Part 1

THE SWEATING SICKNESS IN ENGLAND.

BY FRANCIS C. WEBB, M.D., F.S.A.,

PHYSICIAN TO THE MARGARET STREET DISPENSARY FOR CONSUMPTION, ETC.

Reprinted from THE SANITARY REVIEW AND JOURNAL OF PUBLIC HEALTH, for July 1857.

LONDON: PRINTED BY T. RICHARDS, 37 GREAT QUEEN STREET.

M.DCCC.LVII.

THE SWEATING SICKNESS IN ENGLAND.

There are few subjects which exhibit more points of interest to the epidemiologist and medical historian, than that series of epidemics, of the fifteenth and sixteenth centuries, which went by the name of English Sweating Sicknesses. We are chiefly indebted to a learned German professor, Dr. Hecker, and to his translator Dr. Babington, for the acquaintance we in the present day have with these events; and we would here observe that, in whatever light we may view Professor Hecker’s deductions and theories, there can be but one opinion as to his faithfulness and diligence as a medical historian. As his work, however, is published by a society, and is therefore of somewhat limited circulation, we have thought a short historical sketch, embodying, and in some instances slightly amplifying, Professor Hecker’s researches on the subject of the ravages of the disease in England, might not be uninteresting to our readers; who will then be in a position to follow us on some future occasion in a discussion of the nature of a malady, which five times within a hundred years devastated our island, and once, and once only, spread its ravages amongst the Teutonic races on the continent of Europe.

We may preface our historical resumé by noticing that the disease, in the form in which it then presented itself, was unknown before the year 1485, and that it has never reappeared since its last outbreak, in 1551. Its novelty gave it one of its appellations; it was called by the common people the “new acquaintance”; whilst its limitation to British soil gained for it on the continent the names of the King of England’s Sickness, the English Sweating Sickness, Sudor Britannicus.

Characterised by the suddenness of its seizure, by its short and defined course of twenty-four hours, by its great fatality, by the profuse and fetid perspiration in which the patient was bathed, and from which the disease derived its most common name, by the frequency with which it attacked the same individual several times within a short period, or perhaps, we should more correctly say, by its relapsing tendency, by its selection of strong and robust men in the prime of life as its victims, by the equality with which it invaded the palaces of the rich and the cottages of the poor, we cannot wonder at its producing a marked effect on the national mind, and being long held in remembrance. Even as late as the days of the great rebellion, occasional references may be found to it in popular sermons and treatises; whereas we might have supposed its memory would have been effaced by the frequent outbreaks of plague which had intervened. The sweating sickness has come down to us as the remarkable epidemic of a remarkable age. In an era distinguished by the emancipation of thought, by the spread of letters, by the splendours of a social and religious reformation, death appeared in a new garb, and in unwonted tones asserted his dominion.

It has been a frequent observation, that epidemic diseases have had their origin in camps; and it is perfectly needless here to remind the reader of instances. Such will present themselves to every student of history. The English sweat is stated by Caius to have first appeared in the army of the Earl of Richmond, shortly after their landing; and doubtless they were predisposed by the circumstances of the expedition, by their confinement during their voyage in close, dirty ships, and especially by their previous habits (for they are described by Philip de Comines as recruited from the loosest and most profligate class in Normandy), to suffer from any disease. But it is perfectly clear that, granting the distemper to have first appeared in the invading force, it was not long limited to it. It must quickly have spread amongst the population; as we learn from the Historia Croylandensis that, a few days after the landing of the earl, Lord Stanley excused himself from joining Richard III, by alleging that he was attacked by the new disease, he being then at his seat in Lancashire. A mere excuse, no doubt; but such as would not have been urged had not the progress of the epidemic rendered it possibly true. We likewise have proof that a fatal disease reigned at the time in York, although we lack information as to its precise nature. On the 16th of August, 1485, it was determined in the town council to send a messenger to King Richard with the offer of a force “for subduing of his enemies lately arrived in the partes of Wales”. “Also it was determyned that all such aldermen and other of the counsail as was sojournyng, for the plage that reigneth, without the citie, should be sent for to give their best advises in such things as concerned the wele and savegard of the said citie, and all other inhabitants of the same” (Drake’s Eboracum, b. i, p. 120). It is moreover remarkable, that, although the circumstances of the march of Richmond’s army, and of its final struggle and victory, have come down to us with tolerable minuteness, no mention, as far as we are aware, is made by the chroniclers of any pestilence tracking their course. The battle was fought on the 22nd of August; and before the end of that month the epidemic appeared at Oxford, a town through which the army is not reported to have passed, and which, devoted to learning, may be supposed to have suffered less from military occupation than other places.

