A practitioner at Chichester does indeed say as much of those treated by himself about the same date: “when the distemper did rage so much in and about Chichester, ten or a dozen years since [written in 1685], it was a great many that fell under my care, I believe sixty at the least, and yet I lost but one person of the disease. Nor was one of my patients marked with them to be seen but half a year after[848].” As these experiences must have been somewhat exceptional I shall give a section to the general case.
Pockmarked Faces in the 17th Century.
The smallpox of 1667-68 had among its numerous victims one of the king’s mistresses, the beautiful Frances Stewart, duchess of Richmond, residing in Somerset House, who caught the disease in March 1668 and was “mighty full of it.” Pepys, who records the fact, had seen her portrait taken shortly before: “It would make a man weep,” he exclaims, “to see what she was then and what she is likely to be by people’s discourse now.” Happily the worst fears were not realized. Pepys saw her driving in the Park in August, and remarks, without a strict regard to grammar, that she was “of a noble person as ever I did see, but her face worse than it was considerably by the smallpox.” The king, unlike the Lord Castlewood of romance, suffered no loss of ardour for his mistress, having visited her over the garden wall, as Mr Pepys relates, on the evening of Sunday, the 10th of May. It is rather the idea, and especially the historical idea, of these horrors that “would make a man weep,” and it has moved a great and eloquent historian of our own time to deep pathos[849]. If there be anything that can counteract the effects of agreeable rhetoric it is perhaps statistics. The following numerical estimate of the proportion of pockmarked faces in London after the Restoration is accordingly offered with all deference. It applies mainly to the criminal and lower classes, who were as likely as any to bear the marks of smallpox.
In the London Gazette, the first advertisement of a person “wanted” appears in December, 1667; and thereafter until June, 1774, there are a hundred such advertisements of runaway apprentices, of footmen or other servants who had robbed their masters, of horse-stealers, of highwaymen, and the like. There is always a description more or less full; and in the consecutive hundred I have included only such persons as are so particularly described in feature that pock-pits would have been mentioned if they had existed. It is not until the ninth case that “pock-holes in his face” occurs in the description, the eleventh case following close, with the same mark of identity. Then comes a long interval until the twenty-fourth and twenty-fifth cases, both with pock-holes, two of a band of highwaymen concerned in an attempt to rob the Duke of Ormond’s coach near London, one of them having emerged from Frying-pan Alley in Petticoat Lane. Fifteen cases follow, all described by distinctive features, without mention of pock-marks, until we come to the fortieth, a boy of twelve or thirteen, who “hath lately had the smallpox.” The next is the forty-ninth, a Yorkshireman, long-visaged, and “hath had the smallpox,” and close upon him the fiftieth “marked with smallpox.” Then come four in quick succession, the 56th, 59th, 61st and 63d; next the 71st; and then a long series with no marks of smallpox, until the 95th, 97th, 99th and 100th, three of these last four having been negroes.
