Influenza enters undoubtedly into the Protean infections of the sixteenth century, and is itself no small part of the Proteus. But what is influenza? The name is comparatively modern—Italian of the 18th century—and appears to mean defluxion or catarrh, not in the familiar sense only, but as derived from the comprehensive pathological doctrine of humours: thus the Venetian envoy in London called the sweat of 1551 an “influsso.” It is open to us to include much or little under influenza; but the name itself, having its root in an obsolete doctrine of humours, can never be made exact or scientific. Usage has applied it to all universal colds and coughs; and it has been applied capriciously to some universal fevers, but not to others. There are two tolerably clear references to its prevalence in England before the peculiarly unwholesome state of Europe began with the modern age. Under the year 1173, the chronicle of Melrose enters “a certain evil and unheard-of cough” (tussis quaedam mala et inaudita), which affected everyone far and near, and cut off many.
One of the St Albans chroniclers, an unknown writer who kept a record from 1423 to 1431 (reign of Henry VI.), has the following entry under the year 1427: “In the beginning of October, a certain rheumy infirmity (quaedam infirmitas reumigata) which is called ‘mure’ invaded the whole people, and so infected the aged along with the younger that it conducted a great number to the grave[804].” A good deal is said in this brief passage, and all that is said points to influenza—the rheumy nature of the malady, the universality of incidence, presumably the suddenness and brief duration, the deaths among the aged and the more juvenile. It is known also that a similarly general malady was prevalent the same year in Paris, where it bore the name of ladendo; the particulars given in the French record of it leave no doubt that it was influenza.
The singular name of pestilentia volatilis given by Fordoun to two epidemics in Scotland in his own lifetime, one which began at Edinburgh in February, 1430 (1431 new style), and the other at Haddington in 1432, suggests that they may have been influenzas, but there is nothing more than the name to indicate their nature. Those years are not known to have been years of influenza in any other country of Europe: the record of the malady passes direct from 1427 to 1510. There was certainly a great wave of influenza over Europe in 1510, under the names of cocqueluche and coccolucio. It is said to have come up from the Mediterranean coasts and to have extended to the shores of the Baltic and North Seas; its prevalence in Britain is likely enough, and is indeed asserted in one foreign account, but there is no known native notice of it. Abroad, it had the usual character of suddenness, simultaneity and universality, and the symptoms of heaviness, prostration, headache, restlessness, sleeplessness, and for some time after a violent paroxysmal cough, like whooping-cough. None died except some children; in some it went off with a looseness, in others by sweating[805]. The mention of sweating in the influenza epidemic of 1510 is not without importance. It may serve to explain a remark by Erasmus, in a letter of 25th August, 1511, from Queens’ College, Cambridge, that his health was still rather doubtful “from that sweat” (a sudore illo[806]); the sweat can hardly have been the sweating sickness of 1508, three years before, but the still unsettled health of Erasmus in 1511 may perhaps have been the dregs of the influenza of 1510.
The next great European epidemic of influenza was in 1557, for which I shall produce medical evidence of England sharing in it, probably during that year and certainly in the one following. But the intervening years afford some notices of sickness in England, which was neither so severe as plague at one end of the pestilential scale nor altogether mild at the other, being forms of illness which contemporaries pronounced to be “new” and “strange,” and appear to have been of the nature of pestilent fever and dysentery.
Neither typhus nor dysentery was really new to England in the sixteenth century; on the contrary, they were (with putrid sore throat and lientery) the common types of disease in the great English famines which came at long intervals, as described in the first chapter. But on the continent of Europe typhus and dysentery and putrid sore throat (angina maligna) began with the modern age to appear as if capriciously, and independently of such obvious antecedents as want, although some of the epidemics of typhus and dysentery were clearly related to the hardships of warfare[807]. Typhus, indeed, was a disastrous malady on the Continent in those years, notably in 1528 in Spain, where it was known as “las bubas,” and in France, where it was called “les poches”—both names relating to the spots on the skin, and both more strictly applicable to the eruptions of the lues venerea, which was then also rampant.
