Dr. Blanton, the authority on seventeenth-century Virginia medicine, in contrast argues that "there is not evidence ... that malaria was responsible for a preponderating part of the great mortalities of the Seventeenth Century in Virginia." He bases this conclusion on a number of facts: he has been able to find only five or six references to the ague (malaria) in the records of the century; because the ague was well-known he does not believe its symptoms, such as the racking chill, would have escaped notice. On the other hand, he does not doubt the presence of the ague in Virginia throughout the century even though it did not cause the most distress.
As in the case of the ague, a reasonable assumption would be that the plague existed in seventeenth-century Virginia. The Great Plague of London (1665) carried away 69,000 persons, and other cities of Europe had even more disastrous epidemics. During the two years before the first settlers arrived at Jamestown, over 2000 victims were buried in London. The accounts of the ocean voyage indicate rat-infested ships. Ships of the London Company reported plague and death aboard. Virginians took pains to describe their illnesses, and there would have been little difficulty in recognizing this well-known killer. Yet little evidence of the presence of the plague appears in the seventeenth-century Virginia record; cases are reported but the number is small. Why Virginia should have been spared—especially in view of the known rat-infestation aboard ship—remains a question.
The evidence relative to yellow fever, or calenture, during this period in Virginia is contradictory. Early sources do make reference to numerous deaths from it at sea and even to an epidemic of it at Jamestown before 1610, but subsequent notices are infrequent and of questionable validity. Prevalence of the disease in the earlier years and its comparative infrequency in later is not a likely circumstance because with the increase of commerce, especially from tropical ports, an increase of the disease should have followed.
Smallpox, the mark of which is seen in early portraits, emerges from the colonial record with a more reasonable history. Its incidence in Virginia during the first half of the seventeenth century was small, and this might be expected in view of the fact that there were few children in the colony and that most of the adults had been infected before they left the Old World. The number of smallpox epidemics in Virginia did increase—again, as might be expected—later in the century as the number of children and of native-born unimmunized adults multiplied.
Smallpox caused such a scare in 1696 that the assembly, in session at Jamestown, asked for a recess—another example of the influence of disease upon political history. Earlier, in 1667, a sailor with smallpox, if the contemporary account can be accepted, landed at Accomack and was solely responsible for the outbreak of a terrible epidemic on the Eastern Shore of Virginia. A measles epidemic during the last decade of the century may actually have been smallpox as the two diseases were often confused by contemporaries.
Respiratory disorders, as has been noted, caused much distress for great numbers of early Virginians during the winter months. Influenza, pneumonia, and pleurisy must have reached epidemic proportions on numerous occasions in Virginia as elsewhere in America (influenza epidemics are recorded for New England in 1647 and in 1697-99). One note from a Virginia source for the year 1688 describes "a fast for the great mortality (the first time the winter distemper was soe very fatal... the people dyed, 1688, as in a plague... bleeding the remedy, Ld Howard had 80 ounces taken from him...)." (If "Ld Howard" gave eighty ounces, it means that he lost five pints of blood from a body that contained approximately ten—perhaps the "letting" was over an extended period.)
In a century in which numerous diseases had not been identified, many, known today, must have occurred that were diagnosed in general terms. Appendicitis, unrecognized until later, must have been common, and heart disease probably went undiagnosed. Distemper, a general term, often was used when the physician could not be more specific ("curing Eliza Mayberry and her daughter of the distemper").
Other prevalent disorders were over-eating ("hee died of a surfeit"); epilepsy ("desperately afflicted with the falling sicknesse soe that he requires continuall attendance"); and the winter cold ("our little boy & Molly have been both sicke with fever & colds, but are I thanke God now somewhat better").
The continued presence of deadly disease throughout the century shows itself in the population figures for the period. Over 100,000 persons migrated to Virginia before 1700 and numerous children were born, but only 75,000 people lived in Virginia in 1700. Many returned to Europe, many emigrated to other parts of America, and Indians accounted for some deaths, but the chief reason for the decline in population was the high mortality prevailing throughout the century.
Health conditions, however, did not deteriorate as the century passed. By 1671 Governor Berkeley could report generally improved health conditions; for example, newcomers rarely failed to survive the first few months, or seasoning period, which had formerly exacted such an awful toll. How much these improved conditions were due to better provisioned ships, to a better diet in Virginia, and to the movement of the settlers out from Jamestown is open to question, but in any consideration of the explanations for the promotion of health, prevention of illness, the restoration of health, and the rehabilitation of the sick, the seventeenth-century Virginia physician or surgeon must be considered.