SWEATING SICKNESSES.
Ἔστι γὰρ τὸ πάθος λύσις τῶν δεσμῶν τῆς εἰς ζωὴν δυνάμιος.
ARETÆUS.
SECT. 1.—THE CARDIAC DISEASE OF THE ANCIENTS.
(MORBUS CARDIACUS.)
Thus by the autumn of 1551, the Sweating Sickness had vanished from
the earth: it has never since appeared as it did then and at earlier
periods; and it is not to be supposed, that it will ever again
break forth as a great epidemic in the same form, and limited to a
four-and-twenty hours’ course; for it is manifest, that the mode of
living of the people had a great share in its origin; and this will
never again be the same as in those days. Yet nature is not wanting
in similar phenomena, which have appeared in ancient and modern
times; and if we take into the account the great frequency of cognate
rheumatic maladies, it is possible that isolated cases may have
sometimes occurred, in which repletion of impure fluids, and violently
inflammatory treatment have augmented a rheumatic fever, even to the
destruction of nervous vitality, by means of profuse perspiration—only,
perhaps, that they ran a longer course, (which does not constitute
an essential difference,) and under totally different names, whereby
attention is misled. Of all the diseases that have ever appeared
which can in any way be compared to the English Sweating Sickness, we
have principally three to look back upon—the _cardiac disease_ of the
ancients, the _Picardy sweat_, and the _sweating fever of Rötingen_.
The first was, for reasons which have been already mentioned[812],
almost unknown to the learned of the sixteenth century; and it is
matter of surprise, that Kaye himself, who had chosen for his favourite
the best Roman physician, we mean Celsus, could have so entirely
overlooked his by no means unimportant statements respecting this
disease. _Houlier_ is the only author who ventures a comparison of the
English Sweating Sickness with the ancient cardiac disease; his few,
and almost lost words[813], remained however unheeded; nor are the
differences between the two diseases small: but to return.
The disease of which we are speaking appeared for a period of 500
years, (from 300 B.C. to 200 after Christ,) and was a common, almost
every day occurrence, which is often mentioned even by non-medical
writers. It was exceedingly dangerous, and even esteemed fatal; and
as it was far above the reach of Greek physiology, there were not
wanting extraordinary opinions respecting its nature, and bold and
singular modes of treatment, to which those who were attacked were
subjected. The name _Cardiac disease_ (morbus cardiacus, νόσος καρδιακὴ
and probably also νόσος καρδίτις,) was not bestowed by medical men,
but by the people; who, in the fourth century before Christ, for the
name is as ancient as that period, could not know that the learned
would dispute on that subject. Some affirmed, and among them men of
great authority, such as _Erasistratus_, _Asclepiades_, and _Aretæus_,
that the people were in the right so to call the disease; that the
heart was actually the part affected, and that their knowledge of the
heart’s functions was by no means small[814]. Others, on the contrary,
would only acknowledge in that name an expression indicative, not
of the particular seat of the disease, but only of its importance,
inasmuch as the heart is well adapted, as the centre and source of
life, to indicate this[815]. Others again, who attempted more refined
conjectures, wished to represent the pericardium as the seat of the
malady, because darting pains were sometimes felt[816] in the region
of the heart, or the diaphragm, or the lungs, or even the liver. The
opinions were numerous; the actual knowledge was small[817].
The cardiac disease began with rigors and a numbness in the
limbs[818], and sometimes even throughout the whole body. The
pulse then took on the worst condition, was small, weak, frequent,
empty, and as if dissolving; in a more advanced stage, unequal and
fluttering, until it became completely extinct. Patients were affected
with hallucinations[819]; they were sleepless, despaired of their
recovery, and were usually covered suddenly with an ill-savoured
perspiration over the whole body, whence the disorder was likewise
called _Diaphoresis_. Sometimes, however, a washy sweat broke out,
first on the face and neck. This then spread itself over the whole
body; assumed a very disagreeable odour, became clammy and like water
in which flesh had been macerated, and ran through the bed-clothes in
streams, so that the patient seemed to be melting away[820]. The breath
was short and panting almost to annihilation (insustentabilis). Those
affected were in continual fear of suffocation[821]; tossed to and fro
in the greatest anguish, and with _a very thin and trembling voice_
uttered forth only broken words. They constantly felt an insufferable
oppression in the _left side_, or even over the whole chest[822]; and
in the paroxysms which were ushered in with _a fainting fit_, or were
followed by one, _the heart was tumultuous and palpitated_, without
any alteration in the smallness of the pulse[823]. The countenance was
_pale as death_, the eyes sunk in their sockets, and when the disease
took a fatal turn, all was darkness around them. _The hands and feet
turned blue_; and whilst the heart, notwithstanding the universal
coldness of the body, still beat violently, they for the most part
retained possession of their senses. A few only wandered a short
time before death, while others were even seized with convulsions
and endowed with the power of prophecy[824]. _Finally, the nails
became curved on their cold hands_, the skin was wrinkled, and thus
the sufferers resigned their spirit without any mitigation of their
miserable condition[825].
A striking resemblance is plainly perceived, from this description,
between the ancient cardiac disease and the English Sweating Sickness
in the most exquisite cases of each. In both the same palpitation of
the heart, the same alteration of the voice, the same anxiety, the
same impediment to respiration, and thence the same affection of the
nerves of the chest, the same ill-scented sweat, and, by means of
this sweat, the same fatal evacuation; in short, all the essential
symptoms arising from the same circle of functions. For in the sweating
pestilences of the ancients[826], as well as the moderns, the nerves of
the abdomen remained unaffected; the liver, intestines, and kidneys,
took no part in the primary affection; the diaphragm, as in the English
Sweating Sickness, formed the partition. Hence the acute _Aretæus_ did
not hesitate to call the cardiac disease _fainting_ (syncope), with
certainly an unusual extension of the notion implied by this term,
which in its common acceptation excludes the turbulent commotion of the
heart. In the affection of the brain some difference occurs, for though
the hallucination afforded an unfavourable prognostic in both diseases,
yet the fatal stupor was peculiar to the English Sweating Sickness, no
observer having made mention of it in the cardiac disease.
Greater and altogether essential differences between this affection
and the English Sweating Sickness appear in another respect. There
is every reason to suppose that the cardiac disease first appeared
in the time of _Alexander_ the Great, that is to say, at the end of
the fourth century before Christ; for the Hippocratic physicians
were unacquainted with it, _Erasistratus_, who was body physician
to Seleucus Nicator, and was a universally celebrated professor at
Alexandria under the first Ptolemy, being the first to mention it. If
that age be compared even superficially with that of Henry the VIIth
and Henry the VIIIth; and Africa, Asia Minor, and the South of Europe
with England, we shall easily be convinced that the two diseases,
notwithstanding the agreement in their main symptoms, could not be
the same; moreover, much was comprehended by the ancients under the
name of morbus cardiacus, which, on a nearer examination, proves not
to be one and the same definite form of morbid action: for sometimes
this affection is spoken of as an independent disease; sometimes it
is mentioned only as a symptom superadded to others—as a kind of
transition from other very various diseases, such as has occurred in
modern times. _Soranus_ mentions, as such diseases, continued fevers,
accompanied by much heat[827]; and reckons among them the “Causus,”
that is, an inflammatory bilious fever, to which _Aretæus_ also saw
the cardiac disease superadded. These fevers passed, on the fifth or
sixth day, into the cardiac disease, and such a transition occurred
chiefly on the critical days[828]. In a similar sense _Celsus_ speaks
even of _Phrenitis_, under which name we are here to understand all
inflammatory fevers accompanied by violent delirium, with the exception
of actual inflammation of the brain. Thus we see that the cardiac
disease arose and increased on a very different soil from other
diseases, and was, to furnish an ancient example, as far from being
independent under these circumstances as _lethargy_ was in similar
cases.
But there was doubtless an independent idiopathic form of the cardiac
disease. Whether this was febrile or not, the most celebrated
physicians of ancient times were not agreed. Now, how could they ever
have differed upon the subject, if the cardiac disease had always
appeared only as a sequela on the fifth or sixth day of inflammatory
fevers? _Apollophanes_, a disciple of Erasistratus, and physician to
_Antiochus the First_, considered it, with his master, as constantly
febrile, and his opinion prevailed for a long time: perhaps he was
in the right, for it is probable that in the first half of the third
century, the disorder was much more violent than at a subsequent
period. His celebrated contemporary, _Demetrius_ of Apamea, disciple
of Herophilus, affirmed, that he had recognised fever only in the
beginning of the disease, and that it disappeared in its further
progress. Very soon, most physicians decided that it was not febrile,
but _Asclepiades_ distinguished a febrile and a non-febrile form of
the cardiac disease, and it is certain that this physician was a very
accurate observer. _Themison_ and _Thessalus_ also agreed with him.
_Aretæus_ described, in a cursory manner, the febrile form only, and
perhaps was not acquainted with any other. _Soranus_ followed, in the
essential points, _Asclepiades_, the founder of his school; and later
writers generally regarded the inward heat, the hot breath, and the
burning thirst—symptoms which were occasionally less marked, as proofs
of the febrile nature of the disease. Numerous theoretical views,
belonging to particular schools, of which we do not here treat, were
intermingled with these, and upon the whole, that form seems to have
been esteemed as non-febrile, in which the signs of feverish excitement
appeared less marked. In all cases the cardiac disease set in with
external coldness, and with a small contracted quick pulse, symptoms
which with certainty indicate fever[829].
Respecting the course of the cardiac disease, we are not furnished with
sufficient information. It was no doubt very rapid, for the frame could
not long endure symptoms of so violent a kind, and the disorder must of
necessity soon have come to a crisis; yet from the ample directions for
treatment, we may conclude that it lasted at least some days. If the
perspiration was well surmounted, patients seemed to recover rapidly,
and their sufferings appeared to them, according to the expressions of
_Aretæus_, like a dream, out of which they awoke to a consciousness of
the increased acumen of their senses[830]. But the termination was not
always so fortunate. The disease was very dangerous, and in many, after
the occurrence of an incomplete crisis, an insidious fever remained
behind, which ended in a consumption[831]. The whole phenomenon was
altogether peculiar, and among existing diseases there are none which
bear any comparison with it.
There must therefore have been something in the whole state of
existence among the ancients which favoured the formation of the
cardiac disease. That it arose oftener in summer than in winter, that
it attacked men more frequently than women, and especially young people
full of life, and hot-blooded plethoric persons, who used much bodily
exercise, we learn from credible observers[832]. In this respect,
therefore, it bore a resemblance to the English Sweating Sickness. We
may also add, that indigestion, repletion, drunkenness, as likewise
grief and fear, but especially vomiting and the employment of the bath
after dinner, occasioned an attack of the malady[833]. Let us call to
mind the habits of the ancients. It was in the time of _Alexander_ that
oriental luxury was first introduced. Gluttony became a part of the
enjoyment of life, and warm baths a necessary refinement in sensuality,
which just at this time were philosophically established by _Epicurus_;
nor was this the last instance in which philosophers encouraged the
errors and infirmities of human society.
Here, again, therefore, as in the English Sweating Sickness, we meet
with _the relaxed state of skin, and the foul repletion_ engendered by
the same indulgence in sensuality which we have found to exist in the
sixteenth century. How this corruption of morals increased, and to what
a frightful height it was carried among the Romans, it is not necessary
here further to elucidate; and we may take it for a fact, that in
consequence of it, the general constitution of the ancients underwent a
peculiar modification; that this relaxation of skin and gross repletion
were propagated from generation to generation; and that, as among
chronic diseases, those of _a gouty character_ were its more frequent
results, so among the inflammatory, _the cardiac disease_ made its
appearance as the general effect of this kind of life.
