The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

It was thought remarkable, even at that time, that the Sweating Sickness did not extend beyond the limits of England, and that, remaining the unenviable property of that nation, it did not even spread to Scotland, Ireland, or Calais which belonged to Britain. Much, doubtless, was owing to the peculiarity of the climate, more still to atmospherical changes, and something also to the habits of the people and the circumstances of the times. It plainly appeared in the sequel that the English Sweating Sickness was a spirit of the mist, which hovered amid the dark clouds. Even in ordinary years, the atmosphere of England is loaded with these clouds during considerable periods, and in damp seasons they would prove the more injurious to health, as the English of those times were not accustomed to cleanliness, moderation in their diet, or even comfortable refinements. Gluttony was common among the nobility as well as among the lower classes; all were immoderately addicted to drinking[29], and the manners of the age sanctioned this excess at their banquets and their festivities. If we consider that the disease mostly attacked strong and robust men—that portion of the people who abandoned themselves without restraint to all the pleasures of the table—while women, old men, and children, almost entirely escaped, it is obvious that a gross indulgence of the appetite must have had a considerable share in the production of this unparalleled plague.

To this may be added, the humidity of the year 1485, which is represented by most chronicles as very remarkable[30]. Throughout the whole of Europe the rain fell in torrents, and inundations were frequent. Damp weather is not prejudicial to health if it be merely temporary, but if the rain be excessive for a series of years, so that the ground is completely saturated, and the mists attract baneful exhalations out of the earth, man must necessarily suffer from the noxious state of the soil and atmosphere. Under these circumstances epidemics must inevitably follow. The five preceding years had been unusually wet[31], 1485 proved equally so; the last hot and droughty summer was that of 1479[32]. Extensive inundations of the Tiber, the Po, the Danube, the Rhine, and most of the other great rivers, took place in 1480, and were attended with the usual consequences, the deterioration of the air, misery and disease[33]. The greatest inundation ever remembered in England was that of the Severn, in October, 1483. It was long afterwards called the Duke of Buckingham’s Great Water[34], because it frustrated the rebellion of this powerful subject against Richard III., whom he had been instrumental in placing upon the throne; and consequently defeated also the first enterprise of Henry VII. It lasted full ten days, and the tremendous ravages occasioned by the overwhelming torrent dwelt long in the memory of the people.

Sect. 4.—Other Epidemics.

During the whole of this period the nations of Europe were visited with various and destructive plagues. In 1477, the Bubo-plague broke out in Italy, and raged without interruption till 1485[35]. It was accompanied by striking natural phenomena, among which we may reckon an enormous flight of locusts in 1478[36] and 1482, and remarkable inter-current diseases, such as inflammatory pain in the side, throughout the whole of Italy in 1482[37]. In Switzerland and Southern Germany malignant epidemics[38] appeared in the train of drought and famine in 1480 and 1481, while putrid fever accompanied by phrenites[39], prevailed in Westphalia, Hesse and Friesland. There had never been in the memory of the inhabitants of these districts so many ignes fatui as during this period. There too the people suffered from the failure of the harvest, so that it was necessary to obtain supplies from Thuringen[40]. France, where, under the fearful reign of Louis XI., oppression and misery seemed to mock the gifts of heaven, became in 1482, after a two years’ scarcity, the scene of a devastating plague. It was an inflammatory fever with delirium, accompanied by such intense pain in the head, that many dashed out their brains against the wall, or rushed into the water; while others, after incessantly running to and fro, died in a state of the greatest agony. According to the notion of the age, this disease was attributed to astral influences, for it could not have been brought on only by famine, which left to the poor peasantry, south of the Loire, nothing but the roots of wild herbs to support their miserable existence[41], since the higher classes were also frequently attacked[42]. This fever was without doubt accompanied by inflammation of the meninges, or even of the brain itself, and was, perhaps, identical with that which at the same period desolated the north-west of Germany as far as the shores of the North Sea, only that it was heightened by the greater natural vivacity and miserable situation of the French people, who were kept in a state of perpetual dread by the cruel executions of Louis[43]. This pestilence occasioned the king to follow the advice of his morose physician[44] in ordinary, and to keep himself closely confined within the town of Plessis des Tours. It was prohibited under a heavy penalty to speak in his presence of death which was carrying off its victims in all directions, and forty crossbowmen kept guard in the fosse of the castle to put to death every living thing which might approach[45]. Two years after, in 1484, virulent diseases[46] again visited Germany and Switzerland; and thus it seemed as if the nations were everywhere threatened with death and destruction.

Sect. 5.—Richmond’s Army.

