The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

There is still extant a very complicated prescription of Achilles Gasser[318], the learned physician of Augsburg, which he employed with childish confidence[319] during the prevalence of the sweating pestilence. We might class this with a thousand others of a similar character, were it not evident how little medical art, at that time in its ancient Greek garb, was suited to the exigency of the age, being dull, inefficient, and long since robbed of its original spirit; for thus alone was it taught in the universities.

In the copious epistle of Simon Riquinus to the Count of Newenar at Cologne[320], traces of better principles are indeed observable, which were soon disseminated from Hamburgh all over Germany, yet the prophylactic measures recommended are not much better than those in use in the time of the Emperor Antoninus, when the Theriaca of Andromachus was among the necessaries at the Roman court. Riquinus incidentally tells a story of a peasant in the neighbourhood of Cleve, who, having become affected by the English Sweating Sickness, crept as quickly as he could into a baker’s oven that was still hot, and after some time, again made his appearance in an exhausted state[321]. This very circumstance proves that the man laboured under only an imaginary and not a real sweating fever, but the belief that the bread which was afterwards baked in this oven was infected with the poison, can only be attributed to the credulity of the learned physician.

The Count of Newenar[322] expresses himself on the subject of the sweating fever, like a person well informed, and not unacquainted with medical subjects, and endeavours to prove the critical nature of the sweat by the frequent practice of the empyrics, to throw persons afflicted with the plague, at the very beginning of the attack, into a profuse perspiration[323]. He takes the opportunity to relate of an unprincipled physician, that he freed himself in this manner from the plague, in a public bath, while those who came after him became every one of them affected with the disease and died. According to his account, the English Sweating Sickness was by no means fatal in and about Cologne[324], yet we find it with all its original malignity on the banks of the Scheldt, and in the maritime towns of the Netherlands.

This plainly appears from the pamphlet of a physician in great practice at Ghent, Tertius Damianus, from Vissenaecken, near Tirlemont[325], whose own wife fell sick of the sweating fever, and fortunately was again restored[326]. The cases whereof Damianus gives an account, are among the most marked of which any mention is made, and it also seems, that the disease, contrary to the opinion of many, arose from fear alone, and manifested in the Netherlands a much greater power of contagion than in Germany, to which the hot treatment may have contributed[327]. The manner in which Damianus restrained his patients from indulging in their propensity to sleep, is worthy of notice. When the usual means failed, he directed that their hair should be torn out, that their limbs should be tied together in painful positions, and that vinegar should be dropped into their eyes[328]: the danger justified these means, but violence does not easily attain its end. For the rest, the views of this physician do not differ from those commonly entertained, and if he complains[329] of the great extortions of the apothecaries, this was a natural effect of the customary prescriptions, whereof he himself recommends many that are very objectionable.

Whatever the science of medicine of the sixteenth century could oppose to so fearful an enemy, is set forth in the very excellent treatise of Joachim Schiller[330] of Freiburg, which, however, did not appear until two years later, and unfortunately does not give the wished-for information on the development of the pestilence in the Briesgau. Schiller is moderate in his views, and shews throughout, that he is a very well informed physician, and well versed in Greek literature: and although he cannot steer clear of the rubbish of clumsy remedies, yet the fault should not be charged on him, but on the age in which he lived. This, like every other, had its evils, and enveloped in clouds and darkness the genius of medicine, which, free, great, and elevated above human short-sightedness, is respected only by the intellectual servants of nature.

Sect. 12.—Form of the Disease.

The notions of contemporary writers respecting the phenomena and the course of the sweating epidemic are, it is true, individually unsatisfactory and defective[331]; yet collectively, we may gather from them a lively and complete picture of its effect on the human frame; especially from the German observers, who reported truly and honestly their own, as well as the general experience of their age; for the English had up to that period described little more than the external appearances of this epidemic, which had already attacked them for the fourth time.

It is ascertained that the Sweating Fever was in general very inflammatory; and, leaving out of the account its sequel, came to a crisis at most in four and twenty hours; yet, within this narrow limit as to time, very various symptoms occurred[332], so that by a more exact observation than could be expected from the physicians of those days, several gradations of its development and violence might have been distinguished from each other. Thus one form of this disease appeared that was wanting in precisely that symptom which was the most essential, namely, the colliquative sweating[333], (as in the most dangerous form of cholera, neither vomiting nor purging takes place,) and which, by its overpowering attack, either destroyed life within a few hours, or perhaps took some other turn of a nature unknown to us.

Premonitory symptoms were wanting altogether, unless we may reckon as such, first, an anguish, combined with palpitation of the heart, which may not have been of corporeal origin, but may have proceeded from the general alarm; or secondly, an irresistible sinking of the powers resembling a swoon, which, perhaps, preceded the disorder, in the same manner as it had preceded the general eruption of the plague in northern Germany[334]: or thirdly, rheumatic pains of various kinds, which were frequently felt in the summer of 1529[335]; or finally, a disagreeable taste in the mouth and foul breath, which were very commonly the subject of complaint at that time[336].

In most instances the disease set in like the generality of fevers, with a short shivering fit[337] and trembling, which in very malignant cases even passed into convulsions of the extremities[338]; in many it began with a moderate and constantly increasing heat[339] either without any evident occasion, even in the midst of sleep, so that the patients on waking lay in a state of perspiration, or from a state of intoxication, and during hard work[340], especially in the morning at sunrise[341]. Many patients experienced at the commencement a disagreeable creeping sensation or formication on their hands and feet[342], which passed into pricking pains, and an exceedingly painful sensation under the nails. At times likewise it was combined with rheumatic cramps, and with such a weariness in the upper part of the body, that the sufferers were totally incapable of raising their arms[343]. Some were seen during these attacks, especially women and those who were weak, with their hands and feet swollen[344].