Where, however, such a system of life existed among whole communities,
the original and peculiar occasion was not needed in every individual
case to bring the predisposition for a disease which propagated itself
by hereditary taint, to an actual eruption. Shocks to the constitution
of quite a different kind were often sufficient for the purpose. Thus,
among the Romans, it was by no means always the case, that gluttony
and relaxation of the skin immediately gave rise to the cardiac
disease; while, on the other hand, the usual faintness, induced by too
copious blood-letting, passed into this impetuous agitation of the
heart, accompanied by colliquative sweats[834]; and all overviolent
perspirations in other diseases were apt to take the same dangerous
course[835]. We must here also take into account a practice among the
Romans, which was very injurious, and yet rendered sacred by the laws;
namely, visiting the public baths late in the evening, just after the
principal meal, and awaiting the digestion of their food in these
places of soft indulgence[836]. How much must the tendency of sweating
disorders have been favoured by these means!
Surmises founded on the facts already stated, can alone be offered
respecting the nature of the ancient cardiac disease. The ancients
give us no certain intelligence upon it; for their mode of observing
did not lead to that object at which modern medicine aims. _That the
cardiac disease was not of a rheumatic character_ seems deducible from
several circumstances—from the quality of the atmosphere in southern
climates, which is not so favourable to rheumatic maladies, as to give
rise to a distinctly defined form of that complaint throughout a period
of five hundred years; from the nature of the so-called inflammatory
fever, which exhibited no rheumatic symptoms in its course; and
lastly, from the treatment of the cardiac disease, for it was a common
practice to cool down the “diaphoretic” patients in the midst of their
perspiration, by sponging them with cold water, to expose them to
the air, and some physicians went so far as to advise cold baths and
affusions[837]. How could they have ventured upon such remedies if the
cardiac disease had been of a rheumatic nature?
In the sweating fevers of the sixteenth century, every abrupt
refrigeration, every exposure of the skin, was fatal. It is thence to
be inferred, _that the English Sweating Sickness differed from the
ancient cardiac disease in its rheumatic character_; even although
both diseases were founded in common on an impure gross repletion and
relaxation of skin, and the essential phenomena of both went through
the same course: not to advert to other differences which are manifest
from what has been stated.
The remaining treatment of the cardiac disorder should not be
altogether passed over in this place, because it shews very clearly the
general style of thinking of the medical profession, as also certain
metaphysical excitations which are innate in that profession, and of
which there is therefore a repetition in all ages. For whilst some
proceeded with commendable care and caution, and _Aræteus_ feared[838]
a fatal result from the slightest error, others again, would fain
render excited nature obedient to their rough command by means of
the most violent remedies. It, therefore, occasionally happened that
in their over hasty activity they were unable to distinguish between
a salutary perspiration and a dangerous “diaphoresis.” This they
suppressed at all hazards, and thus sent their patients to the shades
of their fathers. Others forthwith flew to Chrysippic bandaging, the
great means of suppressing profuse evacuations, and even violent
spasms[839]. Others were for obviating the debility as quickly as
possible by means of nourishing diet; and overloaded the stomach, as
if the recovery of strength depended entirely upon eating. Others
allowed as much wine as possible to be drunk for twenty-four hours
together, even to the extent of producing intoxication[840]; and
_Asclepiades_ selected for this extraordinary death-bed carousal the
Greek salt wine[841], for the sake of bringing on a diarrhœa, whereby
the opened pores of the skin might again close, and the too mobile
atoms might be carried towards the bowels. With the same object he
ordered active clysters[842], for if they succeeded in causing a full
evacuation, he maintained that the perspiration must necessarily be
arrested! _Endemus_, of the Methodic sect, recommended even clysters
of cold water[843], and whatever else the rashness of medical men had
fool-hardily contrived; acting on the ancient notion, that severe
diseases always required violent remedies. _Aretæus_ recommended
blood-letting, which others pronounced to be nothing short of certain
death[844]. He had, however, a notion that the Causus was the
foundation of the cardiac disease, and perhaps he was right.
A cautious employment of wine was apparently of great use[845], and
what may excite surprise, physicians gave detailed and frivolous
precepts on the choice and enjoyment of food. If the irritable stomach
rejected this repeatedly, they even went so far, according to the
Roman method, as to make the patient vomit both before and after his
meals, in order that the organ might thus bear the repeated use of
nourishment. It was also asserted that the stomach retained food and
wine better if the body were previously rubbed all over with bruised
onions[846]. All this affords us an insight into the nature of this
remarkable disease, which has now so completely vanished from the
world. Finally, when astringent decoctions proved fruitless, particular
confidence was placed in the application of various powders[847] to the
surface of the body, conjointly with the use of light bed-clothes and
the avoidance of feather-beds, which the effeminacy of the ancients
had already introduced[848]. As astringents they selected pomegranate
bark, the leaves of roses, blackberries, and myrtles, as also fullers’
earth, gypsum, alum, litharge, slaked lime[849], and, when nothing else
was at hand, even common road dust[850]! The efficacy of some of these
extraordinary remedies cannot be denied. At least it has been proved in
modern times with respect to alkalies, which are of a somewhat similar
nature, that they are of great service where there is an abundant
determination of acid towards the skin, and it is very probable that
the perspiration of these diaphoretic patients contained much acid.
SECT. 2.—THE PICARDY SWEAT.
(SUETTE DES PICARDS—SUETTE MILIAIRE.)
The Picardy Sweat is a decided miliary fever, which has often
prevailed, not only in Picardy, but also in other provinces of France,
for more than a hundred years, and even at the present time exists
in some places as an endemic disease[851]. We have pointed out the
affinity between the English Sweating Sickness and miliary fever. Both
are rheumatic fevers—the former of twenty-four hours’ duration, the
latter running a course of at least seven days. In the former there was
no eruption, or if in isolated cases an eruption made its appearance,
it was doubtless subordinate, not essential. In the miliary fever, on
the contrary, the eruption is so essential, that this disease may be
considered as a completely exanthematous form of rheumatic fever.
The history of miliary fever is full of important facts, and the
sweating fever of Picardy forms but a variety of it. The eruption
in itself is of very ancient occurrence, and was most probably, as
at present, observed time immemorial in conjunction with petechiæ,
occurring as a critical metastasis in the oriental glandular plague,
perhaps even in the ancient plague recorded by Thucydides. It also
occasionally accompanied petechial fever, as unquestionably it did
small-pox and many other diseases, in the same manner as we now
see; for the miliary eruption is a very common symptom, which is
easily induced, and increases the danger of various other accidental
complications. This is different, however, from the _idiopathic miliary
fever_, which did not exist either before, or even at the period of
the English Sweating Sickness, but occurred as an epidemic, frequently
mentioned in Saxony, a hundred years later[852], (1652.)
We cannot, therefore, consider this eruptive disease as having
proceeded from the English Sweating Sickness, in the same manner as
the petechial fever had its probable origin in the glandular plague,
even supposing a more decided inclination of the Sweating Sickness
to the eruptive character could be proved than is possible from the
facts afforded. A whole century intervened, and what vast national
revolutions!
This same separation of so long a period makes also against the
supposition, that the English Sweating Sickness was an interrupted
miliary fever, which exhausted its power by a too luxuriant activity
of the skin on the first day, before the eruption made its appearance.
Moreover, the similarity and isolation of all the five epidemic
sweating fevers, as regards the brevity of the course of the disease,
and the absence of all transition forms of any duration, which
certainly would have existed had nature intended gradually to form a
miliary fever out of the English Sweating Sickness, lead to the same
conclusion.
But to return to the miliary fever. Some forms of this disease have
been observed, in which a profuse perspiration, in combination with
nervous symptoms, has endangered life on the first day of the attack;
equally often, too, the eruption has appeared fully formed on the
very first day; and if we duly consider, as we ought, the regular
course of miliary fever whenever it has assumed an epidemic character,
we shall always find, even in that case, a development of symptoms
differing fundamentally from those of the English Sweating Sickness.
If, occasionally, instances of miliary fever occurred, in which no
eruption came out, as was the case recently (in 1821), they were to
be considered in the same light as other acute eruptive diseases,
as, for example, scarlet fever, in which nature indulges in a like
irregularity, without, however, altering the essence of those diseases.
And since, finally, it has been observed in many cases[853], that
the miliary eruption could be prevented by the application of cold
at the commencement, a distinguished modern physician has attached
great consequence to this circumstance, as showing that miliary fever
and the English Sweating Sickness were the same disease[854]; but a
check of this kind is, at all events, impossible in those miliary
fevers where the eruption breaks forth on the first or second day; and
moreover, experience tells us, that many other diseases also, such as
inflammations, rheumatisms, gastric fevers, and even abdominal typhus,
may be arrested in their course, and confined within narrower bounds,
so as not to manifest all their symptoms.
We are, therefore, completely entitled to consider the appearance of
the miliary sweating fevers as altogether a novelty, originating in
the middle of the 17th century, and having no discoverable connexion
with the English Sweating Sickness. There have been in Germany, since
the year 1652, many visitations of miliary fever; but this disease did
not increase much in extent until about the year 1715, when it spread
into France and the neighbouring countries, particularly Piedmont[855],
whilst England remained almost entirely free from it. The French
epidemics were, upon the whole, much more severe than the German; and
on this account we select one of the most ancient, and also the most
recent of them, in order to give a general view of miliary fever, as
compared with the English Sweating Sickness.
The miliary fever first appeared in Picardy, in the year 1718, in le
Vimeux (Vinnemacus pagus), a district on the north of the Somme and
on the south of the Bresle and the department of the Lower Seine. It
increased annually in extent; most places in Picardy were visited by
it, and it was not long before it was seen in Flanders[856].
We are still in possession of a very distinct account, which we will
here detail, of an epidemic at Abbeville in the year 1733, where the
miliary fever had existed fifteen years previously. There were scarcely
any premonitory symptoms, but the disease commenced at once with
pinching pains in the stomach, extreme prostration of strength, dull
headache, and difficulty of breathing, interrupted by sighing. Patients
complained of violent heat, and were bathed in a pungent sweat of foul
odour, while nausea was occasionally felt. Sparks appeared before the
eyes, and _the countenance became flushed_. Patients were tormented
with burning thirst; and yet the tongue was as moist as in perfect
health. The pulse was frequent and undulating, without hardness; and
in the course of _a few hours_, an insufferable itching came on over
the whole body, accompanied by distressing jactitation: upon this,
thickly studded, _red, round pustules_, not bigger than mustard-seeds,
broke out, wherefrom patients emitted an extremely disagreeable urinous
odour, which was imparted to those who were about their persons.
Sometimes they had evacuations, at other times they suffered from
constipation, but all complained of want of sleep; and when they felt
an inclination to doze, they were again aroused by fresh chilliness.
Many bled at the nose till they fainted; and with women, the menstrual
discharge often appeared, though not at the proper time. The urine was
at times deficient in quantity, at others discharged in abundance,
and without any critical signs; if pale and plentiful, it betokened
delirium; then the eyelids twitched convulsively, a humming noise
commenced in the ears, and the patient tossed about restlessly. The
pulse became strong, irregular, and, like the breathing, very quick.