Apart from the gaol fever at Cambridge in 1522, the first mention of those new epidemics in England since the end of the medieval period is under the year 1540: “This said xxx and two year [of Henry VIII.] divers and many honest persons died of the hot agues and of a great lask throughout the realm[808].” The “lask” was dysentery, (Stow, in chronicling the epidemic in his much later Annales calls it “the bloody flux”), and the “hot agues,” according to later references under that name, appear to have been influenza in the sense of a highly volatile typhus[809]. All that we know of the circumstances of this epidemic is that the summer was one of excessive drought, that wells and brooks were dried up, and that the Thames ran so low as to make the tide at London Bridge not merely brackish but salt.
The spring and summer of 1551 were the seasons of the last outbreak of the sweat in England, which curiously coincided with another epidemic of influenza (cocqueluche) in France. The years from 1555 to 1558 were a sickly period for all Europe, the diseases being of the types of dysentery, typhus, and influenza. The most authentic particulars are given under the years 1557 and 1558; and those for England, which specially concern us, are now to be given. Wriothesley, a contemporary, enters under the year 1557: “This summer reigned in England divers strange and new sicknesses, taking men and women in their heads; as strange agues and fevers, whereof many died[810].” Under the year 1558, the continuator of Fabyan’s chronicle says: “In the beginning of this mayor’s year died many of the wealthiest men all England through, of a strange fever[811].”
Some light is thrown upon the sickness, general throughout England in 1557-8, also by Stow in his Annales. Before the harvest of 1557 corn was at famine prices, but after the harvest wheat fell to an eighth part of the price (5s. the quarter), the penny wheaten loaf being increased from 11 oz. to 56 oz.! In the harvest of 1558, he goes on, the “quartan agues continued in like manner, or more vehemently than they had done the last year passed, where-through died many old people and specially priests, so that a great number of parishes were unserved and no curates to be gotten, and much corn was lost in the fields for lack of workmen and labourers[812].” Harrison, canon of Windsor, says that a third part of the people of the land did taste the general sickness, which points to influenza[813].
The year 1557 was certainly remarkable on the continent of Europe as a year of widely prevalent “pestiferous and contagious sickness,” which was described by numerous medical writers. That universal epidemic, or pandemic, is usually counted as one of the great historical waves of influenza; and in the annals of that wonderful disease it stands the first which was well recorded by competent foreign observers, including Ingrassias, Gesner, Rondelet, Riverius, Dodonaeus, and Foreest. The corresponding sickness in England in 1557 (still more severe in 1558), which carried off many of the wealthiest men, and made so great an impression that it is noticed by Stow and Speed, has missed being noticed by English physicians, with a single exception, and that a casual one. If the continental physicians had not been copious in writing on several occasions when our English physicians were silent, such as the epidemic of syphilis in 1494-6, the English sweat of 1529, and the influenza of 1557-8, it might appear ungracious to remark upon the scanty literary productiveness of the profession in the Tudor period. Whoever attempts medical history for England will soon feel our deficiency in materials, and become disposed to envy the easier task of the foreign historian. The academical physicians of the time hardly ever wrote. The men who wrote on medicine were laymen like Sir Thomas Elyot, who justified his interest therein by the example of men of his own rank like Juba, king of Mauritania, and Mithridates, king of Pontus; or they were irregular practitioners desirous to advertise themselves; or booksellers’ hacks like Paynel; or such as Cogan, a schoolmaster and a physician in one. The modern reader will be surprised at the common burden of the prefaces of medical (and perhaps other) books in the Tudor period,—the intolerable nuisance of “pick-faults,” “depravers,” and cavillers, who sat in their chairs and criticised; and if the modern reader happen to be in quest of authentic facts, he can hardly fail to sympathise with Phaer, when he addresses the academical dog-in-the-manger with the Horatian challenge: “Si quid novisti rectius istis, candidus imperti; si non, his utere mecum.”
It is possible, however, to collect a few particulars of the prevalent sickness of 1558 in England from casual notices of it. Thus, it comes into a letter to the queen, of September 6, by Lord St John, governor of the Isle of Wight, from his house at Letley, near Southampton: sickness affected more than half the people in Southampton, the Isle of Wight and Portsmouth (those places being filled with troops under St John’s command), and the captain of the fort at Sandown was dead[814]. Curiously enough we get an intimate glimpse of this epidemic from a book published some years after, the Dyall of Agues by Dr John Jones. In his chapter “Of the Sweating Fevers” (chapter xiv), after illustrating from Galen the proposition that a sweat may not be critical and wholesome, but τυφώδης or typhus-like, attending the seizure from its outset and “the same said sweat little or nothing profiting,” he proceeds to point his remarks by his own experience: