THE FRENCH POX.
One great epidemic disease of the first Tudor reigns, which brought
consternation and distress to multitudes, makes hardly any appearance in
the English records of the time, and no appearance at all in the writings
of the English profession. Long after, in 1576, William Clowes, surgeon to
St Bartholomew’s Hospital, first broke the professional silence about
_lues venerea_ in England, and in his larger work of 1579 he gave a number
of startling facts and figures of its then prevalence in London. But the
great epidemic outburst of that disease in Europe began in the last years
of the 15th century; its ravages on the epidemic scale are supposed to
have lasted for twenty or thirty years from 1494; and its subsequent
prevalence is assumed, not without reason, to have been of a milder type
and within narrower limits. We hear of it, in England, from the political
side, at the time when popular arguments were wanted against the Romish
mass-priests and against the monasteries and the orders of friars. In the
practical reasoning of Englishmen the scandalous lives of priests, monks
and friars made the strongest argument for the policy which the king had
adopted towards Rome; and it so happened in those very years that a
scandalous life was betrayed, and made odious in more than sentiment, by
bearing an outward and visible sign. The epidemic of _morbus Gallicus_
arose at an unfortunate time for the pretensions of Rome, or, perhaps, it
was itself part of the march of events. In Simon Fish’s _Supplication of
Beggars_, which was compiled in 1524 and was read to Henry VIII. shortly
after, the weightiest plea is the charge of scandalous conduct resting
upon the priests. In the inquisitions which preceded the suppression of
the monasteries, the same plea is, justly or unjustly, brought to the
front in the case of one abbey after another. So close did the association
of a scandalous vice and its attendant disease become with the priesthood
that James I., writing long after concerning the sentiments of his mother,
Mary the queen of Scots, represents her as forbidding the archbishop “to
use the spittle” in his own baptism, for the reason that she would not
have “a pokie priest to spet in her child’s mouth[826].” These, says king
James, were “her owne very words;” at all events, “a pocky priest” may be
accepted as a phrase of the time. The fact that the epidemic of syphilis
in England was used to discredit Romish priests is one of the few
indications that we have of its existence in this country. Wide and deep
as the commotion must have been which it caused, it found hardly any more
permanent expression than the private talk of the men of those days. It
was otherwise on the Continent. There, indeed, a copious literature sprang
up, of which some thirty works remain, from the essay of Conrad Schellig
of Heidelberg, printed without date or place, but ascribed to the year
1494 or 1495, down to the elaborate survey of the disease by Nicolas Massa
of Venice in 1532. The single work extant in England from that, the
earliest and greatest, period of the disease, is a poor piece of
manuscript in the Sloane collection, translated from some foreign author,
and entitled, “The tretese of the pokkis: and the cure by the nobull
counsell of parris[827].” One of its cases is that of a man, aged forty,
with two broad and deep, corroding and painful sores on his leg; another
is of a bishop of Toledo, who had “pustules” and nocturnal pains “as if
the bones would part from the flesh.” The vague meaning of the term pox is
shown in one phrase, “paynes, viz. aches and pokkis.”
It was nothing unusual abroad to give cases, and to authenticate them with
the names of the sufferers. Thus Peter Pinctor, physician to the pope
Alexander Borgia, in a notorious but exceedingly scarce work published in
1500, enters fully into the truly piteous case of the cardinal bishop of
Segovia, major-domo of the Vatican, “qui hunc morbum patiebatur cum
terribilibus et fortissimis doloribus, qui die ac nocte, praecipue in
lecto, quiescere nec dormire poterat,” as well as into the case of Peter
Borgia, the pope’s nephew, “in quo virulentia materiae pustularum capitis
corrosionem in pellicaneo [pericranio] et in craneo capitis sui manifeste
fecit[828].”
Contrasted with the copious writing and recording of cases abroad, the
English silence is remarkable. The origin of our first printed book on the
subject is characteristic. A literary hack of the time, one Paynel, a
canon of Merton Abbey, had translated, among other things, the _Regimen
Salernitanum_, a popular guide to health several hundred years old. Going
one day into the city to see the printer about a new edition, he was asked
by the latter to translate the essay on the cure of the French pox by
means of guaiacum (or the West-Indian wood) “written by that great clerke
of Almayne, Ulrich Hütten, knyght.” For, said the printer, “almost into
every part of this realme this most foul and peynfull disease is crept,
and many soore infected therewith.” Ulrich von Hütten’s personal
experience of the guaiacum cure was accordingly translated from the Latin,
in 1533, and proved a good venture for the printer, several editions
having been called for[829]. The translation has no notes, and throws no
light on English experience. It is not until 1579, when Clowes published
his essay on the morbus Gallicus, that we obtain any light from the
faculty upon the prevalence of the malady in England. Meanwhile it remains
for us to collect what scraps of evidence may exist, in one place or
another, of this country’s share in the original epidemic invasion during
the last years of the 15th century.
Earliest Notices of the French Pox in Scotland and England.
The first authentic news of it comes from the Council Register of the
borough of Aberdeen under the date 21st April, 1497[830]:--
“The said day, it was statut and ordanit be the alderman and consale
for the eschevin of the infirmitey cumm out of Franche and strang
partis, that all licht weman be chargit and ordaint to decist fra thar
vicis and syne of venerie, and all thair buthis and houssis skalit,
and thai to pas and wirk for thar sustentacioun, under the payne of
ane key of het yrne one thar chekis, and banysene of the towne.”
