The rapid spread of the Sweating Sickness all over England as far as the Scottish borders, and across to Calais, now demands a more especial consideration. Most fevers which are produced by general causes, as well transient (epidemic) as constant and peculiar to the country (endemic), or a union of both, which almost always takes place, and was here evidently the case, propagate themselves for a time spontaneously. The exhalations of the affected become the germs of a similar decomposition in those bodies which receive them, and produce in these a like attack upon the internal organs; and thus a merely morbid phenomenon of life shews that it possesses the fundamental property of all life, that of propagating itself in an appropriate soil. On this point there is no doubt,—the phenomena which prove it have been observed from time immemorial, in an endless variety of circumstances, but always with a uniform manifestation of the fundamental law. All nations too, and from the most ancient times, have invented ingenious designations for these occurrences, which, however, seldom represent the general notion, but commonly only the peculiar propagation of individual diseases. Certainly one of the best and the most ingenious is that which is conveyed by the German word “Ansteckung,” “setting on fire,” which compares the exciting a disease in the appropriate body, with the inflammation of combustible matter by the application of fire, or with the kindling of powder by a spark. But how various are these “Ansteckungen!”, from the purely mental, on the one hand, which, through the mere sight of a disagreeable nervous malady—through an excitement of the senses that shakes the mind, penetrates into the nerves, those channels of its will and of its feelings, and produces the same disorder in the beholder, to those, on the other hand, which propagate diseases that principally operate only upon matter, and are distinguishable but little, if at all, from animal poisons. The reader must not here expect all the features of a doctrine which extends through the whole immeasurable domain of life. They are clearly derived from the confirmed and well applied experience of the past, and have been delineated by men[123] who had not forgotten, like their modern successors, to take a comprehensive view of epidemic diseases. It may, however, be permitted me just to call to mind the difference between those infectious diseases which are permanent and for centuries together unchangeable, and those which are temporary and transient. The infecting matter of the former may aptly be called the perfect or unchangeable in contradistinction to the imperfect or mutable character of the latter. The former, when once formed, whether in diseased persons or inanimate substances (fomites), are always in existence, and are but called into activity by those causes of general disease (epidemic constitutions) which are favourable to their propagation; and it is to be remarked that under all circumstances, and at all times, they excite the same unchangeable diseases, and, varying only in particular ramifications or degenerations and mild forms, never lose their proper essence. Examples are furnished in the small-pox, the plague, the measles, and, if we may include diseases not febrile, the leprosy, the itch, and the venereal disease. The latter, on the other hand, are not always in existence, they are called forth from nonentity by the causes of general diseases or epidemic constitutions, and they disappear again after the extinction of the epidemic diseases by which they were bred; they likewise vary in their development and their course in each particular epidemic. Examples are found in the yellow fever, in catarrh or influenza, in nervous and putrid fever, and, among many other disorders, in miliary fever, a disease which first grew to a national pestilence in the 17th century, and which, in the kind and manner of its infecting power, approaches nearest to the sweating fever. To this latter category the English Sweating Sickness likewise belongs; a disease altogether of a temporary character, which, after its cessation, left no infecting material behind, and consequently was incapable of propagating itself after the manner of those diseases which are completely contagious. The animal matters, which were expelled along with the profuse perspiration, and spread so horrible a stench around the sick, contained amid their alkaline salts, (probably ammonia in various states of combination,) and their superabundant acid, the ferment of the disease; and this penetrated into the lungs of the bystanders as they breathed, and provided they were but predisposed for its reception, as above stated, continually produced it. It may be considered as certain that mere manual contact was not sufficient to communicate the infection, and that this was propagated, either by the pestilential atmosphere which surrounded the beds of the sick, or by exhalations generated in unclean situations where there was no vent for their escape. On this account it was that the residence at common inns and public-houses was looked upon as dangerous[124].

I would not, however, be understood to maintain that, during the three epidemics with which, up to the present stage of our inquiry, we have become acquainted, the spread of the sweating fever alone was occasioned by infection; for if the general epidemic causes were powerful enough to excite the disease, without any previously existing poison, why might they not produce the same effect still more independently throughout the course of the pestilence, since, as is the case in all epidemics, those causes in all probability continued to increase in intensity? That the plague grew worse on the occasion of any great assemblages of the people, was at that time known, and the notion of contagion thence very naturally arose. Yet, must it here be taken into account, that even without this notion, and merely from the assemblage itself of many people in whom the like malady was germinating, and already had shewn tokens of its approach, that approach might easily be accelerated, and the disease increased among those merely slightly indisposed, by the reciprocal communication of morbid exhalations. For as the predisposition to any malady, which is an intermediate condition between that malady and the previous state of good health[125], plainly displays the properties of the disease in those whom it threatens to attack, so these exhalations (or epidemic causes which give rise to Sweating Sickness in the first instance) certainly differ from those which occur in a sweating sickness which has already broken out, only in unessential respects, and might consequently stimulate the mere disposition to the disease more and more, even to the actual eruption of the disease itself. Yet a contagion was likewise in operation at the same time which was destructive even to the temperate, and to those who were apparently in health, nay, even to foreigners, who were living in an English atmosphere and on English food, as the example of the Italian Ammonius plainly proves[126].

