The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

Inexplicable as the silence of the learned physicians of England, on the Sweating Sickness, appears at first view, (for where is the use of learning if it fail to throw any light on the stormy phenomena of life?) we may yet find, perhaps, its cause in a perfectly simple external circumstance. The reformation had not yet begun in England, the Catholic Church still stood on its ancient foundations, and an intellectual intercourse between the learned and the people was not by any means among the acknowledged desiderata. The faculty would hence have been able to treat of the new disorder only in ponderous Latin works, for they wrote unwillingly in their own language, and the subject could not seem to them an appropriate one for this purpose, because they found it unnoticed and uninvestigated by their highly revered masters the Greeks. They were ignorant that a sweating fever had ever appeared among the ancients, which, otherwise, might have incited them to make researches of their own on the subject; for Aurelian, who describes it to the life, was either unknown to them, or, what at that time was a valid ground, was despised by them, on account of his bad (unclassical) language.

In Germany, on the contrary, the intellectual wants of the people and of the educated classes had already manifested themselves very differently. Twelve years before, the age of pamphlets had there commenced. The thoughts of Luther and of his disciples, as also of his opposers were winged by the rapid press, and the people took an impassioned part in the endeavours of the learned to affect their conviction, and by this altogether novel and authoritative mode of religious instruction, became gradually educated and guided. Hence it is not to be wondered at that people began to investigate, in pamphlets, other important subjects likewise, and thus we see this weighty branch of intellectual commerce, with all its advantages and defects, also turned towards the discussion of popular diseases, and for the first time unfolding its numerous leaves on the subject of the English epidemic. In the maritime cities nothing of this kind happened, because the eruption of the pestilence took them by surprise, and as it was over again in the course of a few weeks, it seemed no longer worth while to instruct the people respecting it.

This surprise was very plainly shewn in the answer of the doctors and licentiates who were assembled together at the bedside of the Duchess, at Stettin: “the disease was new and unknown to them: they were at a loss what to advise, excepting strengthening medicines.”[303] In the central parts of Germany, on the contrary, where, as early as the month of August, the report of the new plague had excited the utmost alarm, and where an eruption of the pestilence in Zwickau had caused a general flight, publications on the Sweating Sickness were even within that month, and still more numerously in September, disseminated in all directions. As scientific productions, they are almost all of them worthless. Many of them, indeed, did harm, and but very few promulgated correct views. Most of them are now lost, as, for example, that which was published by the printer Frantz, at Zwickau, on the 3rd of September: but in what vast numbers they were published appears from the circumstance that Dr. Bayer, at Leipzig, who brought out his own on the 4th of September, states that he has read many of them, and expresses his indignation against these “new unfounded little books,” by which the people were misled to their own sorrow and suffering[304]. This same Dr. Bayer writes in the style of an intelligent practical physician, inveighs boldly against the prejudices of mankind, and the ignorance of medical journeymen, and against their senseless bleedings whenever they see the barber’s basin and his pole. Some of his advice too is not bad, especially where he is speaking of the Arabian use of harmless syrups. He, however, religiously preserves all the rubbish of his age, and has a great opinion of preventive bleedings, purgatives, and powerful medicines, of which he prescribes so many that his reader is necessarily confused by their multiplicity. His precepts respecting the sweat are very appropriate, for he gives a caution against forcing perspiration, prescribes according to the circumstances, and even commences the treatment with an emetic, if the state of the stomach seems to indicate its employment. In order to guard against contagion, he recommends, at the approaching autumnal fair, that foreigners from “dying lands” should be accommodated in distinct inns, that fumigation should be carefully employed, and that before each booth at the fair a fire should be kept up.

Another pamphlet by Caspar Kegeler, of Leipzig, is a melancholy monument of the credulity which, from Herophilus to the present day, has pervaded the whole medical art. It is a regular pharmacopœia for the Sweating Sickness, thrown together at a venture, without any insight into the nature of the disease. A mine of wonderful pills and electuaries composed of numberless ingredients wherewith this “mysterious worthy” undertakes to raise a commotion in the bodies of his patients. If he had but seen even a single case of the disease he would at least have known how impossible it would be to administer, within the space of four-and-twenty hours, the hundredth part of his pills and draughts. With what approbation this little pharmacopœia was received by physicians of equal penetration and understanding as himself, is shewn by the eight editions which it passed through[305], and the melancholy reflection is therefore forced upon us, that possibly thousands of sick persons were maltreated and sacrificed from the employment of Kegeler’s medicines.

A third physician at Leipzig, Dr. John Hellwetter, states in his pamphlet, that he has become acquainted with the Sweating Fever in foreign countries, and on the subject of perspiration gives some very good advice, evidently the result of his own experience, which reminds us of the original English mode of treatment. His notion that fish is injurious seems to have originated in the fact that the continued employment of fish as an article of diet gives rise to offensive perspirations, and his admonition to his medical brethren not to flee from the sick, but to visit them sedulously and give them consolation, furnishes ground for supposing that some of them had been pusillanimous and dishonourable enough to withdraw themselves or to refuse their assistance to the poor.