The countenance grew redder and redder; and soon after, the sufferers,
as though struck by lightning, were seized with lethargy, and expired,
generally in the act of coughing and spitting blood.
Such was the nature of the disease when it attacked many at once: there
were, however, several varieties. With some the miliary vesicles broke
out on the _second_ day, with others not before the _third_; and if
all went on favourably, they lost their redness on the _seventh day_,
and _the skin all over the body scaled off like bran_. The fever was
sometimes extremely violent; at others, without apparent cause, very
mild; at least one might be deceived at the commencement of the attack,
by the apparently favourable symptoms; for those who in the morning
had scarcely any notable degree of fever, who neither suffered from
any anxious sensation nor violent heat, in whom no subsultus tendinum
was perceptible, no want of perspiration, nor any retrocession of the
eruption, were sometimes towards evening seized with phrenzy, and died
in a state of lethargy. Evacuations, which alleviate other diseases,
made this miliary fever worse. Favourable symptoms could never be
depended on. In the midst of profuse perspiration the patient died,
either from constipation or diarrhœa. A copious discharge of urine
was a bad sign; composure was succeeded by delirium, cheerfulness by
lethargy: the disease was throughout treacherous and disguised. It
was particularly necessary for those suffering from pleurisy or any
inflammatory fevers to be guarded against its approach. Many fell
sacrifices to this epidemic who thought themselves in a state of
convalescence; and with such it was easier to foretell than to prevent
the consequences. In cases of this kind the miliary vesicles were less
red and grew pale sooner; but if the disease attacked a healthy person,
then they were redder, and continued longer. Of those who recovered,
not a few suffered for many months, nay, even for a whole year, from
night perspirations, without fever or sleeplessness, but with an
eruption of little miliary vesicles, which disappeared[857] again on
the slightest exposure to cold. The later miliary epidemic fevers in
France, which are distinguished by the name of the Picardy Sweating
Sickness, are generally very well described[858]; so much so, that we
have few epidemics of modern times whose course and succession we can
trace so well. But the epidemic of 1821, which raged in the departments
of the Oise, and of the Seine and Oise, from March to October, has been
observed by all with the greatest care, including men of distinguished
talent[859].
We shall give the description of this disease. There were no constant
premonitory symptoms; it often broke out quite suddenly, but many
complained some days before of debility, despondency, want of appetite,
nausea, headache; sometimes also of giddiness and slight chilliness.
Many retired to rest in health, and awoke during the night with the
disease, covered with a perspiration, which ceased only with death or
recovery. With some the sweating was preceded for some hours, or even
only for some moments, by a scarcely perceptible feverish commotion,
accompanied with burning heat, or with a _sensation of pain_ which ran
through every limb, and nearly always with spasms in the stomach. With
others the disease announced itself by lacerating rheumatic pains,
which gradually increasing, they became bed-ridden. The mouth was
foul, the taste at times bitter, the tongue white, more rarely tinged
with yellow, and thus it remained till the patient was restored. The
sufferer was shortly covered with _a thick, peculiarly fetid sweat_,
that certainly produced alleviation, but became very intolerable to
him from its unpleasant stench, which was even communicated to the
clothes of the bystanders. In the mean time it was discovered by the
pulse, that the fever had considerably abated; but, on the third day,
the patient was seized with convulsive _spasms in the stomach_, great
_oppression at the chest_, and a sensation of suffocation—symptoms
which caused him insupportable anguish. These attacks accompanied by
hiccup and eructation, continued for several hours, and returned from
time to time, an eruption, partly papular, simultaneously breaking out
first on the neck, then on the shoulders down to the hands and breast,
less frequently on the thighs and face. The little pimples were of a
pale red colour and conical, with glistening heads, and between them
appeared innumerable small miliary pustules, filled with transparent
serous fluid, which soon thickened and assumed a whiter hue. At the
time and previous to the breaking out of the exanthem, the patient
experienced a very severe _burning and pricking sensation in the skin_,
which nevertheless sometimes occurred on the second or fourth day, and
which increased sometimes in one part, sometimes in another, when the
sweating declined.
Towards the fifth day, however, after the sweating had entirely ceased,
the complaint grew worse again. The spasms and paroxysms of suffocation
returned, and they were succeeded by renewed eruptions of the exanthem;
a decided improvement, however, shortly took place; the little pimples
lost their redness, the miliary vesicles dried away, and at a period
from the seventh to the tenth day recovery commenced under _a general
exfoliation of the cuticle_. Sometimes the eruption did not appear,
whether the patients were under medical treatment, or left to their own
guidance, but with those few in whom there was an absence of miliary
vesicles, that peculiar pricking and itching of the skin did not take
place.
Between the fifth and seventh day the patients usually complained of
great weakness, and had a desire to eat. A few tablespoonfuls of wine
then agreed with them very well; for the rest, neither thirst nor
lethargy was observable, but it was particularly remarkable that the
urine was clear and abundant. Up to the seventh day a confined state
of bowels was usual, and, with the exception of the already mentioned
attacks of tightness and oppression, the breathing remained free,
though with great sleeplessness, during the whole malady. Nothing
morbid was to be observed in the chest, and the patients lay stretched
out at full length, so that there was no occasion at any time to raise
their heads.
Such was the regular course of this miliary fever, but its progress
was often accelerated by very dangerous symptoms, and occasionally it
proved fatal within a very few hours. If at the time of the attack the
patients were very restless and talkative, the eyes glistening, the
pulse, without being hard, tumultuous, and the edges of the tongue
reddened, delirium soon succeeded and then convulsions and death.
Great depression of the spirits was a very bad symptom; bleeding was
never of any avail, yet the menstrual discharge did not interrupt
the course of the disease. There was in general a great degree of
malignancy perceptible in the malady, as was also rendered apparent
by the course of the epidemic. If the miliary Sweating Fever broke out
in a fresh place, two or three persons only were thereupon attacked,
and that favourably, which led to a supposition that the evil had all
passed away, for during the next fifteen or twenty days, not any fresh
attacks were heard of. Suddenly, however, the epidemic reappeared
with increased virulence. The great number of the sufferers spread
consternation and terror amongst the inhabitants, and the cases of
death became frequent. After this first burst of fury, the epidemic
grew more mild again, so that many patients were not confined to
their beds at all. This mitigation of the miliary fever was likewise
manifested[860] by the prolongation of its course beyond the seventh
day.
If we compare this epidemic with the one observed at Abbeville in 1773,
we shall find between them but very trifling differences, which would
appear still more clearly in some of the intermediate visitations,
thus conforming to what has been observed in other eruptive maladies.
It is consequently evident that the miliary fevers[861] which have
appeared in France in recent times, do not differ in any essential
point from those of more ancient date. The surest proof of their
identity is, their persistence for nearly two centuries; and from the
manner in which they have presented themselves to observation, they
are to be considered as distinct from the English Sweating Sickness,
though certainly allied to it. It would exceed our limits to pursue
this inquiry further, but it may be as well to give the following short
catalogue[862] of the most important miliary epidemics.
1652. Leipzig.
1660. Augsburg.
1666. Bavaria.
1672. Hungary.
1675. Hamburgh.
1680. Germany to a great extent.
1689. Philippsburg.
1690. Stuttgard.
Düsseldorf.
Erfurt.
Jena.
1694. Berlin.
1700. Breslau.
1709. Dantzic, Marienburg.
1712. Mümpelgart.
1713. Saint Valery. (Somme.)
1714, 15. Laybach.
1715. Breslau.
Turin.
1718. Tübingen.
Abbeville. (Somme.)
1720. Canton de Bray. (Lower Seine.)
1723. Francfort on the Maine.
1724. Turin.
Vercelli.
1726. Acqui.
Guise. (Aisne.)
1728. Chambéry, Annecy, St. Jean de Maurienne. (Savoy.)
Carmagnola.
Vercelli.
Ivrea.
Biella.
1729. Vienna. (Austria.)
1730. Pignerol.
1731. Fossano.
1732. Nizza.
Rivoli.
1733. Fossano.
Asti.
Lanti.
Acqui.
Basle.
Silesia.
1734. Strasburg. (Lower Rhine.)
Acqui.
Lanti.
1735. Trino.
Lanti.
Fresneuse. (Lower Seine.)
Vimeux. (Seine et Oise.)
Orleans. (Loiret.)
Pluviers. (Loiret.)
Meaux. Villeneuve.
Saint George. (Seine et Marne.)
Bohemia.
Denmark.
Sweden.
Russia.
1738. Luzarches, Royaumont. (Seine et Oise.)
Susa.
Crescentino.
1740. Caen. (Calvados.)
Provins. (Seine et Marne.)
Vire. (Calvados.)
Berthonville. (Eure.)
Falaise. (Calvados.)
1741. Rouen. (Lower Seine.)
Tartana.
Valencia.
Alexandria.
London.
1742. Caudebec. (Lower Seine.)
Ceva.
Turin.
Sorillano.
Alba.
Ivrea.
Cherasco.
Fossano.
1743. Villafranca.
1744. Acqui.
1746. Zurich.
1747. Paris. (Seine.)
Beaumont. (Seine et Oise.)
Chambly. (Oise.)
Modena.
Lodi.
Mantua.
Piacenza.
1750. Schaffhausen.
Bern.
Geneva.
Beauvais. (Oise.)
1751. Villafranca.
1752. Fernaise. (Seine et Oise.)
1753. Susa.
1754. Valepuiseux. (Seine et Oise.)
1755. Novara.
1756. Cusset. (Allier.)
Boulogne. (Pas de Calais.)
1757. Montaigu les Combrailles. (Puy de Dôme.)
1758. Amiens, environs. (Somme.)
1759. Paris. (Seine.)
Guise. (Aisne.)
Caudebec. (Lower Seine.)
1760. Alençon. (Orne.)
1763. Vire. (Calvados.)
1763, 64. Bayeux. (Calvados.)
1765. Balleroy, Basoques. (Calvados.)
Saint-George, Saint-Quentin. (Calvados.)
1766. Campagny. (Calvados.)
1767. Thinchebray, Truttemer. (Orne.)
1768, 69. St. Quentin. (Aisne.)
1770. Louviers. (Eure.)
1771. Montargis. (Loiret.)
1772. Hardivilliers, environs.
1773. Hardivilliers. (Oise.)
1776. Laigle. (Orne.)
1777. Jouy. (Seine et Oise.)
1782. Castelnaudary. (Aude.)
Boissy Saint-Léger. (Seine et Oise.)
1783. Beaumont. (Seine et Oise.)
1791. Méru. (Oise.)
1810. Nourare, Villotran. (Oise.)
1812. Rosheim, and many other places. (Lower Rhine.)
1821. La Chapelle, Saint-Pierre and sixty places around. (Oise; Seine
et Oise.)
SECT. 3.—THE ROETTINGEN SWEATING SICKNESS.
We now come to a phenomenon which, notwithstanding its short duration
and very limited extension, is one of the most memorable of this
century. Up to the present time, its real importance has not been
recognised, because the clouds of self-sufficient ignorance have
prevented our taking a survey of the formation of diseases, throughout
long periods of time. It has been sunk for an age in the sea of
oblivion, from whence we will now draw it forth to the light of day.
In November, 1802, a very hot and dry summer had been succeeded by
incessant rain. Thick fogs spread over the country, and enveloped such
places in central Germany as were inaccessible to ventilation. Amongst
others, the small Franconian town of Roettingen, situated on the river
Tauber, and surrounded by mountains[863]. Scarcely had a few weeks
elapsed, when unexpectedly, towards the 25th of November, an extremely
fatal disease broke out in the town, which was without example in the
memory of its inhabitants, and totally unknown to the physicians of the
country.
Strong vigorous young men were suddenly seized with _unspeakable
dread_; the heart became _agitated_ and _beat violently against_ the
ribs, a _profuse, sour, ill-smelling perspiration_ broke out over
the whole body, and at the same time, they experienced a _lacerating
pain_ in the nape of the neck, as if a violent rheumatic fever had
taken possession of the tendinous tissues. This pain ceased sometimes
very quickly, and if it then shifted to the chest, the distressing
palpitation of the heart recommenced; a spasmodic trembling of the
whole body ensued; the sufferers fainted, their limbs became rigid,
and thus they breathed their last. _In most cases, all this occurred
within four and twenty hours._ They did not all, however, succumb under
the first attack, but as soon as the accelerated pulse had sunk to the
lowest ebb of smallness and feebleness, a corresponding effect being
observable in the respiration, the violent pain would in some cases
return to the outward parts. The patient then felt a benumbing pressure
and stiffness in the nape of the neck; and the pulse and respiration
became restored again as in health, but the perspiration continued to
pour incessantly down the skin.
This apparent safety was, however, very deceptive, for a renewed
palpitation of the heart unexpectedly commenced, accompanied by a
feeble pulse; and then death was often inevitable. It was remarkable,
that the patients, though bathed in perspiration, had very little
thirst, and the tongue was not dry, nor ever even foul, but retained
its natural moisture. With most, however, the urine was scanty; as
the skin, under the increasing debility, permitted too much fluid to
stream forth through its pores. _If the disease passed off without
heating sudorifics, then in general no eruption made its appearance._
The malady then continued till the sixth day, but on the first only,
did it display its malignant symptoms, for by the second, the sweating
diminished and lost every unfavourable quality, so that increased
transpiration of the skin, without any other symptoms of importance,
alone remained, and on the sixth day the patient was perfectly
restored.
Had there been in Roettingen a physician at hand from the commencement,
_well skilled in medical history_, and who would have adopted the old
English treatment of the Sweating Sickness, this new fever would have
appeared but as a perfectly mild disease, and would certainly have
carried off but few of the inhabitants of this peaceful little town.
As it was, however, the scenes of Lübeck and Zwickau were renewed,
and it seemed as if the innumerable victims to the hot treatment, and
to _Kegeler’s_ truculent medical work, had descended to the grave in
vain. _The sufferers were, as in the sixteenth century, literally
stewed to death!_ for the moment the people imagined that they knew
how nature meant to escape, they ordered feather-beds to be heaped
on the perspiring patient, so that the mouth and nose alone remained
uncovered. Doors and windows were tightly closed, and the stove emitted
a glowing heat, whilst a most intolerable odour of perspiration
streamed forth from beneath the broad and lofty beds; added to which,
that two and even more patients were often lying in the same room;
nay, even stowed together under the same mountain of feathers, and in
order that inward heat might not be wanting, pots of theriaca were
swallowed, and the patient was incessantly plied with elder electuary.
Thus the bad humours were expelled together with the perspiration;
and whether the sufferers were suffocated, or surmounted, as by a
miracle, this mal-treatment of nature, a conviction was felt, that the
most salutary remedies had been employed, and when at last, eruptions
of various colours broke out, it was considered as certain, that the
poison had been carried off in them. The citizens of Roettingen,
therefore, fell into the same erroneous opinion, which, upheld by
medical schools, had, time immemorial, increased inflammatory diseases,
particularly the exanthematous, and caused them to become malignant.
The above-mentioned eruptions were of various sorts; miliary vesicles
of every form and colour, filled with an acrid fluid; actual blistery
eruptions, (pemphigus,) and even petechiæ; and it is to be observed,
that the patients, during the first days of the sweating fever, never
suffered from that peculiar pricking sensation over the whole body,
which precedes the eruption of miliaria, but complained only, and that
not always, of a local itching, where the eruption had broken out. It
was equally rare to observe a regular desquamation of the skin, and it
is therefore to be assumed, that _the eruptions were only symptomatic_,
and not by any means necessarily connected with the disease, as in the
decidedly miliary fevers.
The disease excited, from its very commencement, the greatest
consternation; and as it was increased, even from the first days of
its appearance, by the sudorific system of treatment, deaths were
multiplied; the continual peal of funeral bells struck mortal terror,
as of old at Shrewsbury, into the hearts of both sick and healthy; and
this oppressed little town was shunned as a pesthole by the inhabitants
of the surrounding neighbourhood. At the commencement of the disease,
they were entirely without medical advice, till a skilful physician
arrived from the vicinity[864], and as _most of the inhabitants_ were
already attacked with the sweating fever, he immediately prescribed
the proper treatment. But the powers of one man are not sufficient,
amid such confusion, to contend with the deeply rooted prejudices of
the people, and so they continued in most houses to expel by heat and
theriaca both perspiration and life together; till at last, on the
third of December, _Dr. Sinner_ of Würzburg arrived, without whom the
remembrance of this remarkable disease would have been obliterated, and
conjointly with his gallant colleague, like the anonymous physician
formerly in Zwickau, subdued the destructive prejudices of the people.
He found eighty-four patients[865] under piles of feather-beds, who,
when pure air was admitted, breathed once more freely, and by a prudent
cooling system, all recovered easily, and without danger, one only
excepted. His method reminds us of the old English treatment[866].
The disease was confined entirely to Roettingen, it did not make its
appearance anywhere beyond the gates of this little town. On the fifth
of December, however, clear, frosty weather set in; from that time no
new cases occurred, and all traces of this Roettingen sweating fever,
which was never either preceded or followed by miliary fever in any
part of Franconia, have from that time disappeared.
The resemblance of this fever to the English Sweating Sickness is
manifest, and is proved even by the short (_only ten days’_) duration
of the visitation, which, as we have stated, is a most essential
characteristic of the English sweating epidemic, at least as it
appeared in Germany, the miliary epidemics always having lasted a much
longer period. But if we confine ourselves merely to the symptoms of
the disease, we shall find, that in the Roettingen sweating fever,
there are, throughout, none that can be considered essential, except
the _palpitation of the heart, accompanied with anguish_, the _profuse
perspiration_, and the _rheumatic pains in the nape of the neck_,
which never were wanting in any case; and the very same symptoms are
clearly and perceptibly to be discerned in like proportion as compared
with others, in the representation of the English Sweating Sickness;
whereas, the eruptions were altogether as unessential as in the
epidemic of the sixteenth century. The irritability of the skin, and
tendency to dangerous metastases, were less marked in the Roettingen
fever than in the English Sweating Sickness; for the patients could,
without injury, change their linen in the midst of the perspiration,
which, in the English Sweating Sickness, could not have been done
without fatal consequences; but this difference can easily be accounted
for, from the greater degree of suffering in the latter disease than in
the former. It only now remains to examine the duration of the disease,
and here we plainly perceive that the principal paroxysm was over in
the Roettingen epidemic within the first four and twenty hours, at
least when it was undisturbed by treatment; and the sole symptom which
continued until the sixth day—the increased perspiration, (we speak
here only of perfectly pure cases,) could only reasonably be regarded
as a sequela. The crisis did not occur all on a sudden, as in the
English Sweating Sickness, but this cannot constitute any essential
difference.
We do not hesitate, therefore, to pronounce _the Roettingen fever to
have been the same disease as the English Sweating Sickness_. To give,
however, this phenomenon its proper interpretation—to have a clear
conception of the causes which again drew down from the clouds, into
the midst of Germany, this mist-born spectre of 1529, and allowed it
to expend its brief fury upon a single place, is beyond the power
of human wisdom. Science is not comprehensive enough to discover, in
the crossings of these unknown comet-paths, the moving causes of this
visitation of disease. But as all insight into the works of nature must
be preceded by a strict investigation and search after phenomena in all
countries, at all times, and under all circumstances of development, so
an improved knowledge of diseases and of the whole human system, will
not fail to follow, when the investigations of epidemics throughout
extensive periods have increased in number and success.
_The present age demands such a knowledge of medical men, whose
vocation it is to investigate life minutely in all its bearings. It
demands of them an historical pathology, and to this branch of the
study of nature is the present work intended to contribute._
CHRONOLOGICAL SURVEY.
POLITICAL EVENTS. FIRST VISITATION OF THE SWEATING
SICKNESS.
1461–1483. Louis XI. 1472–1482. Swarms of locusts
1485–1509. Henry VII. in the south of Europe.
1493–1519. Maximilian I. 1480–1485. Wet years.
Mercenary troops are introduced. 1483. Overflow of the Severn,
(the _great water_ of the Duke
1483–1498. Charles VIII. of Buckingham.)
1483–1485. Richard III. 1480 and 1481. Famine in
1483, October. First abortive Germany and France.
attempt of the Earl of Richmond, 1477–1485. Glandular plague
(who had fled to France in Italy.
in 1471,) against Richard III. 1480, 1481. Encephalitis in
The Duke of Buckingham Germany.
executed. 1482. Febrile cerebritis in
1485. Richmond obtains support France, and epidemic pleuritis
from Charles VIII. in Italy.
1485, 25th July. Richmond’s 1483. Glandular plague in
departure from Havre. Spain.
1485, 1st August. Landing at 1484 and 1485. Malignant fever
Milford Haven. in Germany and Switzerland.
1485. From the 1st to the 22d Plague in Spain.
of August, march from Milford 1485. _In the beginning of August:_
Haven to Lichfield and _eruption of the English_
Bosworth. _Sweating Sickness, probably_
1485, 22d August. The battle _amongst Richmond’s_
of Bosworth. Richard III. _mercenary troops. It spread_
falls. The Earl of Richmond _from west to east, and then_
becomes king, under _in a contrary direction._
the name of Henry VII. 1485. _The end of August, in_
_Oxford._
1485, 28th August. Henry’s 1485. _21st September till the_
entry into London. _early part of October, in_
1485, 30th October. Henry’s _London._
coronation. 1485. _The middle of November,_
1481–1492. The wars of Ferdinand _in Croyland._
the Catholic, against 1486. _1st January. Termination_
the Saracens. _of the first epidemic_
1495. Useless war for the _Sweating Sickness._
succession of Charles VIII. 1486. Epidemic scurvy in Germany.
against Alfonso II., (who died Plague in Spain.
in 1495,) and Ferdinand II. 1488–1490. Plague in Spain.
of Naples. The conquest of 1490. First eruption of petechial
the kingdom was again fever in Granada, in the
immediately relinquished. army of Ferdinand the Catholic.
1495. Eruption of the syphilitic
pestilence at Naples,
among the mercenary army
of Charles VIII.
1499. Great plague in London.
SECOND VISITATION.
1485–1509. Henry VII. 1500–1503. Mould-spots (signacula)
1501. His eldest son, Arthur, in Germany and France.
marries Catherine of Arragon,
daughter of Ferdinand 1500. Comet.
the Catholic. 1500. Mortality among cattle
1502. Prince Arthur dies. in Germany.
Prince Henry (VIII.), second 1502. Very extensive destruction
son of Henry VII., is affianced of cultivation in Germany
to Catherine of Arragon. by blights of caterpillars.
The internal condition of England 1503. Glandular plague, and
is altered by Henry VII. destructive epidemics in
The towns begin to rise Germany and France.
importance, and the sciences 1504. Plague in Spain.
to become diffused. A rigorous 1504 and 1505. Encephalitis,
and unjust financial putrid fever, and malignant
system. pneumonia in Germany.
