Among the causes, he mentions putrid exhalations from stinking matters, dung, carcasses of dead horses and other carrion; “and were there care taken for the removing of these noisome inconveniences, and keeping the streets sweet and clean, it would doubtless tend much to the abatement of the disease.” The diet, also, may have had something to do with it; more particularly the brewers should dry their malt better, boil their beer longer, and put in a sufficiency of hops. But the great cause was the presence of the army.
“We need not look far for a cause where there is an army residing, which the Athenians called to mind in their calamity, or as Homer speaks of his Greeks:
εἰ δὴ ὁμοῦ πόλεμός τε δαμᾷ καὶ λοιμὸς ’Αχαιούς.
—it being seldom or never known that an army, where there is much filth and nastiness in diet, worse lodging, unshifted apparel, etc., should continue long without contagious disease.” Whole families were infected, “and seldom in any house where sick soldiers of either side are quartered, but the inhabitants likewise fall sick of the same disease.”
There appears to have been the almost inevitable doubt in some minds, whether the disease were contagious: “But if anyone be yet obstinate, and will not believe it contagious, let him go near and try.” Among the remedies, he mentions a favourite one of the empiric sort, “Lady Kent’s powder,” which Willis also refers to; but Greaves, as became an academical physician, would not admit that it had any advantage over medicines of known ingredients.
This widespread epidemic of typhus, perhaps not without some relapsing fever, and, according to what Willis says in one of his general chapters, complicated, in its diffusive form in the villages around, “with squinancy [sore throat], dysentery, or deadly sweat,” is the only one medically recorded of the Civil Wars. But there was certainly a renewal of it, in the same circumstances, next year at Tiverton; and it seems probable, from the heavy mortality which the parish registers witness to in that year (1644) that some kind of epidemic sickness had spread far and near. Thus, in Short’s abstracts of the burials and christenings in country parishes and market towns, the years 1643 and 1644, and especially the latter, stand out as the most unhealthy for a long time before and after, the next sickly period, as we shall see, being the years 1657-1659. In the year 1643, out of eighty-eight country registers examined, twenty-nine showed a sickly death-rate, although the disproportion of births to deaths does not appear great (821 to 847). That was the year of the epidemic fever in Berkshire, Oxfordshire and Bucks. Next year, which was the year of the Tiverton epidemic, there are again twenty-nine country registers indicating unusual sickness (715 baptisms to 938 burials). In nineteen out of twenty-four market towns, the same two years come out still more unhealthy (844 births to 1193 deaths in 1643 and 1008 births to 1647 deaths in 1644). The registers examined by Short were mostly from Northern and Midland parishes; but they included two or three from Devonshire, and among his market towns was Tiverton. We shall now see what these bald figures mean in that concrete instance.
War-typhus at Tiverton in 1644.
Tiverton was then a town of some 8000 inhabitants, mostly occupied in the weaving industry. On July 5, 1644, Essex arrived with his army on his way to Cornwall to subdue prince Maurice, and lay there till the 18th. The diary of one farmer Roberts has an entry that Mr Thomas Lawrence, who came from Tiverton, reported to him that the earl had 350 and odd carriages, and of horse belonging thereto for draught 2000[1079]. This would have been his large artillery train, baggage and ammunition waggons, etc. His infantry would be some 6000, and his cavalry perhaps 1000. The king’s force meanwhile advanced after Essex, and on July 25 lay in the great meadow at Crediton. They had advanced by Yeovil and may or may not have passed through Tiverton. The two armies came to blows in Cornwall, a prolonged series of encounters in the country around Lostwithiel in wet August weather ending in the escape of Essex to the coast, the retreat of his cavalry through the Royalist lines, and the surrender of the infantry on 1st September. The disarmed foot-soldiers were convoyed back to Poole and Wareham, and did not trouble Tiverton again. The retreating cavalry passed that way, but did not enter the town, which was now held by the Royalists. But the king’s army came back by the way of Tiverton, which they reached on Saturday, the 21st September. They had got no farther than Chard on the 30th, and may have halted in Tiverton some days. A Royalist garrison of 200 men was left in it, and held the place until October 1645, when it was taken by Fairfax after a short siege[1080].
Tiverton was thus occupied by both armies in the summer and autumn of 1644, that of Essex having been quartered in and around the town for a fortnight in July. A serious epidemic followed, especially in the suburb on the western side of the Exe. The particulars of it are in the parish register, from which it would appear that the sickness began in August and lasted until November. The greatest mortality was in October, when 105 were buried, the whole mortality of the year having been 443. The ordinary monthly burials would hardly have exceeded a dozen or fifteen; and as the 105 burials in October would have meant some eight or ten times as many sick, it is not surprising to read that the town was desolate, and that grass grew in the streets[1081]. Of this epidemic there are no medical particulars; but it appears from the parish register that it was known as “the sweating sickness.” It would hardly have been so called if sweating had not been a prominent symptom. Besides the English sweat proper, with its five epidemics from 1485 to 1551, we have had occasion to notice a sweating type in several epidemics of fever. That symptom was so marked in the epidemic of 1558 at Southampton, Portsmouth, and Isle of Wight when they were full of troops, that Dr John Jones, who had personal experience of it, compares it to the sweat proper. It was a sufficiently prominent symptom in the Oxford gaol-fever of 1577 for the sudor Anglicus to be called to mind. In the English fevers and influenzas of 1580-82, a sweat or a lask is mentioned by Cogan as a least occasional; but the fevers of the same years on the Continent had so often the sweating character that it was sometimes said the English sweat had come back. Lastly for the war-fevers of 1643 around Reading and Oxford, Willis asserts in more than one place the occurrence of sweats, critical or giving relief for a time in the milder form, “deadly sweats” in fevers of an aggravated type. To anticipate somewhat, it may be mentioned also that a sweating character is recorded of some cases of the perennial London typhus at its worst period in the middle of the 18th century.
Admitting all these facts, we must still hold to the opinion expressed in the chapter on the Sweating Sickness, that sweating was never again the signum pathognomicum of a whole epidemic, as it had been of the sudor Anglicus in its five outbursts. But if there be gradations of type, or approximations of typhus to sweating sickness (as well as to influenza), then we may perhaps take the Tiverton epidemic as coming nearer than any other to the sweating sickness, on the strength of the name given to it in the parish register.