The next news of it is also from Scotland, from the minutes of the town
council of Edinburgh, wherein is entered a proclamation of James IV.,
dated 22 September, 1497[831]:--
“It is our Soverane Lords Will and the Command of the Lordis of his
Counsale send to the Provest and Baillies within this bur{t} that this
Proclamation followand be put till execution for the eschewing of the
greit appearand danger of the Infection of his Leiges fra this
contagious sickness callit the _Grandgor_ and the greit uther Skayth
that may occur to his Leiges and Inhabitans within this bur{t}; that
is to say, we charge straitly and commands be the Authority above
writtin, that all manner of personis being within the freedom of this
bur{t} quilks are infectit, or hes been infectit, uncurit, with this
said contagious plage callit the _Grandgor_, devoyd, red and pass
fur{t} of this Town, and compeir upon the sandis of Leith at ten hours
before none, and their sall thai have and fynd Botis reddie in the
havin ordanit to them be the Officeris of this bur{t}, reddely
furneist with victuals, to have thame to the _Inche_ [the island of
Inch Keith in the Firth of Forth], and thair to remane quhill God
proviyd for thair Health: And that all uther personis the quilks taks
upon thame to hale the said contagious infirmitie and taks the cure
thairof, that they devoyd and pass with thame, sua that nane of thair
personis quhilks taks sic cure upon thame use the samyn cure within
this bur{t} in pns nor peirt any manner of way. And wha sa be is
foundin infectit and not passand to the _Inche_, as said is, be
_Mononday_ at the Sone ganging to, and in lykways the said personis
that takis the sd Cure of sanitie upon thame gif they will use the
samyn, thai and ilk ane of thame salle be brynt on the cheik with the
marking Irne that thai may be kennit in tym to cum, and thairafter gif
any of tham remains, that thai sall be banist but favors[832].”
Sir James Simpson, with his indefatigable research over antiquarian
points[833], has brought together evidence of payments from the king’s
purse to persons infected with the “Grantgore” at Dalry, Ayrshire, in
September, 1497, at Linlithgow on 2nd October, 1497, at Stirling on the
21st February, 1498 (“at the tounne end of Strivelin to the seke folk in
the grantgore”), at Glasgow (also “at the tounn end”) on 22nd February,
1498, and again at Linlithgow, 11th April, 1498. He quotes also from a
poem of William Dunbar, written soon after 1500, on the conduct of the
Queen’s men on Fastern’s e’en, the terms “pockis” and “Spanyie pockis.”
From Sir David Lyndsay’s poems, of much later date, and from other
references, he makes out that “grandgore” or “glengore” was the usual name
in Scotland down to the 17th century. Grandgore means _à la grande gorre_,
which is the same as _à la grande mode_. This name was given for a time in
France to the great disease of the day, but it was soon superseded by
_vérole_. Scotland is the only country where “grandgore” became
established as the common name of the pox.
Before leaving the Scots evidence, two other ordinances may be quoted
from the town council records of Aberdeen. In a long list of regulations
under date the 8th October, 1507, there occur these two[834]:--
“Item, that diligent inquisitioun be takin of all infect personis with
this strange seiknes of Nappillis, for the sauetie of the town; and
the personis beand infectit therwith be chargit to keip thame in ther
howssis and uther places, fra the haile folkis.”
“Item, that nayne infectit folkis with the seiknes of Napillis be
haldin at the common fleschouss, or with the fleschouris, baxteris,
brousteris, ladinaris, for sauete of the toun, and the personis
infectit sall keip thame quyat in thar housis, zhardis, or uther comat
placis, quhill thai be haill for the infectioun of the nichtbouris.”
“Sickness of Naples” is a reference to the well-known diffusion of the
disease all over Europe by the mercenaries of Charles VIII. of France,
dispersing after the Italian war and the occupation of Naples.
For England the first known mention of the pox is several years later than
the Scots references, although that proves nothing as to its actual
beginning in epidemic form. In the book of the Privy Purse Expenses of
Elizabeth of York, queen of Henry VII., there is an entry under the date
of March 15, 1503, of a sum of forty shillings paid on behalf of John
Pertriche “oon of the sonnes of mad Beale;” which sum appears to have been
what the youth cost her majesty for board, clothes, education, and
incidental expenses, during the year past. The various items making up the
sum of forty shillings are: his diets “for a year ending Christmas last
past,” a cloth gown, a fustian coat, shirts, shoes and hose, “item, for
his learning, 20_d._ item for a prymer and saulter 20_d._ And payed to a
surgeon which heled him of the Frenche pox 20_s._ Sm̅{a.} 40_s._” It will
be observed that the surgeon’s bill was as much as all his other expenses
for the year together[835].
The London chronicler of the time is alderman Robert Fabyan; but although
Fabyan, writing in the first years of the 16th century, uses the word
“pockys” to designate an illness of Edward IV. during a military
excursion to the Scots Marches in 1463, or long before the epidemic
invasion from the south of Europe, he says nothing of that great event
itself. There is a record, however, of one significant measure taken in
the year 1506, the suppression of the stews on the Bankside in Southwark.
These resorts were of ancient date, and for long paid toll to the bishop
of Winchester. In 1506 there were eighteen of them in a row along the
Surrey side of the river, a little above London Bridge; they were wooden
erections, each with a stair down to the water, and each with its river
front painted with a sign like a tavern, such as the Boar’s Head, the
Cross Keys, the Gun, the Castle, the Crane, the Cardinal’s Hat, the Bell,
the Swan, etc. These houses, says Stow, were inhibited in the year 1506,
and the doors closed up; but it was not long ere they were set open again,
the number being at the same time restricted to twelve[836]. They had been
suppressed once before, at the earnest demand of the citizens, in the
reign of Henry IV., and it appears from a sermon of Latimer’s that they
were again suppressed about the year 1546. Thus Shakespeare had several
precedents in London for the situation which he creates in a foreign city,
in _Measure for Measure_.
The next reference that I find to it is an oblique one, by Bernard André
in his _Annals of Henry VII._ On the occasion of mentioning the sweating
sickness of 1508, he says the latter disease occurred first in England
about four-and-twenty years before, and that it was “followed by a far
more detestable malady, to be abhorred as much as leprosy, a wasting pox
which still vexes many eminent men” (“multos adhuc vexat egregios alioquin
viros tabifica lues[837]”). Bernard André’s association of the pox with
the sweating sickness, as of one new disease following another, is in the
same manner as the reference to it by Erasmus. In a letter from Basle, in
August, 1525, to Schiedlowitz, chancellor of Poland, he discourses upon
the sickliness of seasons and the mutations of diseases[838]: Until
thirty years ago England was unacquainted with the sweat, nor did that
malady go beyond the bounds of the island. In their own experience they
had seen mutations:--“nunc pestilentiae, nunc anginae, nunc tusses; sed
morbum morbus, velut ansam ansa trahit; nec facilé cedunt ubi semel
incubuere.” He then proceeds:
“But if one were to seek among the diseases of the body for that which
ought to be awarded the first place, it seems to my judgment that it
is due to that evil, of uncertain origin, which has now been for so
many years raging with impunity in all countries of the world, but has
not yet found a definite name. Most persons call it the French pox
(_Poscas Galleas_), some the Spanish. What sickness has ever traversed
every part of Europe, Africa and Asia with equal speed? What clings
more tenaciously, what repels more vigorously the art and care of
physicians? What passes more easily by contagion to another? What
brings more cruel tortures? Vitiligo and lichens are deformities of
the skin, but they are curable. This lues, however, is a foul, cruel,
contagious disease, dangerous to life, apt to remain in the system and
to break out anew not otherwise than the gout.”
Whether it was from some mistaken theory of contagiousness or for other
reasons, a fellow of Merton was ordered to leave in 1511 because he had
the French pox[839]. In the English history nothing appears above the
surface until the beginning of the movement against the papal supremacy
and in favour of Reformation. That was a time of public accusations of all
kinds, and among the rest of opprobrious references to the pox. In Simon
Fish’s _Supplication of Beggars_[840], which was written in 1524, certain
priests are thus hyperbolically spoken of:
“These be they that have made an hundred thousande ydel hores in your
realme, which wold have gotten theyr lyvinge honestly in the swete of
their faces had not there superfluous riches illected them to uncleane
lust and ydelnesse. These be they that corrupte the hole generation of
mankynd in your realme, that catch the pockes of one woman and beare
it to another, ye some one of them will boste amonge his felowes that
he hath medled with an hundreth wymen.”
In the year 1529, there is a more painful and most undignified charge. In
the Articles of Arraignment of Wolsey in the House of Peers, the sixth
charge is:
“The same Lord Cardinall, knowing himself to have the foul and
contagious disease of the great pox, broken out upon him in divers
places of his body, came daily to your Grace [the King], rowning in
your ear, and blowing upon your most noble Grace with his perilous and
infective breath, to the marvellous danger of your Highness, if God of
his infinite goodness had not better provided for your Highness. And
when he was once healed of them, he made your Grace believe that his
disease was an impostume in his head, and of none other thing[841].”
Among the glimpses of contemporary manners in Bullein’s _Dialogue of the
Fever Pestilence_ (1564), there is one referring to the pox; Roger, the
groom, soliloquizes thus: “her first husband was prentice with James
Elles, and of him learned to play at the short-knife and the horn thimble.
But these dog-tricks will bring one to the poxe, the gallows, or to the
devil[842].” Bullein, in his more systematic handbook to health, promises
to treat of the pox fully, but omits to do so. In one place he refers to
the wounds of a young man who fell into a deep coal-pit at Newcastle as
having been healed “by an auncient practisour called Mighel, a Frencheman,
whiche also is cunnynge to helpe his owne countrey disease that now is to
commonly knowen here in England, the more to be lamented: But yet dayly
increased, whereof I entinde to speake in the place of the Poxe.” But the
only other reference is (in the section on the “Use of Sicke Men and
Medicine,”) to certain drugs “which have vertue to cleanse scabbes, iche,
pox. I saie the pox, as by experience we se there is no better remedy than
sweatyng and the drinkyng of guaiacum,” etc[843].
A good instance of the oblique mode of reference to the malady occurs in
another dialogue by a surgeon, Thomas Gale[844]. The pupil who is being
instructed tables the subject of “the morbus,” which he farther speaks of
as “a great scabbe;” whereupon Gale pointedly takes him to task for the
affectation of “the morbus;” any disease, he says, is the morbus; what you
mean is the morbus Gallicus.
About the same date, 1563, a casual reference is made to the wide
prevalence of the pox by John Jones in his _Dyall of Agues_. In
illustration of the fact that various countries originate different forms
of pestilence, as the Egyptians the leprosy, the Attics the joint-ache,
the Arabians swellings of the throat and flanks, and the English the
sweating sickness, he instances farther, “the Neapolitans, or rather the
besiegers of Naples, with the pockes, spread hence to far abroad through
all the parts of Europe, no kingdom that I have been in free--the more
pity[845].”
English Writings on the Pox in the 16th Century.
The first original English writer on the pox was William Clowes. In his
treatise[846] of 1579, dedicated to the Society of the Barbers and
Chirurgions, he says that he had been bold “three years since to offer
unto you a very small and imperfect treatise of mine touching the cure of
the disease called in Latine _Morbus Gallicus_, the which, forasmuch as it
was at that time rather wrested from me by the importunitye of some of my
frendes, upon certain occasions then moving, than willingly of my selfe
published, it passed out of my handes so sodeinly and with so small
overlooking or correction,” that he now in 1579 reissues it in a revised
and corrected form.
“The Morbus Gallicus or Morbus Neapolitanus, but more properly Lues
Venera, that is the pestilent infection of filthy lust, and termed for
the most part in English the French Pocks, a sicknes very lothsome,
odious, troublesome and daungerous, which spreadeth itself throughout
all England and overfloweth as I thinke the whole world.” He then
characterises the vice “that is the original cause of this infection,
that breedeth it, that nurseth it, that disperseth it.” In the cure
of the malady he has had some reasonable experience, and no small
practice for many years. According to the following passage, St
Bartholomew’s Hospital, to which Clowes was surgeon, was three parts
occupied by patients suffering from this malady:--
“It is wonderfull to consider how huge multitudes there be of such as
be infected with it, and that dayly increase, to the great daunger of
the common wealth, and the stayne of the whole nation: the cause
whereof I see none so great as the licentious and beastly disorder of
a great number of rogues and vagabondes: The filthye lyfe of many lewd
and idell persons, both men and women, about the citye of London, and
the great number of lewd alehouses, which are the very nests and
harbourers of such filthy creatures; By meanes of which disordered
persons some other of better disposition are many tymes infected, and
many more lyke to be, except there be some speedy remedy provided for
the same. I may speake boldely, because I speake truely: and yet I
speake it with very griefe of hart. In the Hospitall of Saint
Bartholomew in London, there hath bene cured of this disease by me,
and three (3) others, within this fyve yeares, to the number of one
thousand and more. I speake nothing of Saint Thomas Hospital and other
howses about this Citye, wherein an infinite multitude are dayly in
cure.... For it hapneth in the house of Saint Bartholomew very seldome
but that among every twentye diseased persons that are taken in,
fiftene of them have the pocks.” Like the earlier writers on the
Continent he recognizes that the disease is communicated in more ways
than one; he speaks of “good poor people that be infected by unwary
eating or drinking or keeping company with those lewd beasts, and
which either for shame will not bewray it, or for lack of good
chirurgions know not how to remedy it, or for lack of ability are not
able otherwise to provide for the cure of it.”
In so far as Clowes follows his own experience, he is under no illusion as
to the nature and circumstances of the French pox. But he goes on to
append a pathology of the disease, which is taken from foreign writers and
reflects the bewilderment of the faculty over the constitutional effects
of the malady. As Erasmus said, in the letter quoted, it went all through
the body, “not otherwise than the gout.” When it was first observed, it
appeared to be constitutional from the outset. More particularly it
covered the skin with “pustules” or “whelks” as if it had been a primary
eruption like variola, to which it was compared; hence the names “great
pox” and “small pox.” It was not until long after that our present
pathology of primary, secondary and tertiary effects was worked out; in
the earliest writings the constitutional effects were referred to an
“inward cause,” as Clowes says, to some idiopathic corruption of the
humours having the liver for their place of elaboration, or _minera
morbi_. Thus the learned explanation of the malady, which Clowes adopts
from foreign writers more skilled than himself in such disquisitions, has
no organic unity with his own common-sense observations. In his _Proved
Practice_ he defers still farther to the academical view, as given in the
treatise of John Almenar, a Spanish physician[847].
Although Clowes, in 1579, testifies to the very wide prevalence of the
disease, to so great an extent, indeed, that it occupied the hospitals
more than all other diseases put together, yet there is reason to think
that it had by that time lost the terrible severity of its original
epidemic type. The usual statement is that the disease abated both in
extent and in intensity within twenty or thirty years of the Italian
outbreak among the soldiery in 1494-96. A contemporary and ally of Clowes,
John Read, of Gloucester, published in 1588 a volume of translations, from
the Latin manuscript of the English surgeon of the 14th century, John
Ardern, on the cure of fistulas, and from the treatise on wounds, etc. by
the Spanish surgeon Arcaeus (Antwerp, 1574)[848]. In the latter he finds
the following passage, which seems to describe the _morbus Gallicus_ on
its first appearance:--
“The French disease did bring with it a kind of universal skabbe,
oftentimes with ring wormes, with the foulness of all the body called
vitiligo and alopecia, running sores in the head called acores, and
werts of both sortes, and many times with flegmatic or melancholic
swellings or ulcers corrosive, filthie and cancrouse, and also running
over the body, together with putrifying of the bone, and many times
also accompanied with all kind of grief, with fevers, consumptions,
and with many other differences of diseases.”
Read’s own remarks draw an explicit contrast between the disease on its
first appearance and in his own later experience. Everyone knows now, he
says, how to treat the French pox, “the disease daylie dying and wearing
away by the exquisite cure thereof”--which may be taken to mean, at least,
a notable mitigation of the constitutional effects[849]. The treatment,
however, must have been much less effective then than now. Clowes speaks
of a class who “either for shame will not bewray it, or for lack of good
chirurgions know not how to remedy it, or for lack of ability are not able
otherwise to provide for the cure of it.” The expense of a cure would have
been considerable, to judge by the case given above from an account-book
of the year 1503. Unable to employ “good chirurgions,” the poorer class
would resort to quacks, of whose practice, in that and other diseases, we
have some glimpses both from Clowes in London and from Read in Gloucester
and Bristol. Of one irregular practitioner Clowes says, “He did compound
for fifteen pound to rid him within three fits of his ague, and to make
him as whole as a fish of all diseases.” There was still a lower order of
empirics, whom Clowes disdained to contend with:
“Yet I do not mean to speak of the old woman at Newington, beyond St
George’s Fields, unto whom the people do resort as unto an oracle;
neither will I speak of the woman on the Bankside, who is as cunning
as the horse at the Cross Keys; nor yet of the cunning woman in
Seacole Lane, who hath more skill in her cole-basket than judgment in
urine, or knowledge in physic or surgery”--nor of many others who are
compared to “moths in clothes,” to “canker,” and to “rust in iron.”