1498–1515. Louis XII. 1505. Plague in Portugal.
1501. conquers Naples in 1505. First epidemic petechial
conjunction with the Spaniards, fever in Italy. The morbid
and is by them activity of the organism
1504. expelled thence. He shewed a decided determination
establishes his power in towards the skin during
Upper Italy. all this period.
1511. Pope Julius II. (1503–1513) 1505. Moist summer. Lamentable
forms the sacred league moral state of England.
against France, into which 1506. _The summer: the Sweating_
enters likewise, in 1512, _Sickness breaks out in_
Henry VIII. The French _London, and continues to a_
lose their power in Italy. _moderate extent, being confined_
1504. Isabella of Castile dies. _to England, until the_
Philip I. of Austria, her _autumn. This second visitation_
daughter Johanna’s husband, _is the mildest of all, and_
succeeds her, his son, _the old English method of_
Charles V., having been born _treatment proves effectual_
in 1500. _everywhere._
1506. Philip I. dies. 1506–1508. Pestilential epidemics
1516. Ferdinand the Catholic in Spain.
dies. 1508. Swarms of locusts in
Spain.
THIRD VISITATION.
1509–1547. Henry VIII. 1515. Pestilential epidemics in
1515–1547. Francis I. immediately Spain.
attacks Milan again, 1516. Comet.
and conquers. 1517. Unproductive, but not
1515. the Swiss, in the battle moist summer.
of Marignano. Keeps possession 1510. Great influenza (Coqueluche)
of Milan, and establishes throughout France,
the French dominion in Italy and probably to a still further
until the year 1522. extent. Plague in the north
1516. Cardinal Wolsey changes of Europe.
the policy of England in favour 1517. In the early months epidemic
of Francis I., trachæitis and œsophagitis
1520. then of Charles V. (diphtheritis) in Holland,
1513–1522. Leo X., against lasting only eleven days.
France. Promotes, by a new This epidemic extends towards
bull of indulgences, the outbreak the south, and appears
of the Reformation. in the same summer at
1517. 31st of October, Luther Bâsle.
commences the Reformation. 1517. On the 16th June, earthquake
1519. 12th January, the Emperor in Swabia (and Spain).
Maximilian I. dies. 1517. Encephalitis and other
1519–1556. Charles V. inflammatory fevers in Germany.
1521. Imperial diet at Worms. 1517 _In July, outbreak in_
1517. May: Insurrections of _London of the third visitation_
the operatives in London. _of epidemic sweating sickness;_
1517. In the autumn and winter, _it spreads with great_
Henry VIII. frequently _malignity all over England,_
changes the residence of his _and among the English at_
Court in consequence of the _Calais; in the sixth week_
Sweating Sickness and the _it attains its greatest_
Plague. _violence, and terminates in_
1518. 11th February, Queen _December. Ammonius, of Lucca,_
Mary is born. _and many distinguished and_
1518. The College of Physicians _learned persons in Oxford_
in London is founded _and Cambridge are carried_
by Linacre. _off by it._
1521. Henry VIII. opposes 1517. In December, immediately
Luther, and obtains the title after the Sweating Sickness,
of “Defender of the Faith.” a plague occurs in
(_Thomas More._) England and lasts all the
winter.
1517. Small-pox breaks out in
Hispaniola.
FOURTH VISITATION.
1524. October, Francis I. 1524. Great plague at Milan,
passes Mont Cenis, and is 1527. Inundations in Upper
1525. beaten at Pavia and captured. Italy.
1526. 14th January. Peace of 1527. 11th August, a comet.
Madrid. 1527. Plague in the imperial
1526. Clement VII. (1523–1534) army in Italy, after the sacking
becomes the head of of Rome; and in Wittenberg.
the Holy League against the 1528–1534. Years of famine,
Emperor. with a prevalence of moisture
1527. 6th May. Rome is vanquished and heat.
by the imperial army 1528. Repeated inundations.
and sacked. Continual south winds and
1528. A French army, under summer fogs in Italy. Second
Lautrec, conquers the greatest great epidemic petechial
part of Italy, and fever there.
commences 1528. Destruction of the French
1528. 1st May, the siege of army before Naples by a
Naples. Lautrec dies in pestilential Spotted Fever.
August. 1528. Cold spring and moist
1528. 29th August, the siege of summer in France.
Naples is raised. The remains 1528–1532. Warm winters, moist
of the French army summers. Repeated failures
are made prisoners. of harvest, and great famines
1528. Charles V. challenges in that country.
Francis I. to single combat. 1528. The Trousse-galant carries
1529. 5th August, Francis I. off a fourth part of the
concludes the unfavourable inhabitants of France in this
peace of Cambray. Termination and the following years.
of the French dominion 1528. Wet and mild winter.
in Italy. The Reformation Moist summer with fogs.
in England is Failure in crops, and famine
retarded. in England.
1527. Scruples of Henry VIII. 1528. _At the end of May: outbreak_
respecting his marriage with _in London of the Fourth_
Catherine of Arragon. Various _epidemic Sweating Sickness._
negotiations on the subject _It spreads with great_
in the following years. _malignity, and with much_
Cardinal Wolsey falls into _disturbance of social life,_
disgrace. Thomas More becomes _all over England; carries off_
chancellor. _many distinguished persons,_
1528. Henry VIII. retires to _and terminates in the winter._
Tytynhangar in consequence _This year it remains confined_
of the Sweating Sickness. _to England, and does_
1532. Separation of the king _not return in the following_
from Catherine. Mary is excluded _year._
from the government. 1528. Continual south-east
1533. January, Anna Boleyn winds. Great drought.
becomes queen. The Reformation Swarms of locusts and fiery
is introduced. meteors in the north of
1535. Thomas More and Fisher Germany.
are executed. 1529. Earthquake in Upper
1536. Anna Boleyn is executed. Italy. Sanguineous rain at
Jane Seymour becomes Cremona. A comet in July
queen. Dies 1537. and August.
1537. Anne of Cleves becomes 1529. Mild winter in Germany.
queen. Separation after six The spring begins in February.
months. Great moisture
1541. Catherine Howard, queen, throughout the summer. General
and executed one year and dearth in March. Disease
six months afterwards. among the porpoises in
1544. Catherine, queen. the Baltic. Unwholesomeness
1547. 13th December, Henry of the river fish in the
VIII. dies. north of Germany. Disease
1521. Plots of the Iconoclasts among birds. Languor resembling
in Zwickau and Wittenberg. syncope in Pomerania.
1523–1525. Peasant war. On Frequent suicides
the 15th May, battle of in the March. In the middle
Frankenhausen. of June a flood of rain
1529. Imperial Diet at Spires. lasting four days (torrent of
1529. 22d September-16th St. Vitus) in the south of
October, the Turks before Germany. On the 10th of
Vienna. August, a universal tempest.
1529. 2d October, assemblage 24th of August, and the
of the Reformers in following days great heat.
Marburg. 1529. _25th July, outbreak of_
1530. 25th June, surrender of _the epidemic Sweating Sickness_
the Augsburg confession. Severe _in Hamburgh. Termination_
decrees against the _on the 5th August._
Protestants. _On the 29th July in Lübeck._
1531. League of the Protestant _On the 14th August_
princes at Schmalkalden. _in Zwickau. About the_
Continued danger from the _1st September the English_
Turks. _Sweating Sickness appears_
1532. Imperial Diet at Nuremberg. _to spread universally all over_
The Protestants obtain _Germany. On the 31st August_
security. _in Stettin; termination_
1333–1535. Excesses of the _on the 8th September. On_
Anabaptists at Münster. _the 1st September in Dantzic;_
1536. The Schmalkaldic league _termination on the 6th_
is strengthened. _September. On the 24th_
1538. The Catholic States establish _August in Strasburg. On_
the sacred league at _the 5th, 6th and 7th September_
Nuremberg. _in Cologne, Augsburg_
1540. Paul III. (1534–1550) _and Francfort on the Maine._
confirms the order of the Jesuits, _About the 20th September_
founded in 1534 by Ignatius _in Vienna and among the_
Loyola. _besieging Turks. On the_
1519–1541. Conquest of Mexico, _27th September in Amsterdam._
Peru, Chili, &c. _Termination on the_
_1st October in Antwerp and_
_the rest of the Netherlands;_
_simultaneously, at the end_
_of September, in Denmark,_
_Sweden and Noway. At_
_the commencement of November_
_a universal cessation_
_of the epidemic Sweating_
_Sickness._
1530. In October, overflow of
the Tiber. Bursting of the
dykes, and sudden inundations
in Holland, which were
repeated in 1532.
1531. 1st of August to 3d
September, the comet of Halley.
1532. From 2d October to 8th
November, and
1533. From the middle of June
to August, comets.
1534. Termination of the years
of scarcity, during which
malignant fevers prevailed
in circumscribed localities
throughout Europe.
FIFTH VISITATION.
1542. Maurice Duke of Saxony 1538. Epidemic dysentery in
renounces the league of France.
Schmalkalden. 1540. The hot summer. The
1542. The imperial army which forests take fire spontaneously.
opposes the Turks in Hungary, 1541. Plague in
under Joachim II. of Constantinople.
Brandenburg, is destroyed 1542. Swarms of locusts in the
by sickness. south of Europe, and plague
1546. The 18th of February, in Hungary during the war
Luther dies. of the Turks in that kingdom.
1546. Charles V. takes the field 1543. Plague and petechial
against the Protestants, proclaims fever in Germany. Metz.
the Elector, John Frederick, 1545 and 1546. Trousse-galant
and Landgrave Philip in France, of which
of Hesse, outlaws. Gains 10,000 English die at
1547. 24th April, the battle of Boulogne.
Muhlberg. Raises 1546. Plague in the Netherlands
1548. Duke Maurice to the and France.
electorate of Saxony, and 1547. Petechial fever in the
prescribes the _interim_, which imperial army.
is not accepted by Magdeburg. 1547–1551. Mould spots and
1551. Magdeburg declared to red water in the north of
be under the imperial ban, Germany.
and besieged in vain by the 1549. Caterpillars destroy the
Saxons. herbage, and a mortality occurs
1552. Henry II. of France among cattle in Germany.
(1547–1559), in alliance with The 21st of September
the Protestant princes, takes an aurora borealis.
Metz, Toul, and Verdun. 1549 and 1550. Malignant fever
1552. The treaty of Passau (petechial fever?) in the
secures to the Protestants north of Germany.
equal rights with the 1551. Dry and cold spring;
Catholics. hot and wet summer. Inundations,
1547–1553. Edward VI. nine earthquakes, meteors,
years old. The Duke of mock suns, great tempests,
Somerset governs the kingdom summer fogs.
as Protector. The Reformation 1551. Malignant fever in Swabia:
is favoured, and plague in Spain.
makes progress. Influenza.
1553. Mary persecutes the 1551. In the spring, stinking
and in 1558 loses Protestants, mists on the banks of the
Calais. Severn.
1556. Charles V. abdicates, and 1551. _On the 15th of April_
dies on the 11th of September, _outbreak of the fifth epidemic_
1558, in Spain. _Sweating Fever in Shrewsbury_
_on the Severn. It gradually_
_spreads with stinking_
_mists all over England, and_
_on the 9th of July reaches_
_London. The mortality is_
_very considerable. Foreigners_
_are unaffected, but Englishmen_
_in foreign countries_
_sicken with the English_
_Sweating Sickness. The epidemic_
_terminates on the 30th_
_of September._
1552 and 1553. Malignant fever
in Germany and Switzerland.
