The continent of Europe had been familiar with the same type of fever ever since the beginning of the 16th century, now in Italy, now in Spain, another time in the Low Countries, or in Hungary, or in Germany in the Thirty Years’ War. Greaves, our first writer on epidemic typhus, had been preceded a whole century by Fracastori, whose description of the fever at Verona in 1505 is perhaps the first account of epidemic sickness free from subservience to ancient or medieval authority, and based upon direct observations made in modern Europe. At the same time typhus or spotted fever was not new to England in 1643. There is always the difficulty whether some epidemics of fever should be called influenza or typhus; but the fever of the Black Assizes, as well as the standing “sickness of the house,” was certainly typhus, and so probably was the “new disease” in 1612.
The history of fever in England has been partly traced in the chapter on gaol-fevers in the Tudor period and on the Protean “hot agues,” “new sickness,” “strange fevers” or influenzas of 1540, 1557-8 and 1580. At a much earlier period, fevers of the same type (with dysenteries, lienteries, and pestilent sore throats) have been described, with whatever details there are, in connexion with the periodic famines, especially since the Conquest. But we are now come to a time in the history when typhus fevers appeared in the country unconnected with gaols or with famines. We are come, indeed, to the new era of epidemics, which is revealed more clearly after the plague was extinguished for good, but was really concurrent with the last half-century of plague, preparing, as it were, to succeed the long reign of that infection. The Civil Wars may be admitted to have given the new types of sickness an impulse, but the wars did not originate them, nor did they serve in any way to establish them as the predominant forms of epidemic sickness for nearly two centuries. Whatever it was in the condition of England that favoured the prevalence of fevers, fluxes, and smallpox, that factor was beginning to make itself felt shortly after the Tudor period ended: it continued in operation through all political changes of Restoration, Revolution, and Georgian rule; and if the conditions at length changed, largely for the better so far as the adult population is concerned, and for the better even as regards infancy, there has followed the “nova cohors febrium” of our own time, appropriate to its own state of society, as was the old troop before it. This theme is really the subject with which a new volume should open; but as the plague-period overlaps its successor the fever-period by half a century, and as one must pay heed to the chronology, it remains to insert some facts about fevers in this place.
Review of Fever in England to 1643.
Of the prevalence of malignant fevers in England in the earlier years of the 17th century we have only occasional glimpses. Thus, in London in November, 1612, there were several deaths of prominent personages. Prince Henry, eldest son of James I., died of a fever in the course of that month, the illness being thus referred to by Chamberlain in one of his letters to Carleton, written on November 12 from London:
“It is verily thought that the disease was no other than the ordinary ague that hath reigned and raged almost all over England since the latter end of summer, which, by observation, is found must have its ordinary course, and the less physic the better, but only sweating and an orderly course of keeping and government. The extremity of the disease seemed to lie in his head Sir Theodore Mayerne, the king’s physician (who had been driven from Paris by the intolerance of the Galenists towards those who used antimony and other Paracelsist remedies), was a good deal blamed because he had purged the patient instead of bleeding him. Writing again on the 19th November, Chamberlain says: “On Friday Sir Harry Row, our alderman died, and, same morning, Sir George Carey, master of the wards, of this new disease.” Chamberlain’s statement that an epidemic fever, which he calls “the ordinary ague,” had raged all over England from the end of summer, 1612, is supported by Short’s abstracts of the parish registers for that year, while the following year, 1613, stands out as still more unhealthy. The next unwholesome year in Short’s tables is 1616; and of that sickly time we have one great personal illustration. Shakespeare died on April 23 at Stratford-on-Avon, after three days’ illness of a fever (but possibly of a chill) having just completed his 52nd year. So far as is known, he was not in failing health. It is a singular coincidence that he made his will on March 25 preceding, the first day of the year, old style; but the customary phrase, “in perfect health and memory (God be praised!),” would have been perhaps varied a little if illness had been creeping upon him. Now the year 1616 is the most unhealthy in Short’s tables from the beginning of the century; the parish registers do not bear witness again to so much sickness until 1623, which, as we have seen, was a year of typhus. The winter of 1615-16 was altogether exceptional: warm and tempestuous south-westerly and westerly winds prevailed from November until February; on the 8th February, there were East Indiamen lying in the Downs, which had been at anchor there for ten weeks waiting for a change of wind to take them down the Channel. The warm winds brought “perpetual weeping weather, foul ways and great floods,” and brought also an early spring. In the last week of January the archbishop found a nest of young blackbirds in his garden at Lambeth, and had “another sent to him from Croydon about four days after.” That was proverbially the kind of Christmas to make a fat churchyard; but it is impossible to say whether one type of sickness, such as fever, predominated, as in the preceding sickly years, 1612-13, and in the next following 1616, namely 1623-24. The following figures from Short’s tables will prove, at least, that there was excessive mortality. In the year 1616, twenty-one parish registers out of eighty-eight examined, showed excessive mortality, the burials being 601 and the baptisms 417, the year 1617 showing a somewhat improved state of health. In the market towns for the same two years, the excessive proportion of burials to christenings is equally striking: of sixteen town registers examined, ten showed a bad state of health in 1616 (714 burials to 568 baptisms), and in 1617, nine towns had 786 burials to 652 baptisms. But neither in town nor country do the years 1616-17 stand out so unhealthy as the years 1623-24. Those two biennial periods are the only very conspicuous ones in Short’s list for the first quarter of the 17th century, the year 1613 coming next in unhealthiness. Let us now seek for any causes such as unwholesome conditions of living upon which these epidemic fevers might have depended. One of the most notorious forms of typhus in the 18th century was the ship-fever. The problem how to destroy its infection in the hulls of transports and ships of war occupied the attention of the men of science, Stephen Hales among the rest. Parliament, eager for any cure of so disastrous a pest, voted some thousands of pounds to a projector whose method, when tried, resulted in nothing but the burning of three ships to the water’s edge. This ship-fever became notorious early in the 17th century, having occurred before in 1588. If the Elizabethan naval annals in Hakluyt’s collection were less engrossed than they are with adventures and doughty deeds, we should probably have had more glimpses of an unwholesome state of things in the ’tween-decks. At all events there is no doubt that fever infested the shipping of England as well as of France about the year 1625. The conditions on board ship are, of course, special; there might have been ship-fever, when there was no gaol-fever, workhouse-fever, or domestic typhus in general. But what happened on board ship was no bad index of what was happening on shore. The nation, both on sea and on land, was expanding far beyond its old medieval limits, with very crude notions of the elbow-room that it needed. The ideas of cubic space, ventilation, and the like, with which we are now so familiar, had then no existence. A few facts about the shipping, gaols and houses will serve to illustrate this statement.