Read gives an account of a travelling mountebank, which is too graphic to
be omitted:
“In this year, 1587, there came a Fleming into the city of Glocester
named Woolfgange Frolicke, and there hanging forth his pictures, his
flags, his instruments, and his letters of mart with long lybells,
great tossells, broad scales closed in boxes, with such counterfeit
shows and knacks of knavery, cozening the people of their money,
without either learning or knowledge. And yet for money got him a
licence to practise at Bristow. But when he came to Gloceter, and
being called before some being in authority by myself and others, he
was not able to answer to any one point in chirurgerie; which being
perceived, and the man known, the matter was excused by way of
charity, to be good to straungers.”
One of the most systematic and detailed surgical treatises of the time,
John Banister’s book on the “general and particular curation of ulcers”
(1575), is significant for the indirect way in which it refers to the lues
venerea.
Thus at folio 25, “the malignant ulcer called cacoethes” is described
without anything said of a venereal origin, but the specific guaiacum
is given among the remedies. The same is the ease on the 31st and 32nd
leaves, which treat of “filthie and putrefied ulcers,” guaiacum being
again prescribed. At folio 51, on ulcers of the mouth, it is said, “If
it proceed a morbo venereo, then first begin with due purgation, and
prescribe the party a thin diet with the decoction of guaiacum, and
use ointments requisite for that disease, strengthening the inner
parts. Use twice a day a sublimated water, as is afore written, to
touch the ulcer with lint rolled therein:
Rec. Aqua Rosar.} an. two
& Plantag.} ounces,
Sublimati i dragme.
Boil them in a glass bottel till the sublimate be dissolved.”
On fol. 57, he describes “ulcers of the privie parts,” among which are
corroding ulcers, but without reference to the lues. It is in the
section headed, “To prepare the humours” (fol. 61) that the most
explicit reference occurs: “When the ulcers proceed through the French
pockes, a thinne diet must be used, with the decoction of guaiacum or
use universall unctions ex Hydrargyro[850].”
In 1596 there appeared Peter Lowe’s essay on _The Spanish Sickness_[851],
which is purely a product of experience abroad, his own or of others, and
is mainly doctrinal or theoretical. The other properly English works on
the subject are all subsequent to the Restoration, and do not come into
the period of this volume, nor, from an epidemiological point of view,
into this work at all.
The evidence as to the wide prevalence of the pox in high and low becomes
abundant in the writings and memorials of the reign of James I. The
effects of the disease, as they would have been commonly remarked at this
period, are summed up in a well-known passage in _Timon of Athens_. It
would serve no purpose to collect the numerous references from Puritan
sermons, moral and descriptive essays, plays, and letters of the time. An
anonymous work of the year 1652 actually couples “the plague and the pox,”
and shows “how to cure those which are infected with either of them[852].”
One more piece of evidence may be given for London in the year 1662, or
the beginning of the Restoration period,--a date which brings us down a
century and a half from the epidemic invasion with which we are more
immediately concerned; but the information for 1662 will serve to show how
the existence of the disease was still viewed _sub rosa_, and it may help
one to realize what its prevalence and its serious effects on the public
health must have been continuously in the generations before, and most of
all in the generation which experienced the full force of it as an
epidemic[853].
The London bills of mortality, setting forth the several causes of death,
were first printed in 1629. The entry of the French pox is in them from
the beginning, and the annual total of deaths set down to it is
considerable, approaching a hundred in the year. But according to Graunt,
who made the bills of mortality the subject of a critical study in
1662[854], they were defective or incorrect in their returns of deaths due
to the pox:--
“By the ordinary discourse of the world, it seems a great part of men
have, at one time or other, had some species of this disease ...
whereof many complained so fiercely, etc.” He then explains, with
reference to the deaths entered as due to it in the bills of
mortality: “All mentioned to die of the French pox were returned by
the clerks of St Giles’ and St Martin’s in the Fields only, in which
place I understand that most of the vilest and most miserable houses
of uncleanness were; from whence I concluded that only _hated_
persons, and such whose very noses were eaten off were reported by the
searchers to have died of this too frequent malady”--the rest having
been included under the head of consumption.
Origin of the Epidemic of 1494.
The French pox, as it was called in England (also the great pox and simply
the pox), or the Spanish pox, as it was called in France, or the sickness
of Naples, or the grandgore, is one of the epidemic diseases concerning
which it seems fitting to say something of the antecedents, in addition to
what has been said of its arrival as an epidemic in this country, and of
its prevalence therein. But this will have to be said very briefly, and
without entering upon the pathology or ultimate nature of the disease.
The numerous foreign writings upon it during the first years of its spread
over Europe are all singularly at a loss to account for its origin. One of
the earlier guesses was that it arose out of leprosy, as if a graft or
modification of that medieval disease, replacing it among the maladies of
the people. The occasion of that hypothesis seems to have been the lax
diagnosis of leprosy itself, a laxity which goes as far back as Bernard
Gordonio and Gilbert, if not farther back. Many things were called _lepra_
which were not elephantiasis Graecorum, and among those things the lues
venerea in the Middle Ages was undoubtedly included. At a time when true
leprosy was disappearing or had already disappeared from Europe, a new
form of disease, which came suddenly into universal notice although by no
means then first into existence, seemed to be the successor of leprosy,
evoked out of it, and even caught from the leprous by contagion. That is
the view of Manardus, in a passage quoted in the sequel,--that syphilis
began in certain most particular circumstances at Valencia, in Spain, the
source of all the subsequent contamination of Europe having been a certain
soldier of fortune who was _elephantiosus_ or leprous. In the infancy of a
science it is natural to assign to some such single and definite source a
new phenomenon which was really called forth by a concurrence of
causes[855].