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APPENDIX.
A BOKE, OR COUNSEILL
AGAINST
THE DISEASE
COMMONLY CALLED
►THE SWEATE◄,
OR
►SWEATYNG SICKNESSE◄.
MADE BY JHON CAIUS
DOCTOUR IN PHISICKE.
UERY NECESSARY FOR EUERYE PERSONNE, AND MUCHE
REQUISITE TO BE HAD IN THE HANDES OF AL
SORTES, FOR THEIR BETTER INSTRUCTION,
PREPARACION AND DEFENCE, AGAINST
THE SOUBDEIN COMYNG, AND FEARFUL
ASSAULTING OF THE SAME
DISEASE.
1552.
TO THE RIGHTE HONOURABLE
WILLIAM EARLE OF PENBROKE,
LORDE HARBERT OF CARDIFE, KNIGHT OF THE
HONOURABLE ORDRE OF THE GARTER, AND
PRESIDENT OF THE KYNGES HIGHNES
COUNSEILL IN THE MARCHES
OF WALES:
►JHON CAIUS◄
WISHETH HELTH AND HONOUR,
In the fereful tyme of the sweate (ryghte honourable) many resorted
vnto me for counseil, among whōe some beinge my frendes & aquaintance,
desired me to write vnto them some litle counseil howe to gouerne
themselues therin: saiyng also that I should do a greate pleasure to
all my frendes and contrimen, if I would deuise at my laisure some
thīg, whiche from tyme to tyme might remaine, wherto men might in such
cases haue a recourse & present refuge at all nedes, as thē they had
none. At whose requeste, at that tyme I wrate diuerse counseiles so
shortly as I could for the present necessite, whiche they bothe vsed
and dyd geue abrode to many others, & further appoynted in my self to
fulfill (for so much as laye in me) the other parte of their honest
request for the time to come. The whiche the better to execute and
brynge to passe, I spared not to go to all those that sente for me,
bothe poore, and riche, day and night. And that not only to do thē that
ease that I could, & to instructe thē for their recouery: but to note
also throughly, the cases and circumstaunces of the disease in diuerse
persons, and to vnderstande the nature and causes of the same fully,
for so much as might be. Therefore as I noted, so I wrate as laisure
then serued, and finished one boke in Englishe, onely for Englishe mē
not lerned, one other in latine for men of lerninge more at large, and
generally for the help of thē which hereafter should haue nede, either
in this or other coūtreis, that they may lerne by our harmes. This I
had thoughte to haue set furth before christmas, & to haue geuē to your
lordshippe at new-yeres tide, but that diuerse other businesses letted
me. Neuertheles that which then coulde not be done cometh not now out
of season, although it be neuer so simple, so it may do ease
hereafter, which as I trust this shal, so for good wil
I geue and dedicate it vnto your good Lordshippe,
trustyng the same will take this with as good a
mind, as I geue it to your honour, whiche
our Lorde preserue and graunt long
to continue.
At London the first of Aprill.
1552.
THE
BOKE OF JHON CAIUS
AGAINST THE SWEATYNG SICKNES.
Man beyng borne not for his owne vse and cōmoditie alone, but also
for the commō benefite of many, (as reason wil and al good authoures
write) he whiche in this world is worthy to lyue, ought al wayes to
haue his hole minde and intente geuen to profite others. Whiche thynge
to shewe in effecte in my selfe, although by fortune some waies I haue
ben letted, yet by that whiche fortune cannot debarre some waies again
I haue declared. For after certein yeres beyng at cambrige, I of the
age of xx. yeres, partly for mine exercise and profe what I coulde do,
but chefely for certein of my very frēdes, dyd translate out of Latine
into Englishe certein workes, hauyng nothynge els so good to gratifie
theim w^t. Wherof one of _S. Chrysostome de modo orandi deum_, that
is, of y^e manner to praye to god, I sent to one my frende then beyng
in the courte. One other, a woorke of _Erasmus de vera theologia_,
the true and redy waye to reade the scripture, I dyd geue to Maister
Augustine Stiwarde Alderman of Norwiche, not in the ful as the authore
made it, but abbreuiate for his only purpose to whome I sent it, Leuyng
out many subtile thinges, made rather for great & learned diuines, thē
for others. The thirde was the paraphrase of the same Erasmus vpon the
Epistle of S. Jude, whiche I translated at the requeste of one other my
deare frende.
These I did in Englishe the rather because at that tyme men ware not
so geuen all to Englishe, but that they dyd fauoure & maȳteine good
learning conteined in tongues & sciences, and did also study and apply
diligently the same thē selues. Therfore I thought no hurte done. Sence
y^t tyme diuerse other thynges I haue written, but with entente neuer
more to write in the Englishe tongue, partly because the cōmoditie of
that which is so written, passeth not the compasse of Englande, but
remaineth enclosed within the seas, and partly because I thought that
labours so taken should be halfe loste among them whiche sette not by
learnyng. Thirdly for that I thought it beste to auoide the iudgement
of the multitude, from whome in maters of learnyng a man shalbe forced
to dissente, in disprouyng that whiche they most approue, & approuyng
that whiche they moste disalowe. Fourthly for that the common settyng
furthe and printīg of euery foolishe thyng in englishe, both of
phisicke vnperfectly, and other matters vndiscretly diminishe the grace
of thynges learned set furth in thesame. But chiefely, because I wolde
geue none example or comforte to my countrie men, (whō I wolde to be
now, as here tofore they haue bene, comparable in learnyng to men of
other countries) to stonde onely in the Englishe tongue, but to leaue
the simplicite of thesame, and to procede further in many and diuerse
knoweleges bothe in tongues and sciences at home and in vniuersities,
to the adournyng of the cōmon welthe, better seruice of their kyng, &
great pleasure and commodite of their owne selues, to what kinde of
life so euer they shold applie them. Therfore whatsoeuer sence that
tyme I minded to write, I wrate y^e same either in greke or latine.
As firste of all certein commentaries vpon certein bokes of William
framinghā, maister of art in Cambrige, a man of great witte, memorie,
diligence and learnyng, brought vp in thesame scholes in Englande that
I was, euer frō his beginnyng vntil his death. Of the which bokes,
ij. of _cōtinētia_ (or cōtinence) wer in prose, y^e reste in metre
or verse of diuerse kindes. One a comforte for a blinde mā, entitled
_ad Aemilianum cæcum consolatio_, one other _Ecpyrosis, seu incendiū
sodomorū_, the burnyng of Sodome. The thirde _Laurentius_, expressyng
the tormentes of Saincte Laurence. The fourthe, _Idololatria_,
Idolatrie, not after the trade and veine of scripture (wherein he
was also very well exercised) but conformable to scripture and after
the ciuile and humane learnyng, declaryng them to worshippe _Mars_,
that warre, or fight: _Venus_, that lyue incontinently: _Pluto_, that
folowe riches couetousely; and so forth through all vices vsed in his
time. The fineth boke _Arete_, vertue: the sixth, Epigrāmes, conteined
in two bokes, whiche by an epistle of his owne hand before y^e boke
yet remainyng, he dedicated vnto me, purposyng to haue done many more
prety thynges, but that cruell death preuēted, and toke him away wher
he and I was borne at Norwiche, in the yere of our Lord M.d.xxxvij.
the xxix. daie of September, beynge then of the age of xxv. yeres,
vij. Monethes, and vj. daies, a greate losse of so notable a yonge
man. These workes at his death he willed to comme to my handes, by
which occasion after I had viewed thē, and perceiued them ful of al
kyndes of learnyng, thinkyng thē no workes for all mē to vnderstande
with out helpe, but such as were wel sene in all sortes of authours: I
endeuoured my selfe partely for the helpe of others, & partly for mine
owne exercise, to declare vpon theim the profite of my studie in ciuile
and humane learnynge, and to haue before mine eyes as in a worke (which
was alwaies my delyght) how muche I had profited in the same. Thys so
done, I ioyned euery of my commentaries to euery of hys saied bokes,
faier written by Nicolas Pergate puple to the saied Maister Framyngham,
myndyng after the iudgement of learned men had in thesame, to haue set
theim furthe in prynte, if it had ben so thought good to theim. For
whyche cause, at my departynge into Italie, I put an Epistle before
theym dedicatorye to the right Reuerend father in God Thomas Thirlbye,
now Bishoppe of Norwiche, because thesame maister Framyngham loued
hym aboue others. He after my departure deliuered the bokes to the
reuerende father in god Jhō Skippe, late bishop of Hereforde, then to
D. Thirtle, tutor to the sayd maister framynhā, frō him to syr Richard
Morisine, now ambassadoure for y^e kinges maiestie with thēperour, then
to D. Tailour Deane of Lincolne, and syr Thomas Smithe, secretarie
after to y^e kynges Maiestie, all great learned men. Frō these to
others they wente, among whome the bokes died, (as I suppose,) or els
be closely kept, that after my death they may be setfurthe in the names
of them which now haue thē, as their workes. Howe soeuer it be, wel I
knowe that at my returne out of Italie (after vj. yeres continuance
ther) into Englād, I coulde neuer vnderstand wher they wer, although I
bothe diligently and desirousely sought thē. After these I translated
out of Greke into Latine a litle boke of _Nicephorus_, declarynge howe
a man maye in praiynge confesse hym selfe, which after I dyd geue
vnto Jhō Grome bacheler in arte, a yong man in yeres, but in witte
& learnyng for his tyme, of great expectatiō. That done I beganne a
chronicle of the citie of Norwiche, of the beginninge therof & thinges
done ther frō time to time. The matere wherof yet rude and vndigested
lyeth by me, which at laisure I minde to polishe, and to make an
end of that I haue begunne. And to be shorte, in phisicke diuerse
thynges I haue made & settefurth in print bothe in Greke and Latine,
not mindyng to do other wise, as I haue before said, al my life: For
which cause al these thinges I haue rehersed, els superfluous in this
place. Yet see, meaning now to counseill a litle agaynst the sweatyng
sickenes for helpe also of others, notwithstandyng my former purpose,
two thynges compell me, in writynge therof, to returne agayne to
Englishe, Necessite of the matter, & good wyl to my countrie, frendes,
& acquaintance, whiche here to haue required me, to whome I thinke my
selfe borne.
Necessite, for that this disease is almoste peculiar vnto vs Englishe
men, and not common to all men, folowyng vs, as the shadowe the body,
in all countries, albeit not at al times. Therfore compelled I am to
vse this our Englishe tongue as best to be vnderstande, and moste
nedeful to whome it most foloweth, most behoueth to haue spedy remedie,
and often tymes leaste nyghe to places of succource and comforte at
lerned mennes handes: and leaste nedefull to be setfurthe in other
tongues to be vnderstand generally of all persons, whome it either
haunteth not at all, or els very seldome, as ones in an age. Thinkynge
it also better to write this in Englishe after mine own meanyng,
then to haue it translated out of my Latine by other after their
misunderstandyng.