Whilst, however, the assertion that the malady commenced amongst the soldiery of the Earl of Richmond rests principally on the authority of Dr. Caius, who wrote his account three-quarters of a century after the event, yet, in the lack of other evidence, we believe we must receive it. Caius was evidently aware of the interest and importance of his subject, and would scarcely have hazarded such a statement had he not been assured of its truth. On the other hand, it is a groundless assumption to claim for the sweating sickness a foreign origin. No such disease had appeared in Normandy, Brittany, or elsewhere on the continent; and there is no reason for supposing other causes present to produce the first epidemic of 1485, than those which resulted in the outbreak of 1551, when it commenced at Shrewsbury, and importation from abroad was simply out of the question.

It was on the evening of the 1st of August, 1485, that the sails of Henry’s little fleet were furled in the harbour of Milford Haven. They had accomplished the passage from Harfleur in seven days. The soldiers landed with promptitude, in the neighbourhood of the village of Dale, on the western side of the bay, and there encamped for the night. At sunrise the next morning they removed to Haverfordwest, a march of something less than ten miles. Here, reinforced by the men of Pembrokeshire, they proceeded to Cardigan, where they were joined by forces under Richard Griffith and John Morgan. Crossing the Severn, they entered Shrewsbury, where they were again augmented by a goodly band of Welshmen under Rice ap Thomas. The night before they entered the town, the army was encamped on Forton or Fortune Heath (to the west of Shrewsbury, near the river). They then marched to Newport, and the earl pitched his camp on a little hill adjoining, where he stopped a night. Here he was joined by the power of the young Earl of Shrewsbury, under George Talbot. He next halted at the town of Stafford, and thence marched on Lichfield, where his army bivouacked outside the walls. From this place they removed to Tamworth, their last halting-place before the great battle which decided the fate of England, and placed her crown on Henry’s brow.

Three weeks were occupied in the march, and their road lay chiefly through a mountainous country, not, as far as we are aware, more likely to give origin to malarious influence than other parts of the island. Yet the halt of the army at Shrewsbury, the place at which the last outbreak of the “gret dethe and hasty” undoubtedly commenced; the passage of the river Severn, which in the year 1483, overflowing its banks, had inundated the whole of the surrounding country; and the encampment on the low marshy ground outside the walls of the city of Lichfield, are especially worthy of remark.

Fortune and victory sat on Henry’s helm. Disbanding his army, he advanced by easy stages to London, greeted as he went by the acclamations of the populace. All things seemed to promise a

“harvest of perpetual peace, By this one bloody trial of sharp war”,

when “sodenly”, to use the graphic words of an old chronicler, “a newe kynde of sicknes came through the whole region, which was so sore, so peynfull, and sharp, that the lyke was neuer harde of to any mannes remembraunce before that tyme: For sodenly a dedly and burnyng sweate inuaded their bodyes and vexed their bloud with a most ardent heat, infested the stomack and the head greuously: by the tormentyng and vexacion of which sicknes, men were so sore handled and so painfully pangued that if they were layed in their bed, beyng not hable to suffre the importunate heat, they cast away the shetes and all the clothes liyng on the bed. If they were in their apparell and vestures, they would put of all their garmentes, euen to their shirtes. Other were so drye that they dranke the colde water to quenche their importune heate and insaciable thirst. Other that could or at the least woulde abyde the heate and styntche (for in dede the sweate had a great and a strong sauoure) caused clothes to be layed upon theim asmuch as they coulde beare, to dryue oute the sweate if it might be. All in maner assone as the sweate toke them, or within a short space after, yelded vp their ghost. So that of all them that sickened ther was not one emongest an hundreth that escaped.”