Another guess of the same kind was the famous theory, which found a truly
learned defender in Astruc last century and has had supporters more
recently, that the lues venerea came from the New World with the returning
ships of Columbus. There never was any considerable body of facts,
consistent as regards times and places, in support of that theory; and, on
antecedent grounds, the objection to it was that it is as difficult, to
say the least, to conceive of the origin of such a disease among the
savages of Hispaniola as among the natives of Europe. “Here or nowhere is
America” is the proper retort to all such visionary theories put upon the
distant and the unknown. The American theory is now hopelessly dead; the
more that the New World became known, the less did syphilis appear to be
indigenous to it: indeed the disease followed the track of Europeans, and
those parts of the American continent, north and south of the Isthmus,
which were longest in being reached by the civilisation of the Old World,
were also longest in being reached by the lues venerea[856].
The name “sickness of Naples,” which occurs in the Aberdeen records as
early as 1507, indicates the common opinion of the laity as to the origin
and means of diffusion of the strange malady. In the passage above quoted
from Jones’s _Dyall of Agues_, it will be seen that he refers it to “the
besiegers of Naples.” The besiegers of Naples were the mercenaries of
Charles VIII. occupying it in the beginning of the year 1495, although
there was no real siege. The new disease was at the time, rightly or
wrongly, traced to them while they occupied Italy, and its diffusion over
Europe was justly traced to their dispersion to their several countries at
the end of the campaign. There is medical testimony that the malady
appeared in 1495 among the Venetian and Milanese troops which were banded
against Charles VIII. at the siege of Novara. Marcellus Cumanus, of
Venice, who was surgeon to the forces, thus speaks of the event, in
certain _Observationes de Lue Venerea_ which he wrote on the margin of
Argelata’s work on Surgery[857]:
“In Italy, in the year 1495, owing to celestial influences, I have
myself seen, and do testify that, while I was in the camp at Novara
with the troops of the Lords of Venice and of the Lords of Milan, many
knights and foot-soldiers suffered from an ebullition of the humours,
producing many pustules in the face and through the whole body; which
pustules commonly began under the prepuce or without the prepuce, like
a grain of millet-seed, or upon the glans, attended by considerable
itching. Sometimes a single pustule began like a small vesicle without
pain, but with itching. Being broken by rubbing, they ulcerated like a
corrosive _formica_, and a few days after, troubles began from pains
in the arms, legs and feet, with great pustules. All the skilled
physicians had difficulty in curing them.... Without medicines, the
pustules upon the body lasted a year or more, like a leprous variola.”
He then gives many other details of symptoms and treatment.
For the year after, 1496, two German writers, who were not surgeons but
occupied with affairs of state, Sebastian Brant (author of the _Ship of
Fools_) and Joseph Grünbeck, have described the disease, apparently in
connexion with the troops serving in Italy under Maximilian I. against the
invading army of Charles VIII. Thus, there is sufficient evidence that the
malady in its first two or three years of epidemic prevalence, was
associated with a state of war on Italian soil, in the persons of French
troops (and mercenaries of all nations), of Venetian and Milanese troops,
and of the German troops of the Emperor.
But the German writers are clear that the disease did not originate on
Italian soil, at the siege of Naples or elsewhere. Thus Brant in his poem
of 1496 assigns to it an origin in France, and a dispersion within a year
or two over all Europe[858]:
“Pestiferum in Lygures transvexit Francia morbum,
Quem _mala de Franzos_ Romula lingua vocat.
Hic Latium atque Italos invasit, ab Alpibus extra
Serpens, Germanos Istricolasque premit;
Grassatur mediis jam Thracibus atque Bohemis
Et morbi genus id Sarmata quisque timet.
Nec satis extremo tutantur in orbe Britanni
Quos refluum cingit succiduumque fretum.
Quin etiam fama est, Aphros penetrasse Getasque
Vigue sua utrumque depopulare polum.”
Grünbeck, who wrote briefly on the disease in 1496, returned to the
subject at much greater length in 1503, when he was secretary to the
Emperor Maximilian, his later treatise, _De Mentulagra, alias Morbo
Gallico_, being, indeed, among the best that the epidemic called forth.
Hensler doubts whether Grünbeck was himself in Italy, so as to observe the
ravages of the disease among the troops of the Emperor (including
Venetians and Milanese) at the sieges of Pisa and Leghorn in the summer of
1496, and among the opposing troops of Charles VIII. Be that as it may,
the following is from Grünbeck’s description[859]:
“O! quid unquam terribilius et abominabilius humanis sensibus
occurrit! Difficile est dictu, creditu fere impossibile, quanta
foeditatis, putredinis et sordium colluvione, quantisque dolorum
anxietatibus nonnullorum militum corpora involuerit. Aliqui etiam a
vertice ad usque genua quodam horrido, squalido, continuo, foedo et
nigro _scabiei_ genere, nulla parte faciei, (solis oculis exemtis),
nec colli, cervicis, pectoris vel pubis immuni relicta, percussi, ita
sordidi abominabilesque effecti sunt, qui ab omnibus commilitonibus
derelicti, ac etiam in plano et nudo campo sub dio emarescentes, nihil
magis quam _mortem_ expetiverunt.... At his omnibus nihil vel parum
proficientibus, et morbo ipso non contento hoc hominum numero, ut eos
solos tantis passionum cruciatibus afficeret, venenum contagiosum in
multos spectantes Italos, Teutones, Helveticos, Vindelicos, Rhaetos,
Noricos, Batavos, Morinos, Anglicos, Hispanos, et alios quos belli
occasio in copias conscripserat, transfudit.... Interea temporis, per
clandestinam Gallorum abitionem, exercitus fuerunt
dissoluti,”--Grünbeck himself proceeding with some merchants to
Hungary and thence to Poland[860].