In all epidemics which increase to such a degree as to become contagious, it is of importance to distinguish which of these causes are the more powerful, the predisposing or epidemic causes, which originate the proneness to the disease, or the proximate causes, among which, in the generality of cases, contagion is the most prominent. The predisposing were here evidently the more operative; contagion was not added till the disease was at its height, and although it contributed not a little to its spread, yet it always remained subordinate to the other sources of the disease, and all the matter of infection vanished without a trace, on the cessation of the disorder, so that the subsequent eruptions of it were always produced by the renewal of those general causes which are in operation upon and under the earth. It is, however, as little within the compass of human knowledge to discover the essential foundation of this renewal, as the proximate causes of the appearance of the mould spots at the commencement of the sixteenth century, or any other of those processes which are prepared and brought into activity by the hidden powers of nature.

Sect. 6.—Influenzas.

Several epidemics thus originating in causes beyond human comprehension appeared in the 16th century. Among the most remarkable was a violent and extensive catarrhal fever in 1510, of that kind which the Italians call Influenza, thus recognising an inscrutable influence which affects numberless persons at the same time. It prevailed principally in France, but probably also over the rest of Europe, of which, however, the accounts do not inform us, for in those times they took little pains to record the particulars of epidemics which were not of a character to affect life. According to recent experience we should be warranted even in supposing that this malady had its origin in the remotest parts of the East. During the whole of the winter, which was very cold, violent storms of wind prevailed, and the north and middle of Italy were shaken by frequent earthquakes; whereupon there followed so general a sickness in France, that we are assured by the historians that few of the inhabitants escaped it. The catarrhal symptoms, which on the appearance of disorders of this kind usually form their commencement, seem to have been quite thrown into the background by those of violent rheumatism and inflammation. The patient was first seized with giddiness and severe headache; then came on a shooting pain through the shoulders, and extending to the thighs. The loins too were affected with intolerably painful dartings, during which an inflammatory fever set in with delirium and violent excitement. In some the parotid glands became inflamed, and even the digestive organs participated in the deep-rooted malady; for those affected had, together with constant oppression at the stomach, a great loathing for all animal food, and a dislike even to wine. Among the poor as well as the rich many died, and some quite suddenly, of this strange disease, in the treatment of which the physicians shortened life not a little by their purgative treatment and phlebotomy, seeking an excuse for their ignorance in the influence of the constellations, and alleging that astral diseases were beyond the reach of human art[127].

From this prejudicial effect of our chief antiphlogistic remedy, bleeding, as well as of evacuations from the bowels, we may conclude that the disease, though in its commencement rheumatic, yet had an essential tendency to produce relaxation and debility of the nerves, and in this respect, as well as in its extension to all classes, accorded with the modern influenzas, in which the same phenomena have manifested themselves only much less vividly and plainly. The French, who, from the levity of their character, have always called serious things by jocose names, designate this disease “Coqueluche” (the monk’s hood), because, owing to the extreme sensibility of the skin to cold and currents of air, this kind of hood was generally necessary, and was a protection against an attack of the malady, as well as against its increase. That in the accounts, which are, to be sure, very incomplete, there should be no express mention of any affection of the air-passages, is remarkable, since this could not in all likelihood have failed to exist; although it might perhaps have been only slightly manifested. Nearly a century before (1414), this affection appeared far more prominently on the occurrence of a no less general disorder of the same kind; so that all those who had the complaint, suffered from a considerable hoarseness, and all public business in Paris was interrupted on this account[128]. It was on that very occasion that the name Coqueluche was first employed, and this having, as is well known, been transferred to the whooping-cough, it is easier to suppose, with respect to the influenza of 1510, which was similarly named, an omission in the account, than the real absence of a symptom so very generally prevalent; for in these kinds of comparisons and denominations, the common sense of the people errs much less than the learned profundity of political historians.

We must not omit here to remark that three years before (1411), and thirteen years afterwards, two diseases entirely similar and equally general, made their appearance in France, of which we nowhere find that any notice has been taken up to the present time. The first was called Tac, the second Ladendo, which designations have since entirely gone out of use. Both were accompanied by very severe cough, so that in the former, ruptures not unfrequently occurred, and pregnant women were in consequence prematurely confined, and by the latter, from its universality, the public worship was disturbed. In the ladendo, there seems to have been an affection of the kidney of an inflammatory character, and much more severe than in the coqueluche of 1510, a memorable example of epidemic influence, and without a parallel in modern times. This pain in the kidneys, which was as severe as a fit of the stone, was followed by fever with loss of appetite, and an incessant cough that terminated in disagreeable eruptions about the mouth and nose. The disorder ran a course of about fifteen days, and was generally prevalent throughout October, being unattended with danger, notwithstanding the severity of its symptoms. One might almost be tempted to regard the tac of 1411 as the coqueluche of 1414, which is only slightly alluded to by Mezeray, and whereof the author from whom we are now quoting, has made no mention; for a false date might easily occur here. Yet this must remain undecided until we can obtain fuller information, for we have experienced, even in the most recent times, an example of influenzas (1831 and 1833) following each other in quick succession. Gastric symptoms and an inordinate degree of irritability accompanied the spasmodic cough, and the complaint terminated with evacuations of blood. However, the disease was unattended with danger, and lasted upon the whole only three weeks[129].