The result is that sixteen in the hundred are marked more or less with smallpox, four of them being black men or boys. One had “lately had the smallpox,” another had “newly recovered of the smallpox.” One was a cherry-cheeked boy of twelve, “somewhat disfigured with smallpox,” who had run away from Bradford school. Two are described as much disfigured, some as a little disfigured, several others as “full of pock-holes.” The same mark of identity is occasionally mentioned in the advertisements beyond the hundred tabulated, but not more frequently than before, the usual term in the later period being “pock-broken.” This proportion of pock-marked persons among the London populace, sixteen in the hundred, or about twelve in the hundred excluding negroes, does not err on the side of under-statement, if it errs at all. Some such small ratio is what we might have expected in the antecedent probabilities, arising out of the varying degrees of severity of smallpox and the various textures of the human skin. Pitting after smallpox has always been a special risk of a certain texture of the skin, namely, a sufficient thickness of the vascular layer to afford the pock a deep base. Such complexions are common enough even in our own latitudes; and those are the faces that have always borne the most obvious traces of smallpox. It was some of the confluent cases, or rather, of such of them as recovered, that became pock-marked: the babe that became a changeling was not likely to survive. Adults retained the marks more than children, so that there must always have been a good many pock-marked faces in a population where the incidence of the disease was largely upon grown persons, as in the 17th century and in our own time. When smallpox was something of a novelty at the end of the Elizabethan period, a poet addressed a pathetic lyric to his mistress’s pock-marked face. A medical writer of the same period reproduces the old Arabian prescription against pitting, to open the pocks on the face with a golden pin, and adds: “I have heard of some, which, having not used anythinge at all, but suffering them to drie up and fall of themselves, without picking or scratching, have done very well, and not any pits remained after it[850].” Whitaker, in 1661, dismisses the risk of pitting very briefly, remarking that the means of prevention was “commonly the complement of every experienced nurse[851].” Morton, in his sixty-six clinical cases and in his commentary, makes but slight reference to pitting. In his 14th case, a severe one, “no scars remained”; in his general remarks he treats pitting as a bugbear: “women set the fairness of their faces above life itself,” which may mean, as in Beaumont and Fletcher’s comedy, that they would chill themselves at all risks by the cooling regimen so they might drive the pocks in[852].
The Epidemiology continued to the end of the 17th century.
What little remains to be said of smallpox in England to the end of the seventeenth century may be introduced by the following table of the deaths in London.
Smallpox Deaths in London 1661 to 1700.
| Year | Total deaths | Smallpox deaths | ||
| 1661 | 16,665 | 1246 | ||
| 1662 | 13,664 | 768 | ||
| 1663 | 12,741 | 411 | ||
| 1664 | 15,453 | 1233 | ||
| 1665 | 97,306 | 655 | ||
| 1666 | 12,738 | 38 | ||
| 1667 | 15,842 | 1196 | ||
| 1668 | 17,278 | 1987 | ||
| 1669 | 19,432 | 951 | ||
| 1670 | 20,198 | 1465 | ||
| 1671 | 15,729 | 696 | ||
| 1672 | 18,230 | 1116 | ||
| 1673 | 17,504 | 853 | ||
| 1674 | 21,201 | 2507 | ||
| 1675 | 17,244 | 997 | ||
| 1676 | 18,732 | 359 | ||
| 1677 | 19,067 | 1678 | ||
| 1678 | 20,678 | 1798 | ||
| 1679 | 21,730 | 1967 | ||
| 1680 | 21,053 | 689 | ||
| 1681 | 23,951 | 2982 | ||
| 1682 | 20,691 | 1408 | ||
| 1683 | 20,587 | 2096 | ||
| 1684 | 23,202 | 1560 | ||
| 1685 | 23,222 | 2496 | ||
| 1686 | 22,609 | 1062 | ||
| 1687 | 21,460 | 1551 | ||
| 1688 | 22,921 | 1318 | ||
| 1689 | 23,502 | 1389 | ||
| 1690 | 21,461 | 778 | ||
| 1691 | 22,691 | 1241 | ||
| 1692 | 20,874 | 1592 | ||
| 1693 | 20,959 | 1164 | ||
| 1694 | 24,100 | 1683 | ||
| 1695 | 19,047 | 784 | ||
| 1696 | 18,638 | 196 | ||
| 1697 | 20,972 | 634 | ||
| 1698 | 20,183 | 1813 | ||
| 1699 | 20,795 | 890 | ||
| 1700 | 19,443 | 1031 |
Sydenham’s remarks throw some light on the smallpox of the several years. While the epidemic of 1667-68 was of a regular and mild type, that of 1670-72, which has fewer deaths in the bills, was of the type of black smallpox complicated with flux. The year 1674 has the highest figures yet reached; the type of the disease was confluent, and so severe that it “almost equalled the plague”; while the smallpox of the year 1681, with a still higher total, was “confluent of the worst kind.”