How came this terrible infection to be among the troops of all nations on
Italian soil in the years 1494, 1495 and 1496? Sebastian Brant clearly
states that the French brought it with them, and that it spread first over
Liguria. Grünbeck says that it was seen _primo super Insubriam_, or the
Milanese, on which it rested like a dense cloud, until it was scattered by
the winds over the whole of Liguria, and so found its way into the armies
in Italy. Beniveni, of Florence, who wrote in 1498, says that it came to
Italy from Spain, and from Italy was carried to France. Thus we have a
theory of a Spanish origin, of a French origin, and perhaps also of a
native Italian origin--all agreeing that Italy during the state of war
from 1494 to 1496 was the theatre of its first ravages on the great scale,
and the source from which the disease was brought to all the countries of
Europe by the returning soldiery.
The solution of the difficulty is to be looked for in the inquiries after
still earlier notices of the _lues venerea_. It is beyond the purpose of
this book to enter upon that large subject, farther than has already been
done with the object of proving the generic use of the medieval term
_lepra_. It is now accepted by competent students of medical history that
the same disease, with all varieties or modes of primary, secondary or
tertiary, existed in antiquity and in the Middle Ages, although
secondaries and tertiaries may not have been ascribed to their primary
source. But what specially concerns us here is the question whether the
malady was anywhere beginning to be more noticeable in the years
immediately preceding the great military explosion on Italian soil. On
that point there is some evidence from more than one source, that the
malady was sufficiently prevalent in the south of France to be a subject
of remark previous to the French expedition to Italy, that it had found
its way to the ports of Spain (Barcelona and Valencia), and that the
troops of Charles VIII., if not also that youthful monarch himself,
carried it across the Alps into Liguria, and so gave it that start on
Italian soil which the state of war for the next two years raised to the
power of a virulent and diffusive epidemic[861].
The best piece of evidence of its prevalence in Languedoc and its
spreading thence to the adjoining coast of Spain is found in a letter of
the 18th April, 1494 (four months before Charles VIII. entered Italy),
written by Nicolas Scyllatius just after arriving at Barcelona[862]. The
province of Narbonne, he says, a part of France adjoining Spain, now sent
forth another vice. Women felt it most; it infected neighbours by contact;
it has lately invaded Spain, hitherto untouched by it. “I was horrified,”
he continues, “on first landing at Barcelona; for I met with many of the
inhabitants who were seized by that contagion. On my inquiring of the
physicians (for with these I held converse during nearly all that
journey), they assured me that the new _lues_ had been derived from
truculent France.” In keeping with this entirely credible testimony is the
statement of Torella, a native of Valencia, who wrote one of the earlier
essays on the new disease (“De Pudendagra”) in November, 1497. The disease
first broke out, he says, in Auvergne in 1493 (incepit, ut aiunt, haec
maligna aegritudo anno 1493 in Alervnia), and so came in the way of
contagion to Spain and the Islands [to Sardinia, where he was bishop, and
to Corsica], and to Italy, creeping in the end over all Europe, and, if
one may so speak, over the whole globe[863].
Torella thus confirms the Barcelona traveller so far as regards
importations from the south of France to the neighbouring ports, the
former writer naming Auvergne as the endemic seat of the malady, whereas
the latter gives Narbonne. Another piece of evidence, that the pox was in
Valencia, as well as in Barcelona, before the expedition of Charles VIII.,
is found in a story told by Manardus of Ferrara (1500), a story which is
wholly improbable so far as concerns the origin of syphilis, at a stated
time and place, out of a case of leprosy, but is entirely credible so far
as regards the grossness of its circumstances:
“Coepisse hunc morbum per id tempus, dicunt, quo Carolus, Francorum
rex, expeditionem Italicam parabat: coepisse, autem, in Valentia,
Hispaniae Taraconensis insigni civitate, a nobili quodam scorto, cujus
noctem elephantiosus quidam, ex equestri ordine miles, quinquaginta
aureis emit; et cum ad mulieris concubitum frequens juventus
accurreret, intra paucos dies supra quadringentos infectos; e quorum
numero nonnulli, Carolum Italiam petentem sequuti, praeter alia quae
adhuc vigent importata mala et hoc addiderunt[864].”
The evidence that follows is not so explicit, but it has strong
probability. The progress of Charles VIII. from France to Italy in the
autumn of 1494 has been told by Philip de Comines in his _Cronique du Roy
Charles VIII._, first printed at Paris in 1528, nineteen years after the
author’s death. De Comines accompanied his master, the French king, as far
as Asti; he was then sent on a mission to Venice, and rejoined the king at
Florence. But De Comines, who was no gossip, omits one interesting fact
near the beginning of the journey to Italy, which has been preserved for
us in a contemporary work (1503) called _La Cronique Martiniane_, or
chronicle of all the popes down to Alexander Borgia lately deceased[865].
This chronicle relates as follows concerning Charles VIII.’s journey:--“Il
se arresta premierement aucuns jours a Lyon, doubteux s’il passeroit les
mons, car il y estoit detenu pour les delices et plaisances de la cité et
pour les folles amours de aucunes gorrieres lyonnoises. Mais quant l’air
devint pestilent, il s’en tyra à Vienne, citè de Daulphinè.” His great
army had already passed the Alps and arrived in the country of Asti: it is
said to have consisted, in round numbers, of 3600 men-at-arms, 6000
bowmen, 8000 pikemen, and 8000 with arquebuses, halberds, two-handed
swords, or other arms, together with a heavy artillery train of 8000
horses. A large part of this force were Swiss; another part were
Gascons[866].
