The remedies employed shew the circumspection and ability of the Dutch physicians. They had recourse, as soon as possible, at the latest within six hours, to venesection, and followed this up immediately by purgatives, of which, however, some eminent men disapproved, and this to the great detriment of their patients, for without the combined effect of both these means, the sudden suffocation could not be averted. Moreover, the employment of detergent gargles, whereby the extension of the affection to the lungs was prevented, as also of demulcent pectoral remedies, was decidedly beneficial, and it is affirmed that all who were thus treated were easily restored[138].
Extraordinary and peculiar as this disease, for which contemporaries found no name, was, its rapid onset and its sudden disappearance were still more so. Most of those affected were taken ill at the same time, and eleven days of suffering and misery had scarcely elapsed when not another case occurred; the numbers who had fallen victims were buried; and but for the journal of the worthy Tyengius[139], no distinct record would have existed of this remarkable epidemic, which however, it is certain, spread further than merely over the misty territory of Holland, and apparently with still greater malignity; for in the same year we find it in Basle, where, within the space of eight months, it destroyed about 2000 people, and its symptoms would seem to have been still more strongly marked. Respecting the intermediate countries, which it is highly probable that the disease passed through from Holland before it reached Basle, we unfortunately have no information. The tongue and gullet were white as if covered with mould, the patient had an aversion to food and drink, and suffered from malignant fever, accompanied with continued headache and delirium. Here also, in addition to an internal method of cure which has not been particularly detailed, the cleansing of the mouth was perceived to be an essential part of the treatment: the viscous white coating was removed every two hours, and the tongue and fauces were afterwards smeared with honey of roses[140], whereby patients were restored more easily than when this precaution was omitted[141].
It appears, according to modern experience, to admit of no doubt that this disease consisted of an inflammation of the mucous membrane which, accompanied by a secretion of lymph, spread from the œsophagus to the stomach, and likewise through the air passages to the lungs, being thus identical with pharyngeal croup, which was represented a few years ago as a new disease, and has in consequence been designated by a special name[142]. Its subsequent appearance in the memorable year 1557, respecting which we have a still more complete account, gives additional weight to this supposition. In that year it broke out in October, and was observed by Forest, who was himself the subject of it, at Alkmaar, where it attacked whole families, and in the course of a few weeks destroyed more than 200 people. It was not, however, so excessively rapid in its course as in 1517, but began with a slight fever like a common catarrh, and shewed its great malignity only by degrees. Sudden fits of suffocation then came on, and the pain of the chest was so dreadfully distressing that the sufferers imagined they must die in the paroxysm. The complaint was increased still more by a tight convulsive cough, and until this was relieved by a secretion of mucus, proved dangerous, especially to pregnant women, sixteen of whom died within the space of eight days, whilst those who survived were all prematurely brought to bed. The fever which accompanied the inflammation was very various in its course. It was rarely observed to continue without intermission, but where this was the case, was attended with the greatest peril. Yet death did not take place on this visitation until the ninth or fourteenth day, whereas in the year 1517 as many hours would have sufficed to produce a fatal termination. After this period the danger diminished, and those patients were most secure from suffocation, provided they had good medical attendance, whose complaint had been accompanied throughout its course by fever of only an intermittent character. So marked was the influence of the Dutch soil, that until this intermittent passed into continued fever of different gradations, it appeared of the purest and most unmixed type. In these cases the inflammation was less completely formed, so that even bleeding, a remedy otherwise indispensable, was sometimes unnecessary. Those affected all suffered most at night and in the morning, the latter generally bringing with it the inflammation of the larynx and trachea, which, however, they had not at that time experience enough to recognise as such, perceiving as they did only a slight redness in the fauces. The painful affection of the stomach was also in this epidemic very distinctly marked, so that a sense of pressure at the præcordia, accompanied by continual acid eructations, continued to exist even after a succession of six or seven fits of fever; and convalescents were troubled for a long time with dyspepsia, debility and hypochondriasis. The inflammation of the mucous membrane, no doubt, affected the nervous plexuses of the abdomen, as is usually the case, and totally changed the secretion. This was proved by the treatment, for, by administering the necessary purgative remedies, a vast quantity of offensive mucus, mixed with bile, was evacuated.
Our excellent eye-witness assures us that the people sickened as suddenly as if they had inhaled a poisonous blast, so that more than a thousand people in Alkmaar betook themselves to their beds in a single day, a thick stinking mist having previously for several days spread over the land. This pestilence did not terminate so speedily as that of the year 1517; on the contrary, it delayed until the winter, and seems to have formed the conclusion of a whole series of morbid phenomena, particularly of the already mentioned influenza throughout Europe, and of the bubo plague in Holland, which had occurred in the middle of the summer,—phenomena that were accompanied by the usual attendants of epidemics, namely great scarcity, and unusual occurrences in the atmosphere, such, for instance, as electric illuminations of prominent objects, and so forth[143].
The close connexion between this inflammation of the air-passages and gullet and the epidemic catarrh is quite apparent; for these are but gradations and gradual transitions in the affection of the mucous membrane, as also in the power of atmospherical causes, which especially influence the organs of respiration. We believe, therefore, that we are fully justified in classing the epidemic described to have taken place in Holland and Germany in 1517, with the influenzas; and in declaring the morbid commotion in human collective life which thus manifested itself, to have been a forerunner of the English pestilence, which was simultaneously prepared by the altered condition of the atmosphere, and broke out a few months later.
We ought not to omit here to mention that, in this same year, 1517, the small-pox, and with it, as field-poppies among corn, the measles, was conveyed by Europeans to Hispaniola, and committed dreadful ravages at that time, as afterwards, among the unfortunate inhabitants. Whether the eruption of these infectious diseases in the new world was favoured by an epidemic influence or not, can no longer be ascertained; yet the affirmative seems probable from the fact, that the small-pox did not commit its greatest ravages in Hispaniola[144] until the following year, and, according to recent experience, those epidemic influences which extend from Europe westward, always require some time to reach the eastern coasts of America.
But even without this phenomenon in the New World, which is now for the first time placed within the pale of observations on epidemics, we have facts at hand sufficiently numerous and worthy of credit to prove—that the English Sweating Sickness of 1517, made its appearance, not alone, but surrounded by a whole group of epidemics, and that these were called forth by general morbific influences of an unknown nature.