The Epidemics of the Middle Ages

by J. F. C. Hecker; John Caius

How great the decomposition of the organic matter was is convincingly proved from all the testimony hitherto adduced, but it might have been inferred from the very rapid putrefaction of the body, which rendered it necessary everywhere to use the greatest despatch in the performance of burials[372]; and fortunately did away with all fear of being buried alive. Of post mortem examinations we have no information, and even if they could have been instituted, they would, from the manner of conducting researches in those times, scarcely have thrown any important light on the disease. Hardly any physicians but those who had studied in Italy knew the inward structure of the body from their own observation, superficial as it was; the rest learned it only from Galenic manuals; how could they with such slender knowledge have distinguished between healthy and diseased parts? Moreover, the Sweating Sickness could not in so short a period cause such a palpable and substantial destruction of the viscera as they would alone have sought for. Details respecting the condition of the blood in the dead body, which after such an enormous loss of watery fluid, such severe oppression at the chest, and so great an impediment to the function of respiration, would in all probability be thickened and darkened in colour, as well as respecting the condition of the lungs and of the heart, it would be highly desirable to obtain; but these likewise are wanting altogether, and after the lapse of so long a period there only remains room for conjectures.

The observation was repeated in Germany which had been so frequently made since the year 1485, that the middle period of life was especially exposed to the Sweating Fever. Children, on the contrary, remained almost entirely exempt from this disease, and when the aged were affected by it, it was as individual exceptions to a general rule[373], and this as it would appear, only during the height of the epidemic; as for example at Zwickau, where a woman of 112 years of age was carried off by it[374]. We have already in part discovered the cause of this perfectly constant phenomenon in the luxurious mode of living of robust young men, and if we look back to the moral condition of the Germans in the 16th century, we find among them the same immoderate luxury as among the English, the same drunkenness, the same intemperance at their frequent banquets, where the wine-cups and beer-jugs were emptied with but too eager draughts; finally, also, the same relaxation of skin consequent upon the use of warm baths and warm clothing. All contemporary writers mention these circumstances[375], and our bold forefathers, with respect to these matters, were not in the best repute with their southern neighbours.

But we have, moreover, to survey the disease in another point of view, namely, in relation to its peculiar character. In the outset we designated the Sweating Sickness as a rheumatic fever, and if we take the notion of a rheumatic affection, as in propriety we ought, in its widest acceptation, weighty and convincing grounds have been adduced in the course of our whole inquiry in confirmation of this view. When we observe that those very nations were visited by the Sweating Fever, which are characterized by a fair skin, blue eyes, and light hair—the marks of the German race, it may with justice be assumed, that even this peculiarity in the structure of the body rendered it susceptible of this extraordinary disease. It is this which causes the proneness to fluxes of all kinds, and which makes these diseases endemic in the north of Europe, whilst the dark-haired southern nations and the blacks in the tropical climates remain, under similar circumstances[376], more free from them. If it be remembered further how overcharged with water were the lower strata of the atmosphere in which the pestilent Sweating Fevers existed, what thick and even offensive mists prepared the way for the disease and indicated its approach, what rapid alternations of freezing cold and excessive heat took place in the summer of 1529; and, moreover, how frequent all kinds of fluxes were in this very year, the complete form of the rheumatic constitution will be recognised in every individual feature.

Did we possess in the showy systems of modern times a maturer knowledge of the electricity of living bodies, much light would of necessity hence be thrown on the great object of our research. We should not then be compelled to rest satisfied with the fact that a cloudy atmosphere abstracts electricity from the body, robs the skin and lungs of their electrical atmosphere, disturbs their mutual electrical relation with the external world, and by this disturbance prepares the body for rheumatic indisposition, with all that peculiar decomposition of the fluids, irritable tension of the nerves, fever, and painful affection of particular parts, with which it is accompanied. If this disturbance be represented according to certain new and inviting hypotheses, supported by some important facts[377], as being perhaps an accumulation of electricity in the interior of the body, owing to a morbid, isolating activity of the skin, we may expect a more perfect knowledge of the nature of rheumatism through the medium of future diligent researches; and until these be made, some evident signs of connexion between rheumatic affections and the English Sweating Sickness will perhaps be sufficient to demonstrate the rheumatic nature of this latter disease.

In the first place, the very great susceptibility of those affected with the Sweating Fever to every change of temperature—the decidedly great danger of chill. In no known disease does this irritability of the skin shew itself in so prominent a degree as in rheumatic fevers and in those non-febrile fluxes in which there even exists a very evident sensitiveness to metallic action.

Secondly, The tendency of the rheumatic diathesis to come to a crisis through the medium of a profuse, sour and offensive perspiration without any assistance from art[378]. The English Sweating Sickness manifests this commotion of the organism in the most exquisite form hitherto known; for it admits of no kind of doubt that the sweat in this disease was of itself, and in itself, critical, in the fullest acceptation of the term.

Thirdly, The peculiar alteration in the fundamental composition of organic matter in rheumatic diseases, in consequence of which volatile acids of a strange odour are prevalent in the sweat, and urine, and animal excretions. The English Sweating Sickness exhibits also this result of morbid activity in a greater and more striking manner than any other disease. Nor can we regard the tendency to putridity, which has been observed, as any thing but an increased degree of this condition.

Fourthly, The shooting pains in the limbs, the most decided sign of rheumatism, were not wanting in the English Sweating Sickness; nay, they became developed even to the extent of an incipient paralysis, and even the convulsions of those affected with this disease may not unjustly be attributed to the same source.

Fifthly, The tendency of rheumatism when it takes an unfavourable course to pass into regular dropsy, which is a consequence of the peculiar decomposition, manifested itself in the Sweating Fever in so marked a manner that the dropsy itself gradually destroyed the patient.

Should the sceptical still need another link in the comparison, we may adduce the miliary fever, a disease of decidedly rheumatic character. We must not, however, take as our standard the degenerate forms of miliary fever existing in modern times, but those grand and fully developed forms of the disease which occurred in the 17th and 18th centuries, and in which we find a similar odour in the perspiration, the same oppression, and the same inexpressible anguish, with palpitation and restlessness. The arms became enfeebled as if seized with paralysis, violent pains of the limbs set in, and unpleasant pricking sensations in the fingers and toes, resembling in all these particulars the Sweating Sickness, only pursuing a more lengthened and irregular course, and becoming developed altogether in a different manner.