Good wyll to my countrie frendes and acquaintance, seynge them wyth
out defence yelde vnto it, and it ferefully to inuade thē, furiousely
handle them, spedily oppresse them, vnmercyfully choke them, and that
in no small numbers, and such persons so notably noble in birthe,
goodly conditions, graue sobrietie, singular wisedōe, and great
learnynge, as Henry Duke of Suffolke, and the lorde Charles his
brother, as fewe hath bene sene lyke of their age: an heuy & pitifull
thyng to here or see. So that if by onely learned men in phisicke &
not this waye also it should be holpen, it were nedeful almost halfe
so many learned men to be redy in euery toune and citie, as their
should be sweatynge sicke folkes. Yet this notwithstandynge, I wyll
euery man not to refuse the counseill of the present or nighe physicen
learned, who maie, accordyng to the place, persone, cause, & other
circūstances, geue more particular counseil at nede, but in any wise
exhorte him to seke it with all diligence. To this enterprise also
amonge so many learned men, not a litle stirreth me the gentilnes and
good willes of al sortes of men, which I haue well proued heretofore by
my other former bokes. Mindynge therefore with as good a will to geue
my counseil in this, and trusting for no lesse gentlenes in the same, I
wyll plainly and in English for their better vnderstandynge to whome I
write, firste declare the beginnynge, name, nature, and signes of the
sweatynge sickenes. Next, the causes of the same. And thirdly, how to
preserue men frō it, and remedy them whē they haue it.
_The beginnyng of the disease._—In the yere of our Lorde God
M.CCCC.lxxxv. shortly after the vij. daye of august, at whiche tyme
kynge Henry the seuenth arriued at Milford in walles, out of Fraunce,
and in the firste yere of his reigne, ther chaunced a disease among
the people, lastyng the reste of that monethe & all september, which
for the soubdeine sharpenes and vnwont cruelnes passed the pestilence.
For this commonly geueth iij. or iiij. often vij. sumtyme ix. as that
firste at Athenes whiche _Thucidides_ describeth in his seconde boke,
sumtyme xj. and sumtyme xiiij. dayes respecte, to whome it vexeth.
But that immediatly killed some in opening theire windowes, some in
plaieng with children in their strete dores, some in one hour, many in
two it destroyed, & at the longest, to thē that merilye dined, it gaue
a sorowful Supper. As it founde them so it toke them, some in sleape
some in wake, some in mirthe some in care, some fasting & some ful,
some busy and some idle, and in one house sometyme three sometime fiue,
sometyme seuen sometyme eyght, sometyme more some tyme all, of the
whyche, if the haulfe in euerye Towne escaped, it was thoughte great
fauour. How, or wyth what maner it toke them, with what grieffe, and
accidentes it helde theym, herafter thē I wil declare, whē I shal come
to shewe the signes therof. In the mene space, know that this disease
(because it most did stand in sweating from the beginning vntil the
endyng) was called here, the Sweating sickenesse: and because it firste
beganne in Englande, it was named in other countries, the englishe
sweate. Yet some coniecture that it, or the like, hath bene before
seene among the Grekes in the siege of Troie. In thēperor Octauius
warres at _Cantabria_, called nowe Biscaie, in Hispaine: and in the
Turkes, at the Rhodes. How true that is, let the aucthours loke: how
true thys is, the best of our Chronicles shewith, & of the late begonne
disease the freshe memorie yet confirmeth. But if the name wer now to
be geuen, and at my libertie to make the same: I would of the maner and
space of the disease (by cause the same is no sweat only, as herafter
I will declare, & in the spirites) make the name _Ephemera_, which is
to sai, a feuer of one natural dai. A feuer, for the feruor or burning,
drieth & sweating feure like. Of one naturall day, for that it lasteth
but the time of xxiiij. houres. And for a distinction from the commune
_Ephemera_, that Galene writeth of, comming both of other causes,
and wyth vnlike paines, I wold putte to it either Englishe, for that
it followeth somoche English menne, to whō it is almoste proper, and
also began here: or els pestilent, for that it cōmeth by infection &
putrefaction, otherwise then doth the other _Ephemera_. Whiche thing I
suppose may the better be done, because I se straunge and no english
names both in Latine and Greke by commune vsage taken for Englishe.
As in Latin, Feure, Quotidiā, Tertian, Quartane, Aier, Infection,
Pestilence, Uomite, Person, Reines, Ueines, Peines, Chamere, Numbre,
&c. a litle altered by the commune pronunciation. In Greke, Pleuresie,
Ischiada, Hydrops, Apostema, Phlegma, and Chole: called by the vulgare
pronunciatiō, Schiatica, Dropsie, Impostume, Phleume, & Choler: Gyne
also, and Boutyre, Sciourel, Mouse, Rophe, Phrase, Paraphrase, & cephe,
wherof cometh Chaucers couercephe, in the romant of the Rose, writtē
and pronoūced comōly, kerchief in y^e south, & courchief in the north.
Thereof euery head or principall thing, is comonlye called cephe,
pronoūced & writtē, chief. Uery many other there be in our commune
tongue, whiche here to rehearse were to long. These for an example
shortelye I haue here noted. But for the name of this disease it maketh
now no matter, the name of Sweat beyng cōmōly vsed. Let vs therfore
returne to the thing, which as occasiō & cause serued, came againe in
the M.D.vi. the xxii. yeare of the said Kyng Henry the seuenth. Aftre
that, in the yeare M.D.xvii. the ix. yeare of Kyng Henry the viii,
and endured from July, vnto y^e middest of Decēbre. The iiii tyme, in
the yeare M.D.xxviii. the xx. yeare of thesaied Kyng, beginning in
thende of May, & continuing June and July. The fifth tyme of this
fearful _Ephemera_ of Englande, and pestilent sweat, is this in the
yeare M.D.LI. of oure Lorde GOD, and the fifth yeare of oure Souereigne
Lorde king Edwarde the sixth, beginning at Shrewesbury in the middest
of April, proceadinge with greate mortalitie to Ludlowe, Prestene, and
other places in Wales, then to Westchestre, Couentre, Drenfoorde, and
other tounes in the Southe, and suche as were in and aboute the way
to London, whether it came notablie the seuenth of July, and there
continuing sore, with the losse of vii. C. lxi. from the ix. day vntil
the xvi. daye, besides those that died in the vii. and viii. dayes, of
whō no registre was kept, frō that it abated vntil the xxx. day of the
same, with the losse of C. xlii. more. Then ceassing there, it wente
from thence throughe al the east partes of England into the Northe
vntill the ende of Auguste, at whiche tyme it diminished, and in the
ende of Septembre fully ceassed.
This disease is not a Sweat onely, (as it is thought & called) but a
feuer, as I saied, in the spirites by putrefaction venemous, with a
fight, trauaile, and laboure of nature againste the infection receyued
in the spirites, whervpon by chaunce foloweth a Sweate, or issueth an
humour compelled by nature, as also chanceth in other sicknesses whiche
consiste in humours, when they be in their state, and at the worste
in certein dayes iudicial, aswel by vomites, bledinges, & fluxes, as
by sweates. That this is true, the self sweates do shewe. For as in
vtter businesses, bodies yt sore do labour, by trauail of the same are
forced to sweat, so in inner diseases, the bodies traueiled & labored
by thē, are moued to the like. In which labors, if nature be strōg &
able to thrust out the poisō by sweat (not otherwise letted) ye persō
escapeth: if not, it dieth. That it is a feuer, thus I haue partly
declared, and more wil streight by the notes of the disease, vnder
one shewing also by thesame notes, signes, and short tariance of the
same, that it consisteth in the spirites. First by the peine in the
backe, or shoulder, peine in the extreme partes, as arme, or legge,
with a flusshing, or wind, as it semeth to certeine of the pacientes,
flieng in the same. Secondly by the grief in the liuer and the nigh
stomacke. Thirdely, by the peine in the head, & madnes of the same.
Fourthly by the passion of the hart. For the flusshing or wynde comming
in the vtter and extreame partes, is nothing els but the spirites of
those same gathered together, at the first entring of the euell aire,
agaynste the infection therof, and flyeng thesame from place to place,
for theire owne sauegarde. But at the last infected, they make a
grief where thei be forced, whiche cōmonly is in tharme or legge (the
fartheste partes of theire refuge) the backe or shulder: trieng ther
first a brūt as good souldiers, before they wil let their enemye come
further into theire dominion. The other grefes be therefore in thother
partes aforsaid & sorer, because the spirites be there most plētuous
as in their founteines, whether alwaies thinfection desireth to go.
For frō the liuer, the nigh stomack, braine, and harte, come all the
iij. sortes, and kyndes of spirites, the gouernoures of oure bodies,
as firste spronge there. But from the hart, the liuish spirites. In
putrifieng wherof by the euel aier in bodies fit for it, the harte is
oppressed. Wherupon also foloweth a marueilous heauinesse, (the fifthe
token of this disease,) and a desire to sleape, neuer contented, the
senses in al partes beynge as they were bounde or closed vp, the partes
therfore left heuy, vnliuishe, and dulle. Laste foloweth the shorte
abidinge, a certeine Token of the disease to be in the spirites, as wel
may be proued by the _Ephemera_ that Galene writethe of, whiche because
it consistethe in the Spirites, lasteth but one natural day. For as
fire in hardes or straw, is sone in flambe & sone oute, euen so heate
in the spirites, either by simple distemperature, or by infection and
putrefaction therin conceyued, is sone in flambe & sone out, and soner
for the vehemencye or greatnes of the same, whiche without lingering,
consumeth sone the light matter, contrary to al other diseases restyng
in humoures, wherin a fire ones kindeled, is not so sone put out, no
more then is the same in moiste woode, or fat Sea coles, as well by
the particular Example of the pestilence, (of al others most lyke
vnto this) may be declared, whyche by that it stādeth in euel humors,
tarieth as I said, sometyme, from iiij. vii. ix. & xj. vntill xiiij.
dayes, differentlie from this, by reason therof, albeit by infection
most lyke to this same. Thus vnder one laboure shortelie I haue
declared—both what this disease is, wherein it consisteth, howe and
with what accidentes it grieueth and is differente from the Pestilence,
and the propre signes, and tokens of the same, without the whiche,
if any do sweate, I take theym not to Sweate by this Sickenesse, but
rather by feare, heate of the yeare, many clothes, greate exercise,
affection, excesse in diete, or at the worst, by a smal cause of
infection, and less disposition of the bodi to this sicknes. So that,
insomoche as the body was nat al voide of matter, sweate it did when
infection came: but in that the mattere was not greate, the same coulde
neyther be perilous nor paineful as in others, in whom was greater
cause.
_The causes._—Hetherto I haue shewed the beginning, name, nature, &
signes of this disease: nowe I will declare the causes, which be ij.:
infectiō, & impure spirites in bodies corrupt by repletiō. Infection,
by thaire receiuing euel qualities, distēpring not only y^e hete, but
the hole substāce therof, in putrifieng thesame, and that generally ij.
waies. By the time of the yere vnnatural, & by the nature & site of the
soile & region—wherunto maye be put the particular accidentes of this
same. By the time of the yeare vnnaturall, as if winter be hot & drie,
somer hot and moist: (a fit time for sweates) the spring colde and
drye, the fall hot & moist. To this mai be ioyned the euel disposition
by constellation, whiche hath a great power & dominion in al erthly
thinges. By the site & nature of the soile & regiō, many wayes. First
& specially by euel mistes & exhalatiōs drawen out of the grounde
by the sūne in the heate of the yeare, as chanced amōg the Grekes in
the siege of Troy, wherby died firste dogges & mules, after, mē in
great numbre: & here also in Englād in this m.d.lj. yeare, the cause
of this pestilent sweate, but of dyuers nature. Whiche miste in the
countrie wher it began, was sene flie frō toune to toune, with suche
a stincke in morninges & eueninges, that mē could scarcely abide it.
