The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

The mortality which occurred in the camp, began probably as early as June, after the usual calamities which surround an army in an enemy’s country. The French and Swiss were insatiable in their indulgence in fruit, which the gardens and fields furnished them in abundance, whilst there was a scarcity of bread and of other proper food[153]. Hence fevers soon broke out, which increased in malignity the longer they existed, accompanied no doubt by debilitating diarrhœas, which never fail to make their appearance under circumstances of this kind, and are in themselves among the most pernicious of camp diseases, since they not only destroy in the individual case by the exhaustion which they occasion, but likewise by infecting the air, prepare the way for the worst pestilences.

These diseases were, however, little noticed, and there was consequently no attempt made to diminish their causes. It became daily more and more apparent, that the cutting off of the sources near Poggio reale, which Lautrec had commanded, in order to compel the besieged to a more speedy surrender, was in the highest degree injurious to the besiegers themselves; for the water, having now no outlet, spread over the plain where the camp was situated, which it converted into a swamp, whence it rose, morning and evening, in the form of thick fogs. From this cause, and while a southerly wind continued to prevail, the sickness soon became general. Those soldiers, who were not already confined to bed in their tents, were seen with pallid visages, swelled legs, and bloated bellies, scarcely able to crawl; so that, weary of nightly watching, they were often plundered by the marauding Neapolitans. The great mortality did not commence until about the 15th of July, but so dreadful was its ravages, that about three weeks were sufficient to complete the almost entire destruction of the army[154]. Around and within the tents vacated by the death of their inmates, noxious weeds sprang up. Thousands perished without help, either in a state of stupor, or in the raving delirium of fever[155]. In the entrenchments, in the tents, and wherever death had overtaken his victims, there unburied corpses lay, and the dead that were interred, swollen with putridity, burst their shallow graves, and spread a poisonous stench far and wide over the camp. There was no longer any thought of order or military discipline, and many of the commanders and captains were either sick themselves, or had fled to the neighbouring towns, in order to avoid the contagion[156].

The glory of the French arms was departed, and her proud banners cowered beneath an unhallowed spectre. Meanwhile the pestilence broke out among the Venetian galleys under Pietro Lando. Doria had already gone over to the Emperor[157], and thus was this expedition, begun under the most favourable auspices, frustrated on every side by the malignant influence of the season.

No medical contemporary has described the nature of this violent disease, and historians have on this point preserved only general outlines, which do not afford sufficient materials to ground an investigation. Certain it is, that in the year 1528, a very malignant petechial fever extended throughout Italy, and in the proper sense of the word prevailed so decidedly, that it even followed the Italians abroad in the same way as the Sweating Sickness did the English, as is proved by the case of the learned Venetian Naugerio, who, being dispatched on an embassy to Francis the 1st, died at Blois on the Loire, of this very disease, with which the French had yet no acquaintance[158]. Contemporaries assure us, that this epidemic committed great ravages in the country, already distracted by wars and feuds, and it is therefore hardly to be doubted, that, occurring as it did in those same years, it was the disease of which we have been treating, the malignity of which was increased on extraordinary occasions. A pestilence which, just before the siege of Naples, destroyed one-third of the inhabitants of Cremona, was in all probability the petechial fever[159]. Yet, here and there, the old bubo plague made its appearance. This it was which in the year 1524 carried off 50,000 people in Milan[160], and this appears likewise to have been the disease which, after the sacking of Rome, broke out among the German lansquenets, and in a short time annihilated two-thirds of these troops. Contemporaries saw therein God’s just punishment of their desecration of the Holy See, for in the succeeding years, all the remaining participators in the storming of the eternal city, also met with an end worthy of their crimes[161]. They did not take into account, however, the beastly intemperance and excesses of the soldiery, whose eagerness after plunder led them to encounter the plague poison in the most secret holes and corners; nor did they reflect, that the plague penetrated the Castle of St. Angelo itself, and destroyed some of the courtiers almost under the eyes of the Pope[162]. Of these lansquenets, many went to Naples in the following year under the Prince of Orange, and it may with good ground be supposed, that they took with them to that city fresh germs of plague; to which may be added, the by no means incredible story, that the besieged sent infected and sick soldiers to the French, in order to cause poisonous pestilences to break out among them[163]. This very circumstance tells in favour of bubo plague, for the decided certainty of its contagious nature was known, and seemed beyond all comparison greater than the more conditional communicability of the new disease[164]. Moreover, the same attempt at impestation had been already often made in earlier times.