Four other epidemics similar to that of 1510 appeared in the sixteenth century, two which were quite general in the years 1557 and 1580, and two less extensively prevalent in the years 1551 and 1564[130]. Of the two former we possess accurate descriptions; it will therefore aid us in forming a correct judgment respecting the influenza of 1510, if we here take a review of these also, since the most experienced contemporaries classed all these disorders together as of a similar kind. During the dry unfavourable summer of 1557, invalids were suddenly seized with hoarseness and oppression at the chest, accompanied with a pressure on the head, and followed by shivering and such a violent cough, that they thought they should be suffocated, especially during the night. This cough was dry at first, but about the seventh day, or even later, an abundant secretion took place either of thick mucus or of thin frothy fluid. Upon this the cough somewhat abated, and the breathing became freer. During the whole course of the disorder, however, patients complained of insufferable languor, loss of strength, want of appetite and even nausea at the sight of food, restlessness and want of sleep. The malady ended in most cases in abundant perspiration, but occasionally in diarrhœa. Rich and poor, people of every occupation and of all ages, were seized with this disease in whole crowds simultaneously, and it passed easily from a single case to a whole household. On this occasion death rarely occurred, except in children who had not power to endure the severity of the cough, and medicine was of little avail, either in alleviating the disorder or arresting its destructive course. The already established name of this disease was immediately called to mind again in France. It was not, however, confined to that kingdom, but prevailed as generally, with some considerable varieties of form, in Italy, Germany, Holland, and doubtless over a still wider range of country[131]. The same was the case with the influenza of 1580, which spread over the whole of Europe, and seems to have been less severe; thus bearing a closer resemblance[132] to that of 1831 and 1833, which is still in the recollection of most of our readers from their own experience. A more elaborate research into this very important subject would far surpass the limits of this treatise, for phenomena deeply affecting the whole system of human collective life are here to be considered, which can only become apparent when received as a connected whole, yet we must at least point out the relation which the influenzas bear to the greater epidemics. This is quite apparent; for as catarrhs are not unfrequently the forerunners, accompaniments or sequelæ of important diseases in individual cases[133], excitement of the mucous membrane being often merely an outward sign of more deeply seated commotion, so also are influenzas usually only the first manifestations, but sometimes also the last remains of extensive epidemics. The most recent example is still fresh in our memories. The influenza of 1831 was immediately followed by the Indian cholera, and scarcely had this, after its revival in Eastern and central Europe, vanished, when the influenza of 1833 appeared, as if to announce a general peace. After the influenza of 1510, a plague followed in the north of Europe, which in Denmark carried off the son of King John[134]; 1551 was the year of the fifth epidemic sweating sickness. In 1557, the influenza in Holland, was followed by a bubo plague, which lasted the following year, and carried off 5000 of the inhabitants at Delft[135]. In 1564, a very destructive plague raged in Spain, of which 10,000 people died at Barcelona, and finally, in 1580, the last year of influenza in that century, a plague of which 40,000 died in Paris, appeared over the greater part of Europe and in Egypt[136].

Sect. 7.—Epidemics of 1517.

We now revert to the year 1517, and shall consider the epidemics which accompanied the English sweating sickness. First of all, the Hauptkrankheit, that brain fever which so often recurred in the central parts of Europe, appeared extensively throughout Germany. Many died of this dangerous disease, and we are assured by contemporaries that other inter-current inflammatory fevers were also very fatal[137]. Such was the case in Germany, the heart of Europe. Another disease, however, much more important, and till that time wholly unknown to medical men, appeared in Holland, which broke out in January, 1517, and from its dangerous and quite inexplicable symptoms, spread fear and horror around. It was a malignant, and, according to the assurance of a very respectable medical eye-witness, an infectious inflammation of the throat, so rapid in its course that, unless assistance were procured within the first eight hours, the patient was past all hope of recovery before the close of the day. Sudden pains in the throat, and violent oppression of the chest, especially in the region of the heart, threatened suffocation, and at length actually produced it. During the paroxysms the muscles of the throat and chest were seized with violent spasm, and there were but short intervals of alleviation before a repetition of such seizures terminated in death. Unattended by any premonitory symptoms, the disease began with a severe catarrhal affection of the chest, which speedily advanced to inflammation of the air passages, and where death did not occur on the day of the attack, ran on to a dangerous inflammation of the lungs, which followed the usual course, but was accompanied by a very high fever. Occasionally a less perilous transition into intermittent fever was observed, but in no case did a sudden recovery take place; for even when the fever subsided, the patient continued to suffer, for at least a month, from pain in the stomach and great debility, which symptoms admit of easy explanation to a medical man of the present day, from the fissures and small ulcers of the tongue, which appeared when the fever was at its height, and obstinately resisted the usual treatment.