Consternation and affright reigned everywhere. “Some”, says Caius, were “immediatly killed in opening theire windowes, some in plaieng with children in their strete dores, some in one hour, many in two it destroyed, and at the longest, to them 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 and some ful, some busy and some idle, and in one house sometyme three sometyme fiue, sometyme seuen sometyme eyght, sometyme more sometyme all, of the whyche, if the haulfe in euerye Towne escaped, it was thoughte great fauour.” Numbers were seen rushing from their houses in a state of nudity, hoping to cool their burning torments. The general joy which the victory of Bosworth had inspired was changed into despondence and evil augury. With grim humour, the people exclaimed that the new reign must needs be one of labour, since it began with a sickness of sweat.

It was about the end of the month of August that the disease appeared at Oxford. Here, according to Anthony-à-Wood, it raged with violence for the space of six weeks, killing most of the students, or banishing them from the university. It would seem that it did not reach London until some days later. Several chroniclers state that the 21st of September was the date of its outbreak; yet, as Hecker suggests, it is probable that cases may have occurred before that time, although its virulence was not until then manifested. However this may be, it continued in the city until towards the end of October, but had sufficiently subsided to permit the coronation of Henry on the 30th of that month. During the time that the epidemic was at its height, the mortality was prodigious. On the 11th of October, the mayor, Thomas Hill, died; he was succeeded by Sir William Stokker, knight, who before eight days was also carried off. It was also fatal to several of the aldermen. Grafton says six; Stow enumerates four. The higher classes could claim no immunity from the common enemy. Many of the aristocracy, both secular and clerical, fell its victims. It is noticeable that this was the case in each succeeding epidemic.

From London and the eastern part of the kingdom, it spread to the western and southern districts, and did not wholly disappear until December. In this time it had invaded almost the whole kingdom--every town and village, says Grafton--but without crossing the Scottish border, or being conveyed to the sister kingdom of Ireland.

From the Croyland Annals, we learn that it carried off the excellent Abbot Lambert Fossdyke, after eighteen hours sickness. This is stated to have taken place on the 14th of November, although the writer in another place alters the date to the 14th of October; and we think the latter more probable, as, whilst we do not deny that the disease lingered, as Wood says, in some places until December, we should be inclined to suppose that the fury of the epidemic had in November and December partially subsided, and deaths consequently become rare. To this circumstance we are inclined in some degree to attribute the efficacy ascribed to the Anglican mode of treatment. But on this point we hope to touch hereafter.

Facts are wanting to give a minute topographical or numerical account of its ravages. Baines says that it prevailed in Lancashire; but he furnishes no particulars. We can only infer from general testimony the universality and magnitude of the evil. Its disappearance may have been consummated by a violent storm of wind, which prevailed on the 1st of the following January. For twenty-one years from this date, we read no more in English annals of a return of the “fereful tyme of the sweate.”

The kingdom was only recovering from the tremendous invasion of plague, which in 1499 carried off, it is said, in London alone 30,000 persons, and cessation from civil contention and foreign warfare promised increase and prosperity to her population, when, in the summer of 1506, the old enemy again started into existence. This epidemic appears generally to have been of a milder type, and deaths were in most places unfrequent. We know little as to its origin or spread. As in the close of the first epidemic, the lessened mortality was ascribed rather to the effects of treatment than to any temporary diminution in the virulence of the disorder. One record has come down to us, which is sufficient of itself to show that, under favouring circumstances, the “new acquaintance” of 1506 was capable of being developed in all its ancient severity. In the Annals of Chester (Harl. MSS. No. 2125), we are told that in 1506 there died in one day, of the sweating sickness, three score and eleven householders, of whom only four or five were women. Another account says, that in three days there died ninety-one householders, four only being widows. It matters not which is correct; either is sufficient to prove that no real change had occurred in the nature of the sweating sickness. It lingered until the autumn, and then disappeared. Lysons and Hemmingways make the outbreak at Chester to have occurred in 1507; but Pennant, more correctly, as it appears to us, follows the date of 1506, given in the Chester Annals.