From these data, which might easily be extended[47], it is evident that the Sweating Sickness of 1485 did not make its appearance without great and general premisory events, which for a series of years imparted to the people of England a susceptibility to dangerous and unusual diseases. If, besides this, we take into account the gloomy temperament of the English, and the general depression of their spirits, in consequence of the sanguinary wars of the red and white roses, a series of events which seems to have shaken their faith in an overruling Providence, we may readily conceive that it would require but a very slight impulse to excite a powerful commotion in the mysterious mechanism of the human body. This impulse was evidently given by the landing of Richmond’s army in the very year when great and portentous evils were anticipated; for on the 16th of March, the same day when Queen Ann, the unfortunate wife of Richard III., expired, a total eclipse of the sun enveloped all Europe in darkness, and gave rise to gloomy prognostications[48]. Even under ordinary circumstances, wars beget pestilential disorders—how much more inevitably must these have arisen in the then existing state of affairs! Richmond’s army consisted not of brave men animated by zeal to avenge their dishonoured country or to serve a good cause. It was composed of wandering freebooters, “vile landskneckte,” as they were called in Germany, who assembled under his banner at Havre,—sharpshooters formed under Louis XI., who recklessly pillaged Normandy, and whom Charles VIII. gladly made over to Henry, in order to free his own peaceful territories from so great a scourge[49]. This army may not have been worse than others of the same period[50]; but cooped up as they were for a whole week in dirty ships, they doubtless carried about with them all the material for germinating the seeds of a pestilential disorder, which broke out soon after on the banks of the Severn and in the camp at Litchfield.

Sect. 6.—Nature of the Sweating Sickness.

PRELIMINARY INVESTIGATION.

Before we proceed further, some account is here required of the nature of this disease. It was an inflammatory rheumatic fever, with great disorder of the nervous system. This assumption is supported by the manner of its origin and its especial characteristic of being accompanied by a profuse and injurious perspiration. From the judgment that we are now capable of forming of the pernicious influences which prevailed in the year 1485, it may, without hesitation, be admitted that the humidity of that and of the preceding years affected the functions of the lungs and of the skin, and disturbed the relation of this very important tissue to the internal organs of life. This is the usual commencement of rheumatic fevers, which bear the same relation to the Sweating Sickness as slight symptoms bear to severe ones of the same kind. The predominance of affections of the brain and of the nerves, however, gave to the English epidemic a peculiar character. The functions of the eighth pair of nerves were violently disordered in this disease, as was shewn by oppressed respiration and extreme anxiety with nausea and vomiting, symptoms to which the moderns attach much importance[51]. The stupor and profound lethargy shew that there was injury of the brain, to which, in all probability, was added a stagnation of black blood in the torpid veins. We must also take into the account a previous corruption and decomposition of the blood, which, even if we should be disinclined to infer their existence from the offensive perspiration of the disease itself, were proved by striking phenomena of a similar nature that occurred in Central Europe about the same time; for the scurvy prevailed as an epidemic, more especially in Germany, in the year 1486, and with such severe and unusual symptoms, that people were inclined to regard it as a totally new malady[52]. Now such is the vital connexion of different functions that every impediment to respiration, whether in consequence of pressure from without, or through spasm and irritation of the nerves from within, or even from a morbid condition of the circulating fluid, infallibly calls forth the compensating activity of the skin, and the body becomes suffused with an alleviating perspiration.

Thus it plainly appears that the profuse perspiration in the disease of which we are treating, notwithstanding its apparently injurious tendency, was the result of a commotion excited on the part of the lungs, which was critical with respect to the disease itself; and this is in accordance with all the causes of which we still have any knowledge. Noxious and even stinking fogs penetrated into the organs of respiration, and as the blood was thus so much affected in its composition and in its vitality that its corrupt state was only to be obviated by profuse perspiration, the inevitable consequence was an interference with the extensive functions of the eighth pair of nerves, which interference, as later writers relate, extended in many cases to the spinal marrow, and brought on violent convulsions[53]. We have here only one essential cause, out of many, for this gigantic disease, and one too which accounts for its advance and spread. It is highly probable, for the reasons stated, and as according with all human experience, that it first broke out in the army of Henry the VIIth, and beyond all doubt that it spread from west to east, and afterwards in a retrograde course from east to west. With the perfectly equable operation of the predisposing causes, from which the disease ought indubitably to have broken out all over England at the same time, had the condition of the atmosphere been its sole occasion, we must additionally presume a special cause for its progress through towns and villages. This, according to all appearance, was to be found in the air, impregnated with foul odours, which surrounded the sick, and abounded in the tents and dwellings in which Henry the VIIth’s soldiers, after various privations and hard service, amid storms and rain, were closely crowded together. Of both causes modern observation furnishes analogous examples. Intermittent fevers spread more easily in air which is contaminated by sick people, and bands of soldiers, themselves in perfect health, have not unfrequently conveyed camp fever to remote places. It signifies very little by what expressions of the schools these occurrences are designated; it is best perhaps to abstain from them altogether, for they are all inadequate, and occasion misconceptions. Contemporaries, however, were certainly justified in not admitting the notion of contagion in the same sense as when the term is applied to the plague, with which they were well acquainted[54]. For very frequently cases which were not to be explained on the principle of contagion communicated by persons diseased, occurred among people of rank, and manifestly arose independently of the usual causes. In these cases the fear of death, which everywhere was the harbinger of the disease, and threw the nerves of the chest into spasmodic commotion, gave an impulse to the malady for which the quality of the atmosphere and luxury had long made preparation. Had this view of contemporaries been even less impartial than it really was, it would have found the most striking confirmation in the sudden cessation of the pestilence throughout the whole country. For the destructive spirits of air, which would not have been discerned even by the proud naturalists of the nineteenth century, dispersed and vanished for half an age in the fury of the tempest which raged on the 1st of January, 1486.