Thē by dampes out of the earth, as out of Galenes _Barathrū_, or the
poetes _auernū_, or _aornū_, the dampes wherof be such, that thei kil
y^e birdes fliēg ouer them. Of like dampes, I heard in the north coūtry
in cole pits, wherby the laboring mē be straight killed, except before
the houre of coming therof (which thei know by y^e flame of their
cādle) thei auoid the groūd. Thirdly by putrefactiō or rot in groūdes
aftre great flouddes, in carions, & in dead men. After great fluddes,
as happened in y^e time of Gallien thēperor at rome, in _Achaia_ &
_Libia_, wher the seas sodeinly did ouerflow y^e cities nigh to y^t
same. And in the xi. yeare of _Pelagius_, when al the flouddes throughe
al Italye didde rage, but chieflye _Tibris_ at Rome, whiche in many
places was as highe as the walles of the citie.
In cariōs or dead bodies, as fortuned here in Englande vpon the sea
banckes in the tyme of King Alured, or Alfrede; (as some Chroniclers
write) but in the time of king Ethelred after Sabellicus, by occasion
of drowned Locustes cast vp by the Sea, which by a wynde were driuen
oute of Fraunce thether. This locust is a flie in bignes of a mānes
thumbe, in colour broune, in shape somewhat like a greshopper, hauing
vi. fiete, so many wynges, two tiethe, & an hedde like a horse, and
therfore called in Italy _Caualleto_, where ouer y^e city of _Padoa_,
in the yeare m.d.xiij. (as I remembre,) I, with manye more did see a
swarme of theim, whose passage ouer the citie, did laste two hours,
in breadth inestimable to euery man there. Here by example to note
infection by deadde menne in Warres, either in rotting aboue the
ground, as chaunced in Athenes by theim of Ethiopia, or els in beyng
buried ouerly as happened at Bulloigne, in the yere M.D.xlv. the
yeare aftre king Henrye theight had conquered the same, or by long
continuance of an hoste in one place, it is more playne by dayly
experience, then it neadeth to be shewed. Therefore I wil now go to
the fourth especial cause of infectiō, the pent aier, breaking out of
the ground in yearthquakes, as chaunced at Uenice in the first yeare
of _Andrea Dandulo_, then Duke, the xxiiij. day of Januarye, and xx.
hour after their computacion. By which infectiō mani died, & many were
borne before their time. The v. cause is close, & vnstirred aire, &
therfore putrified or corrupt, out of old welles, holes in y^e groūd
made for grain, wherof many I did se in & about _Pesaro_ in Italy, by
openīg thē aftre a great space, as both those coūtrimē do cōfesse, &
also by exāple is declared, for y^e manye in openīg thē vnwarely be
killed. Out of caues, & tōbes also, as chaūced first in the country of
_Babilonia_, proceding aftre into Grece, and so to Rome, by occasion
that y^e souldiers of themperour _Marcus Antoninus_, vpon hope of
money, brake up a golden coffine of _Auidius Cassius_, spiēg a litle
hole therin, in the tēple of _Apollo_ in _Seleucia_, as _Ammianus
Marcellinus_ writeth. To these mai be ioyned the particular causes of
infectiō, which I cal the accidentes of the place, augmenting thesame.
As nigh to dwelling places, merishe & muddy groundes, puddles or
donghilles, sinkes or canales, easing places or carions, deadde ditches
or rotten groundes, close aier in houses or ualleis, with suche like.
Thus muche for the firste cause.
The second cause of this Englyshe _Ephemera_, I said were thimpure
spirites in bodies corupt by repletiō. Repletion I cal here, abundance
of humores euel & maliciouse, from long time by litle & litle gathered
by euel diete, remaining in the bodye, coming either by to moche
meate, or by euel meate in qualitie, as infected frutes, meates of
euel iuse or nutrimēt; or both ioyntly. To such spirites when the aire
infectiue cometh cōsonant, thē be thei distēpered, corrupted, sore
handled; & oppressed, thē nature is forced, & the disease engendred.
But while I doe declare these impure spirites to be one cause, I must
remoue your myndes frō spirites to humours, for that the spirites
be fedde of the finest partes therof, & aftre bringe you againe to
spirites where I toke you. And forsomuche as I haue not yet forgotten
to whome I write, in this declaration I will leaue a part al learned
& subtil reasōs, as here void & vnmiete, & only vse suche as be most
euident to whom I write, & easiest to be vnderstanden of the same:
and at ones therwith shew also why it haūteth vs English men more thē
other nations. Therfore I passe ouer the vngētle sauoure or smell of
the sweate, grosenes, colour, and other qualities of the same, the
quantitie, the daunger in stopping, the maner in coming furthe redily,
or hardly, hot or cold, the notes in the excremētes, the state longer
or sorer, with suche others, which mai be tokēs of corrupt humours &
spirites, & onli wil stād upō iii. reasōs declaring y^e same swet by
gret repletiō to be in vs not otherwise for al the euel aire apt to
this disease, more thē other natiōs. For as hereaftre I wil shew, &
Galē cōfirmeth, our bodies cā not suffre any thīg or hurt by corrupt
& infectiue causes, except ther be in thē a certeī mater prepared apt
& like to receiue it, els if one were sick, al shuld be sick, if in
this countri, in al coūtres wher the infection came, which thīg we
se doth not chāce. For touching the first reasō, we se this sweting
sicknes or pestilēt _Ephemera_, to be oft in Englād, but neuer entreth
Scotland, (except the borders) albeit thei both be ioinctly within
the cōpas of on sea. The same begining here, hath assailed Brabant &
the costes nigh to it, but neuer, passed Germany, where ones it was
in like faciō as here, with great mortalitie, in the yere m.d.xxix.
Cause wherof none other there is naturall, then the euell diet of
these thre contries whiche destroy more meates and drynckes withoute
al ordre, cōueniēt time, reasō, or necessite, thē either Scotlande,
or all other countries vnder the sunne, to the greate annoiance of
their owne bodies and wittes, hinderance of theim which have nede,
and great dearth and scarcitie in their cōmon welthes. Wherfore if
_Esculapius_ the inuentour of phisike, y^e sauer of mē from death, and
restorer to life, should returne again īto this world, he could not
saue these sortes of men, hauing so moche sweatyng stuffe, so many
euill humoures laid vp in store, frō this displeasante, feareful, &
pestilent disease: except thei would learne a new lesson, & folowe a
new trade. For other wise, neither the auoidyng of this countrie (the
seconde reason) nor fleyng into others, (a commune refuge in other
diseases) wyll preserue vs Englishe men, as in this laste sweate is by
experience well proued in Cales, Antwerpe, and other places of Brabant,
wher only our contrimen ware sicke, & none others, except one or ii.
others of thenglishe diete, which is also to be noted. The cause hereof
natural is onely this, that they caried ouer with thē, & by lyke diete
ther incresed that whiche was the cause of their disease. Wherefore
lette vs asserteine our selues, that in what soeuer contrie lyke cause
and matter is, there commyng like aier and cause efficient, wil make
lyke effecte and disease in persōs of agreable complexions, age, and
diete, if the tyme also doe serue to these same, and in none others.
These I putte, for that the tyme of the yere hote, makethe moche to
the malice of the disease, in openynge the pores of the body, lettynge
in the euill aier, resoluynge the humores and makynge them flowable,
and disposing therfore the spirites accordyngly, besyde, that (as I
shewed in the first cause of this pestilente sweate) it stirreth and
draweth out of the erthe euill exhalations and mistes, to thinfection
of the aier and displeasure of vs. Diet I put, for that they of the
contrarie diete be not troubled with it at all. Age and complexion,
for this, that although it spareth nō age of bothe kyndes, nor no
complexion but some it touchethe, yet for the most parte (wherby rules
and reasones be alwayes to be made) it vexed theim of the middle age,
beste luste, and theim not moch vnder that, and of complexions hote &
moiste, as fitteste by their naughty & moche subtiltie of blode to fede
the spirites: or nigh and lyke to thesame in some one of the qualities,
as cholerike in hete, phlegmatike in moister, excepte thother their
qualities, as drinesse in cholerike, & cold in phlegmatike, by great
dominion ouer thother, did lette. For the clene contrarie complexiōs
to the infected aier, alwaies remaine helthful, saulfe and better then
tofore, the corrupte and infected aier notwithstandyng. Therfore cold
and drie persones either it touched not at all, or very fewe, and that
wyth no danger: such I say as beside their complexion, (whiche is so
harde to finde in any man exacte and simple, as exacte helthes) were
annoied with some corrupt humoures & spirites, and therfore mete by so
moch to receiue it, & that by good reasō. For nothing can naturally
haue power to do ought against any thing, excepte the same haue in
it selfe a disposicion by like qualities to receiue it. As the cause
in the fote cānot trouble the flanke and leue the knee (the mean
betwixte) except there were a greater consent and likenes of nature in
sufferance (whiche we call _sympathian_) betwixte those then thother.
Nor fire refusynge stones, canne burne hardes, strawe, stickes and
charcole, oile, waxe, fatte, and seacole, except these same first of
al wer apte, and by conuenient qualities disposed to be enflamed and
burned. Nor any man goeth about to burne water, because the qualities
thereof be contrary, and the body vndisposed to the like of fire. By
whiche reason it may also be perceiued, that y^e venemouse qualitie
of this corrupt aire is hote and moiste, for it redily enfectethe the
lyke complexions, and those nigh vnto theim, and the contrary not
at all, or hardly: & easely doth putrify, as doe the Southe wyndes.
Therfore next vnto those colde and drie cōplexions, olde men escaped
free, as like to theim by age: and children, as voide of replecion
consumed by their great hete, and therefore alwaies redy to eate. But
in this disease the subtile humour euill and abundant in full bodies
fedyng y^e spirites, is more to be noted then the humour complexional,
whiche notwithstanding, as an helper or hinderer to y^e same, is not
to be neglected. For els it should be in all contries and persones
indifferently, wher all complexiones be. The thirde and laste reason
is, y^t they which had thys sweat sore with perille or death, were
either men of welthe, ease, & welfare, or of the poorer sorte such as
wer idle persones, good ale drinkers, and Tauerne haunters. For these,
by y^e great welfare of the one sorte, and large drinkyng of thother,
heped vp in their bodies moche euill matter: by their ease and idlenes,
coulde not waste and consume it. A comfirmacion of this is, that the
laborouse and thinne dieted people, either had it not, because they dyd
eate but litle to make the matter: or with no greate grefe and danger,
because they laboured out moche thereof. Wherefore vpon small cause,
necessarily must folowe a smal effecte. All these reasones go to this
ende, that persones of all contries of moderate and good diete, escape
thys Englishe _Ephemera_, and those be onely vexed therewith, whiche
be of immoderate and euill diete. But why? for the euill humores and
corrupte aier alone? No, for thē the pestilence and not the swet should
rise. For what then? For y^e impure spirites corrupte in theim selues
and by the infectiue aier. Why so? for that of impure and corrupte
humores, whether thei be blode or others, can rise none other then
impure spirites. For euery thynge is suche as that whereof it commeth.
Now, that of the beste and fineste of the blode, yea in corrupte bodies
(whyche beste is nought) these spirites be ingendred and fedde, I
before expressed. Therfor who wyl haue them pure and cleane, and him
selfe free from sweat, muste kepe a pure and cleane diete, and then he
shalbe sure.