Charles VIII. left Vienne on the 23rd of August, and crossed Mont Genèvre
on the 2nd September, whence he proceeded direct by Susa and Turin,
joining his army at Asti on September 9. At Asti, says De Comines, he had
an illness, which caused that minister to delay setting out on his mission
to Venice for a few days. The original printed text of De Comines’
_Chronique_ (Paris, 1528), says that the author remained at Asti a few
days longer “because the king was ill of the smallpox (_de la petite
verolle_) and in peril of death, for that the fever was mixed therewith;
but it lasted only six or seven days, and I set out upon my way.” The next
edition has no change but “in great peril of death” (_en grant peril de
mort_), instead of merely “in peril.” Now, where did this diagnosis of
_petite verolle_ come from? Nothing is said of smallpox being prevalent at
the time among the troops or along their route. The name _petite verolle_
itself did not exist in 1494; it came into existence with _grosse
verolle_, having being made necessary by the latter; and the first that we
hear of _grosse verolle_ is when the Italian campaign was over and the pox
was raging in Paris, the Parlement of Paris, on the 6th of March, 1497,
having made an ordinance against a certain contagious malady “nommée la
_grosse verole_,” which had been in the kingdom and in the city of Paris
since two years. Probably Comines deliberately wrote “_petite verolle_” in
his manuscript, having composed the latter subsequent to 1498, or at a
time when the terms _verolle_, or _grosse verolle_, and _petite verolle_,
were passing current and were known in their respective senses. The causes
or circumstances of the king’s malady at Asti are not enlarged upon by De
Comines, farther than that he makes a somewhat disjointed remark, that all
the Italian wines of that year were sour and that the season was hot,
which would have had as little to do with the one kind of pox as with the
other. Nor is anything said of smallpox spreading among those near the
king[867].
The whole sequence of events, from the “folles amours” of Lyons to the
sharp sickness at Asti, has suggested to historians, who have no medical
theory to advocate, that it was not really _petite vérole_ that the king
suffered from, but _grosse vérole_. Martin says that Charles VIII.
recommenced at Asti his Lyons follies and that he became violently sick,
“of the smallpox, says one, or, perhaps, of a new malady which began to
show itself in Europe,” meaning syphilis. To show that such infection was
already possible, he quotes an ordinance of the provost of Paris April 15,
1488, enjoining “the leprous” to leave the capital. This is very like
Edward III.’s order to the London “lepers” a century and a half earlier,
in which the reasons given (the frequenting of stews, the pollution of
their breath, &c.) point somewhat clearly to the nature of their
“leprosy.” An order for the banishment of “lepers” from Paris in 1488 must
have been occasioned by some unusual risk of contamination, just as the
London order of 1346 would have been. It is in that sense that the French
historian regards it; the ordinance, he says, “concernait probablement
déjà les syphilitiques confondus avec les lépreux[868].”
De Comines, who is the authority for the diagnosis of smallpox, had
inserted the word _petite_ before _verolle_ for reasons best known to
himself. I shall show in the next chapter, upon smallpox and measles in
England, that the ambiguous teaching of the faculty as to the nature and
affinities of the pox proper within the first years of its epidemic
appearance gave a ready opportunity of calling the _grosse vérole_ by the
name of _petite vérole_ in circumstances where it was polite, or prudent,
or convenient so to do. The only importance of a correct diagnosis of the
king’s malady is that the case of one would have been the case of many.
The indications all point to a somewhat unusual prevalence of _lues
venerea_ previous to the autumn of 1494, in the luxurious provinces of
southern France as well as in the capital. Beyond doubt, the malady had
already spread by contagion to the great Spanish ports nearest the Gulf of
Lyons. The expedition of Charles VIII. passed through that region on its
route over the Alps. According to Sebastian Brant, it was the French who
brought the disease into Liguria, and, according to Grünbeck, it issued,
_Gallico tractu, ab occidentali sinu_, gathered like a dense cloud _super
Insubriam_ (the Milanese), and was thence dispersed, as if by the winds,
over the whole province of Liguria.
But for the circumstances of the military expedition of 1494, and the
state of war in Italy for two years after, it is conceivable that the
unusual prevalence in France of a very ancient malady would have had
little interest for Europe at large, although the cities on the nearest
coast of Spain appear to have already shared the infection. That unusual
prevalence in the south of France has in it nothing of mystery; the period
was the end of the Middle Ages, distinguished by a revival of learning, of
trade and commerce,--a revival of most things except morals. But, assuming
that there was such unusual prevalence above the ancient and medieval
level, it may still seem unaccountable that a great European epidemic, of
a most disastrous and fatal type, should have been engendered therefrom.
There are, however, many parallel cases, on a minor scale from modern
times, of a peculiar severity of type, of inveteracy, and of
communicability by unusual ways, having been cultivated from commonplace
beginnings, among unsophisticated communities about the Baltic and
Adriatic, the people being without resident doctors and unfamiliar with
such a disease and its risks. These have been collected and analyzed by
Hirsch, whose conclusion is that “the mode of origin, and the character of
these endemics of syphilis, appear to me to furnish the key to an
understanding of the remarkable episode of the disease in the 15th
century,--an episode which entirely resembles them as regards its type,
and differs from them only as regards extent[869].”
Referring the reader for farther particulars to the work quoted, I shall
leave the antecedents of the epidemic of pox in the end of the 15th
century to be judged of according to the probabilities thus far stated.