Almost all the medical men of those times were in possession of arcana which they employed either in all or at least in most diseases, in a very unprofessional manner, and the efficacy of which the sweet delusions of self-interest did not permit them to call in question. The severe metallic remedies of the Spagyric school, which was then in its infancy, were not yet introduced, but there were not wanting strong heating medicines from the ancient stores of the empyrics, which almost universally obtained the preference over the mild potions and syrups of the Arabians. Hellwetter sold a powder of unknown composition, and a number of distilled waters, which Dr. Magnus Hundt, of Leipzig, notices with much approbation. The pamphlet of this physician is in every respect of the most ordinary kind; it affords no proof that the author had any sound comprehension of the disease, and belongs to that class of low medical compositions which, in times of danger, is so easily derided by the public, and so much diminishes the estimation of the profession, to the material injury of the general welfare.

It must not, however, be supposed that the people, who in such times of commotion often confound together the good and the bad, listened everywhere so readily to these pamphleteers. The composition of one Dr. Klump, at Ueberlingen, who, on the breaking out of the disease, attacked his patients with theriac and all kinds of heating plague powders, excited great derision[306], and it cannot be denied that the people had on their side, at least occasionally, the advantage of sound sense, as opposed to the endless prescriptions of the physicians, and it is gratifying to observe how this sound sense, which doubtless was guided by respectable medical men, operated in a great many towns to the advantage of those affected.

This is proved by a pamphlet, written in popular language, by a physician in Wittenberg[307], which contains such correct medical views, that our highest approbation is, even now, justly due to its unknown author, as shewing, throughout, great judgment and a very competent knowledge of the Sweating Fever. His whole treatment is mild and cautious; he forbids the use of feather beds, but strongly inculcates the necessity of avoiding every kind of chill, and therefore recommends a practice in use at that time, called, “the sewing of the sick,” that is to say, fastening the edge of the bed clothes to the bed with a needle and thread. He orders his patients a moderate quantity of warm but not heating beverage[308], refreshes them with syrup of roses, and impresses upon his readers that the majority of those affected will recover without medicine. In order to guard against the stupor which was so exceedingly fatal, in addition to continual conversation, refreshing odours of rose water and aromatic vinegar were held before the patient’s nose, in a moderately damp cloth, or their temples were cautiously bathed with them. Convalescents were watched with great care, and it is not the least excellence of this very sterling pamphlet that it likewise combated the timidity of the sick with the inculcation of mild, but manly, religious principles, such as corresponded with the spirit of that age. The rules here laid down are, in essentials, the original English precepts which had already broken the force of the epidemic Sweating Sickness in the year 1485, and the author does not conceal his having in this matter received information from Hamburgh, so far back as the 7th of August. That by this mode of treatment not only individual patients[309] were saved, but also that whole cities were protected against any very great mortality, we are willing with the author to believe, and on this account we cannot but lament the more, that the medical science of the rigid schools of those days so completely mistook its office as the guardian of life, and that it caused greater sacrifices by its hazardous remedies than the pestilence would otherwise have occasioned.

How soon the English treatment met with the recognition which it deserved may be gathered from a Latin composition nearly of the same tenour as the above, and which appears to be an extract from some German pamphlets[310]. Besides aromatic odoriferous waters, the very harmless and only remedies therein recommended are pearls and corals given internally by tablespoonfuls in warm rose water. As a prophylactic, treacle, which was in very common use, was recommended to be taken in the juice of roasted onions, but only in very small doses. Similar just views with respect to the excitement of perspiration were also subscribed to by other physicians[311], and finally the great council at Berne, on the 18th of December, published an exhortation to patience and unshaken courage, in which the use of feather beds, and of all medicines, except cinnamon water, was earnestly deprecated[312] during the disease. The court of Holland also recommended a method of cure[313] apparently English, these two documents being the only traces, on the part of any governments, of a paternal solicitude for their subjects.

The learned and accomplished Euricius Cordus[314], of Marburg, had, when he wrote[315], no information respecting the successful English mode of treatment, and, with all his celebrity, only followed in the ranks of ordinary advisers. He could not free himself from the medical precepts which he brought from Italy and gave to the only patient at Marburg, who was the subject of the Sweating Sickness, the very disagreeable, though much employed potion of “Benedetto.”[316] His prophylactic ordinances were very burthensome, though with respect to the frequent employment of purgatives, which at that time almost all physicians recommended, it must be taken into account, that the intemperance so prevalent in those days, rendered them in general more necessary, perhaps, than they are at the present time. Bishop Ditmar of Merseburg, has betrayed to posterity, that this celebrated man had a great dread of the new disorder, and did not conceal his anxiety[317].