Towards the end of the tenth century a new epidemic appeared in Europe,
the ravages of which spread terror among the people of the Occident;
this disease was known by the name of _mal des ardents_, sacred fire,
St. Anthony’s fire, St. Marcell’s fire, and hell fire.
This great epidemic of the Middle Ages is considered by many modern
writers as one of the forms of ergotism, notwithstanding the contrary
conclusions arrived at by the Commission of 1776, composed of such men
as Jussieu, Paulet, Saillant, and Teissier, who were ordered to report
as to the nature of the disease by the Royal Society. According to the
work of this Commission the _mal des ardents_ was a variety of plague,
with buboes, carbuncles and petechial spots, while St. Anthony’s fire
was only gangrenous ergotism. This is a remarkable example of the
confusion into which scientific facts were allowed to fall through the
fault of careless authors. It is in such instances that we may estimate
the importance of history. We find in the “Chronicles of Frodoard,” in
the year 945, the following: “The year 945, in the history of Paris
and its numerous suburban villages, a disease called _ignis plaga_
attacked the limbs of many persons, and consumed them entirely, so
that death soon finished their sufferings. Some few survived, thanks be
to the intercession of the Saints; and even a considerable number were
cured in the Church of Notre Dame de Paris. Some of these, believing
themselves out of danger, left the church; but the fires of the plague
were soon relighted, and they were only saved by returning to Notre
Dame.”
Sauvel, the translator of Frodoard, remarks that at this epoch the
Church of Notre Dame served as a hospital for the sick attacked by the
epidemic, and sometimes contained as high as six hundred patients.
Another historian of the time was Raoul Glaber,[15] who mentions
that “in 993 a murderous malady prevailed among men. This was a sort
of hidden fire, _ignis occultus_, the which attacked the limbs and
detached them from the trunk after having consumed the members. Among
some the devouring effect of this fire took place in a single night.
“In 1039,” continues our author, “divine vengeance again descended on
the human race with fearful effect and destroyed many inhabitants of
the world, striking alike the rich and the poor, the aristocrat and the
peasant. Many persons lost their limbs and dragged themselves around as
an example to those who came after them.”
In the _Chronicle of France_, from the commencement of the Monarchy up
to 1029,[16] the monk Adhemar speaks of the epidemic in the following
terms: “In these times a pestilential fire (_pestilential ignis_)
attacked the population of Limousin; an infinite number of persons of
both sexes were consumed by an invisible fire.”
Michael Felibien, a Benedictine friar of Saint Maur, also left notes
on the epidemic of gangrene. He states in his _History of Paris_: “In
the same year, 1129, Paris, as the rest of France, was afflicted by the
_maladie des ardents_. This disease, although known from the mortality
it caused in the years 945 and 1041, was all the more terrible inasmuch
as it appeared to have no remedy. The mass of blood, already corrupted
by internal heat which devoured the entire body, pushed its fluids
outwards into tumors, which degenerated into incurable ulcers and thus
killed off thousands of people.”
We could make many more citations, derived from ancient writers, but
we think we have quoted enough authors to prove that the _mal des
ardents_ was only the plague confounded with the symptoms known as
gangrenous ergotism. Could it not have been a plague of a gangrenous
type? We cannot positively affirm, however, that it had no connection
with poisoning by the _sphacelia_ developed in grain, particularly
on rye. Its onset was sudden, and often very rapidly followed by a
fatal termination. The _mal des ardents_ had no prodroma with general
symptoms and marked periods, as in gangrenous ergotism, but it had, to
the contrary, an irregular march, rapid in its evolution, “devouring,”
as Mezeray says, “the feet, the arms, the face, and private parts,
commencing most generally in the groin.”
THE ERUPTIVE FEVERS OF THE SIXTH CENTURY —— VARIOLA,
MEASLES, SCARLATINA.
Before the sixth century, the terrible period of the plague, one never
heard of the eruptive fevers. Small-pox, measles and scarlet fever
were unknown to the ancients. Neither Hippocrates nor Galen nor any
of the Greek physicians who practiced in Rome make mention of these
diseases. The historians and poets of Greece and Italy who have written
largely on medical subjects remain mute on these three great questions
in pathology. Some authors have endeavored to torture texts for the
purpose of throwing light on the contagious exanthemata, but they have
not been repaid for their fresh imagination.[17] It is admitted to-day
that the eruptive fevers are comparatively new diseases, which made
their appearance in the Middle Ages.
The first document that the history of medicine possesses on this
point is that left by Marius, Bishop of Aventicum, in Switzerland,
who says, in his chronicle, “_Anno 570, morbus validus cum profluvio
ventris et variola, Italiam Galliamque valde affecit_.”[18]
Ten years later, Gregory of Tours described the symptoms of the new
disease in the following terms:[19]
“The fifth year of the reign of Childebert, 580, the region of Auvergne
was inundated by a flood and numerous weather disasters, which were
followed by a terrible epidemic that invaded the whole of Gaul. Those
attacked had violent fevers, accompanied by vomiting, great pain in
the neighborhood of the kidneys, and a heaviness in the head and neck.
