The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

The best physicians were agreed on the importance of the petechiæ as an indication of the nature of the crisis; for those cases in which they were abundant and of a good quality were cured much more easily than those in which the eruption was suppressed. An abundant perspiration also was particularly conducive to recovery, whereas all other evacuations, especially a flux from the bowels, proved to be injurious and even fatal.

If we keep these phenomena in view, and consider, moreover, that in the widely extending lues venerea of those times cutaneous eruptions predominated over the other symptoms, the English sweating sickness in the north of Europe will appear, as in connexion with this circumstance, of a very important character; and the supposition, that the morbid activity of the system during the whole of this age, maintained a decided determination to the skin, may thence be fairly considered as something more than a mere conjecture.

This fact speaks for itself, but the causes of this altered temperament of the body it is not an easy matter to discover. Fracastoro, who knew much better than his modern followers how to manage his sagacious doctrine of contagion, looked for these causes in the quality of the air, which was manifest by much more evident phenomena in the epidemic petechial fever of 1528 than in that of 1505, and he traced an active connexion between this quality, which he called “infection of the atmosphere,”[73] and the condition of the blood; thus indicating unknown influences by an obscure notion. He considered the altered quality of the blood according to the established views of that period, which the petechial spotted fever seemed clearly to confirm, as a putrefaction; and he even assumed that, in the non-epidemic petechial fevers, which, from the year 1505 forward, frequently occurred, isolated causes must have given rise to changes in the blood, as well as that quality of the air, to which this great physician attributed the general and continued alterations which take place in the nature of diseases.

The petechial fever made the same impression on the physicians of Italy as new disorders have ever made; for although they were the best in Europe, their view was bounded by the horizon of Galen, within the limits of which the novel phenomenon was not to be found. They were therefore soon perplexed, and whilst they sought to entrammel the dreaded enemy with scholastic doctrines of repletion and acrimony and occult qualities, and betook themselves first to one remedy and then to another, they exposed themselves to the derision of the people, who soon perceived their disagreement and indecision, and, as usual, charged on the whole medical profession the well merited blame of individuals[74].

Sect. 6.—Other Diseases.

About the same period, in October, 1505, a very fatal disease broke out in Lisbon, the further progress of which was marked by the terror, the flight, and the confusion of the inhabitants[75]. Of what kind it was, whether a petechial fever or a bubo plague, and what connexion it had with a pestilence in Spain which had just preceded it, it would perhaps be difficult now to ascertain. This latter pestilence had spread from Seville, following an earthquake, and violent storms of wind and rain in 1504, and may very likely have been a bubo plague. Similar notices are met with of pestilences occurring in that country in 1506, the year of the English Sweating Sickness, in 1507 and 1508, in which years mention is made of swarms of locusts in the neighbourhood of Seville, and finally in 1510, the year of a great influenza[76], and 1515. Exact descriptions, however, of these disorders are entirely wanting[77].

With all the above phenomena, the epidemics which took place in Germany and France at the commencement of the sixteenth century, evidently unite to form a connected whole. Varying in intensity and extent, they continued without intermission for full five years, and moreover were accompanied by unusual circumstances, such as occur only in the time of great pestilences. The century was ushered in by the appearance of a comet[78], which, on this occasion, seemed to confirm the long cherished belief that the appearance of these heavenly bodies was prognostic of evil. For mankind are in the habit of concluding that phenomena which are simultaneous must have some internal connexion, and many examples were called to mind in which great pestilences affecting the whole world had been either preceded or accompanied by comets[79]. Immediately afterwards a great murrain among cattle took place, which may have proceeded from some injurious quality in their food. A notion immediately arose that the pastures were poisoned, and of this there was so firm a conviction, that the most violent resentment, as of old, in the time of the Black Death, prevailed against the supposed poisoners, and in the neighbourhood of Meissen some “böse Buben” (wicked knaves) who had fallen under suspicion, were actually executed[80].

A very considerable blight of caterpillars which, in the north of Germany, stripped the gardens and woods far and wide of their foliage, deserves to be here mentioned as a phenomenon appertaining to the lower grades of the animal kingdom[81]. Natural history has shewn that occurrences of this kind are by no means occasioned by new and wonderful influences, but rather by unusual combinations of circumstances, appearing to occur together almost accidentally, at a given time; especially by the simultaneous union of warmth and humidity in the atmosphere, whereby sometimes one and sometimes another of the lower grades of animal existences becomes extraordinarily developed. It is on this account that unusual phenomena in the insect world, whether it be the appearance or the disappearance of particular kinds, take place much more frequently when the order of succession in the seasons and the condition of the atmosphere are in a greater degree than usual and more permanently disturbed; and thus those phenomena have, with much reason, ever been considered as forerunners of pestilences, whenever the human frame has become, through atmospherical causes, generally susceptible of disease. Swarms of locusts have appeared before and during most great pestilences, and indeed the exuberant production of this insect appears, at least in Europe, to require the most unusual combination of causes.

Sect. 7.—Blood Spots.

Of rarer occurrence, but quite as important in reference to the general tendencies of life, are the luxuriant growths of the minutest cryptogamic plants in the water, and on damp things of all kinds, which, from their spots of various forms and colours, produced the utmost horror both before and during great pestilences, and excited superstitious fears, as appearing to be something miraculous. These spots (signacula), and especially the blood-spots, were seen at a very early period, as for instance during the great general plague in the sixth century[82], and again, during the plague of the years 786[83] and 959, when it is said to have been remarked, that those on whose clothes they frequently appeared, and seemingly imparted to them a peculiar odour, were more susceptible than other people of attack from leprosy, on which account this spotted appearance was inconsiderately called the clothes leprosy[84], (Lepra vestium;) not to mention other examples[85] in which plagues affecting the human species did not take place. The same signs also, in the years from 1500 to 1503, threw the faithful into great consternation, because, as on former occasions, they fancied they recognised in them the form of the cross[86]. The phenomenon on this occasion spread throughout Germany and France, and from its great extent and long duration, may be reckoned among the most remarkable of the kind. The spots were of different colours, principally red, but also white, yellow, grey, and black, and arose, often in a very short time on the roofs of houses, on clothes, on the veils and neck handkerchiefs of women, on various household utensils, on the meat in larders, &c. A historian, who speaks also of blood-rain[87], recounts that they could not be got rid of in less than ten or twelve days, and that they frequently occurred in closed chests, on linen and on articles of clothing[88]. Much information is not to be expected from the researches of the naturalists of those times, but there is no doubt that what is described was some one or more kinds of mould[89], inasmuch as the whole phenomenon evidently corresponds with modern observations[90]. Scientific physicians of the sixteenth century, among whom the naturalist George Agricola, who was born in 1494, and died in 1555, ought especially to be mentioned, recognised, even then, these spots as lichens, and without seeking to account for them by supernatural agencies, or lending credence to popular superstition, they gave them their just interpretation as indications of extensive disease[91]. Should the too bold notion of Nees v. Esenbeck, that fungi of the most minute forms have their origin in the higher regions of the firmament, and descending to the surface of the earth, produce spots and stains, be confirmed, which is not yet the case, these “signacula” would have a much more important connexion with epidemics than can be otherwise conceded to them; for though it be highly probable that they have their origin only in the dissemination of germs in the lower strata of the atmosphere, it must yet be granted, that if they appear over a considerable space, and during a long time, as at the commencement of the sixteenth century, the causes favouring their generation and spread, must be ranked among those of an extraordinary kind, and on this very account may exercise an influence over human organism, as was then evident.