Eleven years elapsed, the crafty Richmond slept the sleep of death in the “sumpteous and solempne chapell which he had caused to be buylded”, and his son reigned in his stead. Unexpectedly, in July 1517, the pestilence again raised its head. We believe that this sweat was the most fatal in its results of any of the series. The dismal scenes of the first epidemic were repeated. It “killed some within three hours”, say the chroniclers, “some within two hours, some merry at dinner and dead at supper.” “In some one town half the people died, in some other town the third part, the sweat was so fervent and the infection so great.”

We learn incidentally, from a letter written by the Cardinal du Bellay, who was ambassador from France to Henry VIII, and himself a sufferer in the next epidemic of 1528, that it was estimated that 10,000 persons died in ten or twelve days. The context warrants us in the supposition that reference is made here to the metropolis alone. Taking this as a mere approximation, we shall at once see, by comparing it with the ravages of other epidemics, how frightful the mortality whilst it lasted was. In 1854, the total number of deaths from cholera and diarrhœa in London, extending over a period of six months, with a population of 2,517,048, was 14,806. The epidemic was at its height during the first fourteen days of September, when 4,371 persons were carried off. The mortality in the epidemic of 1849 was somewhat greater, viz. 18,036, the period again extending over several months. Even in the great plague year, 1665, when 68,590 persons died in London, and the city was nearly abandoned, the mortality never rose higher than 7,165 in a week; this number being reached in the third week of September. The population of the metropolis in 1676, is estimated in Graunt’s Bills of Mortality at 384,000; consequently, in the year 1517, it must have fallen far short of 300,000. Making every allowance for exaggeration, supposing only one-half the number stated to have died in the time specified, the mortality for that time, taking into account the amount of population, must have been as great as in the worst irruption of bubo plague, and so appalling that, in the present day, we can form but a faint idea of it.

Rich and poor were equally victims. Rank claimed for its possessor no exemption; poverty was no shield. The deserted palace no longer echoed the sounds of mirth; the low wail of the mourner interrupted the silence of the streets. Henry VIII, a prince who, like Leviathan in the deep, seemed to consider the earth as merely formed to take his pastime therein, leaving the city, retreated with a few followers from place to place before the advancing waves of pestilence. His Court had been the seat of its triumphs. His private secretary, the learned Italian, Ammonius of Lucca, died a few hours after he had boasted to Sir Thomas More that by abstinence and regimen he had shielded himself and family. The Lord Grey of Wilton, the Lord Clinton, and many other of his knights, gentlemen, and officers, were no more. Michaelmas and Christmas passed without their usual festivities. No gathering of people was permitted, for fear of infection. Oxford and Cambridge, crowded with eager students, amongst whom were already germinating seeds which produced the Reformation, were again attacked, and the former was again deserted. The sweat continued until the middle of December; and its horrors were heightened by the supervention towards the winter of plague. In Chester the mortality from the combined diseases was so great, that grass grew a foot high at the town cross. England, again, with one remarkable exception, was alone the land of the shadow of death. The pestilence passed over to the town of Calais, at that period belonging to the British Crown. But here it is said to have attacked principally the English inhabitants; and we know that it not only did not spread through France, but (from a reliable source) that it did not even reach to Graveling.

It must have been during one of these earlier irruptions of the sweating disease, that a Latin prayer was composed, of which a copy has been preserved. It is addressed “ad beatum Henricum,” either Henry the Emperor, who with his wife Cunegunde, were saints of the Romish calendar, or Henry VI. of that name is intended, who was claimed as uncle by Henry VII., and who, his piety having nearly procured him canonization, was highly revered by the people. In it occurs the petition so characteristic of the period:--

“Non sudore, Vel dolore, Moriamur subito.”