Matter rejected by the stomach looked yellowish and even green, many
deeming this to be some secret poison. The peasants called the pustules
corals.[20] Sometimes, after the application of cups to the shoulders
or limbs, blisters were raised, which, when broken, gave issue to
sanious matter, which oftentimes saved the patient. Drinks composed of
simples to combat the effects of the poison were also very efficacious.
“This disease, which commenced in the month of August, attacked all the
very young children and carried them off.
“In those days Chilperic was also seriously afflicted, and as the King
commenced to convalesce his youngest son was taken with the malady,
and when his extremity was perceived he was given baptism. Shortly
afterwards he was better, and his eldest brother, named Chlodobert, was
attacked in his turn. They placed the Prince in a litter and carried
him to Soissons, in the chapel of Saint Medard; there he was placed in
contact with the good Saint’s tomb, and made vows to him for recovery,
but, very weak and almost without breath, he rendered his soul to God
in the middle of night.
“In those days, Austrechilde, wife of King Gontran, also died of the
disease; while Nantin, Count of Angouleme, also succumbed to the same
malady, his body becoming so black that it appeared as though calcined
charcoal.”
Gregory of Tours, in another chapter, narrates:
“The year of the reign of King Childebert, 582, another epidemic broke
out; this was accompanied by blackish spots of a malignant nature, with
pustules and vesicles, and carried off many victims.
“Touraine was cruelly devastated by this disease. The patient attacked
by fever soon had the surface of his body covered by vesicles and
small pustules. The vesicles were white and very hard, presenting no
element of softness, and were accompanied by great pain; when they had
attained maturity they broke and allowed the humor within to escape.
Their sticking to the clothing of the body added considerably to the
pain. Medical art was wholly impotent in the presence of this malady,
at least when God did not come to the doctor’s aid.
“The wife of Count Eborin, who was attacked by the disease, was so
covered by vesicles that neither her hand nor the sole of her foot nor
any portion of her body was exempt; even her eyes remained closed.
Soon after the fever ceased the fall of the pustules occurred, and the
patient recovered without more inconvenience.”
Small-pox came, then, from the Orient—that eternal center of all
pestilences and curses. From the seventh century the Saracen armies
spread the malady wherever they passed—in Syria, Egypt, and Spain; in
their turn, the Crusaders, in returning from the Holy Land, brought
the disease into France, England, and Germany. From thence the great
epidemics of the twelfth and thirteenth centuries, after which
the small-pox became epidemic, appearing and disappearing without
causation, but always destroying myriads of victims. “In 1445,” says
Sauvel “from the month of August to Saint Andres’ day (November 30),
over 6,000 infants died in Paris from small-pox.[21] The physicians
knew neither the nature nor the treatment of the new disease.[22]
The measles was first noted at the same time as the small-pox, making
its first appearance as an epidemic in the sixth century.
It is more than probable that the measles originated in Egypt, and
according to Borsieri, it had such an extension throughout Western
Europe that there were but few persons who had not suffered attacks.
The history of measles, however, is less clearly defined than that of
small-pox, although Anglada says that it figured among the _spotted
diseases_, of which Gregory of Tours speaks.[23] But it was only in the
sixteenth century that Prosper Martian exactly describes the disease.
Says Martian, “It is a disease of a special type peculiar to children,
who can no more avoid it than small pox. It commences with a violent
fever, followed, towards the third day, by an eruption of small red
spots, which become elevated by degrees, making the skin feel rough to
the touch. The fever lasts until the fifth day, and when it has ceased
the papules commence to disappear.”
Measles was designated in the middle ages under the name _Morbilli_,
which signified a petty plague, the same that _Morbus_ meant a special
plague. It is then fair to presume that the type of disease was no more
serious than it is at the present day.
It is probable that the measles of the sixth century included at the
same time small-pox, measles and scarlet fever, of which the ancients
made no differential diagnosis. Anglada affirms the co-existence of all
forms of eruptive fevers and gives the following reasons:
“The contemporaneous appearance of variola and rubeola represents
the first manifestation of an epidemic constitution, resulting from
a collection of unknown influences as to their nature, but manifest
by their effects. The earth was from thence prepared to receive
scarlatina, and it soon came to bear its baleful fruits. We do meet
some mention of scarlet fever in the writings of the Arabian School,
but it is merely suspected and only vaguely indicated. But when we
remember how difficult it often is to diagnose at first between variola
and measles, we are not astonished at the indecision manifested in
adding another exanthematous affection to the medical incognito. It
was only after innumerable observations and the experience of several
centuries that the third new disease received its nosological baptism.
There is nothing to prove that it did not co-operate with earlier
epidemics of variola and rubeola, remaining undistinguished as to type,
however.”
What clearly proves that there was confusion between the various fevers
of exanthemata is that Ingrassias describes scarlatina in 1510, under
the name of _rosallia_, adding, “Some think the measles and _rosallia_
are the same malady; as for me, I have determined their differences on
many occasions. _Nonnulli sunt qui morbillos idem cum rossalia esse
existimant. Nos autem soepissime distinctos esse affectus, nostrismet
oculis, non aliorum duntaxat relationi confidentes inspeximus._”[24]
These facts appear conclusive enough to admit that measles and scarlet
fever are, like variola, the products of the epidemic constitution
developed during the sixth century, as contemporaries of the bubonic
plague, all these maladies representing the medical constitution of the
first centuries of the Middle Age.