It is, however, also to be considered, on the other side, that the French army was more exposed to the epidemic influence of the air, the water, and the general powers of nature, than any other assemblage of men, and, that this influence was probably more powerful in the year 1529, than at any other time during the sixteenth century. The formation of fog in the heat of summer is at all times an extraordinary phenomenon[165], which decidedly indicates a disproportion in the mutual action of the components and powers of the lower strata of the atmosphere. This was not dependent merely on the local peculiarities of Naples, for during the summer of 1528, grey fogs were observed throughout Italy, which rendered the unwholesome quality of the air visible to the eye[166]. This was increased by the prevalence of southerly winds, which are always, in Italy, prejudicial to health, as also by the thousand privations of a camp, so that a disease which was already prevalent all over Italy,—we allude to the petechial fever,—might well break out on the damp soil of Poggio reale. In the history of national diseases, we find a moral proof of the predominance of epidemic influence which plainly and intelligibly manifests itself under the greatest variety of circumstances. This is a belief, that the water, and even the air is poisoned[167]. Nor is this proof wanting in the deplorable history of the French army before Naples, for it was generally believed, that some Spaniards of Moorish descent, to whom was attributed an especial degree of skill in the management of poison, and some Jews from Germany, who, for the sake of gain, had followed the lansquenets to truckle for their booty, had stolen out of the city under cover of the night, in order to poison the water in the neighbourhood of the camp[168]. It was also surmised, that an Italian apothecary had administered to the French knights poison in their medicine[169]. We will not anticipate on this occasion the researches of naturalists, whose experiments on air and water, during important epidemics, have not yet led to any results; it is, however, not improbable that pond and spring water, under such circumstances as are here described to have occurred, might become impregnated with a noxious quality not inherent in it, which would very naturally give rise to the belief that a poison had been thrown into it. On the whole, this accusation may certainly be judged according to the same views which have been stated in our treatise on the Black Death.

From all these circumstances, the notion is highly probable that it was the petechial fever which raged in the French camp; and if we may attach any importance to the incidental accounts of historians, it may perhaps be to the purpose to state that Prudencio de Sandoval, who has written from authentic materials, calls the disease “las bubas.”[170] This name, it is true, presupposes a rather strange confusion of petechial fever with lues; and, indeed, the diseases among the French troops from 1495 to 1528, have been oddly jumbled together by Sandoval. It shews, however, that there still existed a recollection of the prevalent eruptions which occurred in the pestilence of 1528; and, therefore, this whole account might perhaps be the more justly applied to petechial fever, as this same historian states, that the French called the disease after the village of Poggio reale “les Poches,”[171] by which name the well known bubo plague would hardly have been designated. If, however, we choose to suppose that at one and the same time different diseases prevailed in the French army, this notion is not only supported by the express testimony of a contemporary[172], but also by many observations ancient and modern[173], that have been made in cases where the circumstances have been similar to those which then prevailed. It is ever to be regretted that there was no intelligent Machaon to be found in the camp before Naples; such a one would undoubtedly have left us some pithy observations on the combination and affinity of petechial fever and bubo plague.

Sect. 2.—Trousse-Galant in France.—1528, and the following years.

Deeply as the irreparable loss of such an army was felt by the French, yet were they destined to suffer still greater misfortunes at home. The dark power which threatened all Europe regarded neither distance nor limits. It seized on the French nation in their own country whilst their military youth were destroyed before Naples. The cold spring and wet summer of 1528 destroyed the growing corn[174], and a famine was thus produced throughout France, even more grievous, on account of its duration, than the period of scarcity in the time of Louis the XIth[175], for the failure of the harvest continued for five years in succession, during which all order of the seasons seemed to have ceased. A damp summer heat prevailed in autumn and winter, a frost of a single day only occasionally intervening. The summer, on the other hand, was cloudy, damp, and ungenial. The length of the days alone distinguished one month from another. It appears plainly from detached accounts how much the usual course of vegetation was disturbed. Scarcely had the fruit trees shed their leaves in the autumn when they began to bud again, and to bear fruitless blossoms. No returns rewarded the toil of the husbandman, and the longed-for harvest again and again deceived the hopes of the people. Thus, even during the first of these calamitous years, the distress became general, and the increasing indigence was no longer to be checked by human aid. Bands of beggars wandered over the country in lamentable procession. The bonds of civil order became more and more relaxed, and people soon had to fear not only robbery and plunder on the part of these unfortunate beings, but the contagion of a pestilence, the offspring of their distress, which followed in their train.

This disease was a new production of the French soil, and when it spread generally throughout the country, was the more sensibly felt, as it especially carried off young and robust men; on which account it was designated by the very significant name of Trousse-Galant[176]. It consisted of a highly inflammatory fever, which destroyed its victims in a very short time, even within the space of a few hours; or, if they escaped with their lives, deprived them of their hair and nails, and from a long-continued disinclination for all animal food, left behind it, as sequelæ, a protracted debility and diseases which endangered the recovery of the sick, whose constitutions were already so much shaken. Hence it appears that this fever was combined with a great decomposition of the fluids, and a very morbid condition of the functions of the bowels, not to mention the effects produced by continued hunger, which contemporaries paint in the most dreadful colours.

The stock of provisions was already so far consumed in the first year that people made bread of acorns, and sought with avidity all kinds of harmless roots, merely to appease hunger. These miserable sufferers wandered about, houseless and more like corpses than living beings, and finally, failing even to excite commiseration, perished on dunghills or in out-houses. The larger towns shut their gates against them, and the various charitable institutions proved, of necessity, insufficient to afford relief in this frightful extremity! It was the lot of very few to obtain the tender care and attendance of the Sisters of Charity. In most of those affected their livid swollen countenances, and the dropsical swelling of their limbs, betrayed the sickly condition in which they dragged on their languishing existence. Every one fled from these pestiferous spectres, for they were saturated with the poison of this deadly disease, and the remark was no doubt made a thousand times over, that this poison might be conveyed to persons in health without affecting the carrier, since want and ill health occasionally afford a miserable protection against disease of this kind[177].