CHAPTER II

THE TIME BEFORE THE THIRTY YEARS’ WAR

Numerous as are the historical notices in former years regarding the destruction of armies by pestilence, correspondingly few are the detailed reports on the spread of pestilence among the non-belligerent population. The best-known example from antiquity is the _Plague of Athens_ (430–425 B.C.), described by Thucydides. The plague began in the second year of the Peloponnesian War, a few days after the invasion of the Peloponnesians. That it is famous is due to the classical description of it by Thucydides, himself a sufferer from the disease. The Plague of Athens broke out in the Piraeus, a fact which has led to the inference that it was borne thither by mariners from Egypt. At the time of the invasion of the Peloponnesians, thousands of country people fled to the city of Athens, which on the advice of Pericles opened its gates to them; thus more than 400,000 people were crowded together within its walls. The first outbreak of the plague lasted two years, then there was an intermission of a year and a half, whereupon it commenced anew. The second outbreak, according to Diodorus, carried away 4,400 hoplites, 300 cavalrymen, a large (but uncertain) number of other soldiers, and 10,000 women and slaves. The plague also penetrated to other places, sparing, however, the Peloponnesus. The nature of the sickness described by Thucydides cannot be positively determined; it has been referred to as bubonic plague (Sprengel), as small-pox (Krause-Daremberg, Kobert), as typhus fever (Häser, Kanngiesser), as typhoid fever (Seitz), and even as anthrax. All we know for certain is that it was some highly infectious disease, recovery from which rendered a person immune. Krauss and Hecker believe that it was a special disease (‘antique plague’), which no longer occurs.[3]

The _Plague of the Antonines_, also called the ‘Plague of Galen’, which ravaged Italy in A.D. 166–8, has also been brought into connexion with warlike events. Avidius Cassius, who preceded Verus in command of the army, had been sent to Syria for the purpose of suppressing a rebellion, and there, after the capture of Seleucia, the plague broke out. It was borne by the troops back to Rome, where, after the triumphal procession of 166, it spread far and wide, so that it was necessary to load its victims on wagons and carry them off for burial. The plague spread from Italy to Gaul, to the very banks of the Rhine, and a large part of the province was literally depopulated—decayed and deserted villages were found everywhere. Häser inclines to the view that it was an epidemic of small-pox, while Laveran, Hecker, Krause, and Littré believe that it was neither small-pox nor typhus fever, but ‘antique plague’.[4]

The expeditions of the German emperors to Italy, as well as the Crusades, offer numerous examples of how large armies may be destroyed by disease. So, for instance, in 963 or 964 the army of the Emperor Otto I was attacked by a severe pestilence in Italy—a murderous disease which was usually fatal in twenty-four hours. The German army of Henry IV in 1081–2, but especially after the capture of Rome on June 3, 1083, suffered from plagues in Italy; but the same army fared even worse in 1084, when a plague broke out and carried away, for example, the entire German garrison in Rome. In 1137 Lothair’s army was likewise attacked by infectious diseases in Italy. But by far the most devastating of all was the pestilence which broke out in Rome in August, 1167, shortly after the capture of the city by Frederick Barbarossa, and paved the way to a catastrophe which culminated in the complete annihilation of the German army. At that time many eminent men succumbed to the disease, the army dwindled away in the hands of the leaders, and the soldiers fled in vast numbers in order to escape certain death. Even after the Emperor Barbarossa’s withdrawal from Rome the pestilence continued to rage in his army, and it was a long time before it disappeared from the city. It was the true (bubonic) plague, and usually resulted fatally on the first day. In the winter of 1190–1 a pestilence broke out in Lower Italy in the army of Henry VI; it appeared at the beginning of the siege of Naples and carried away many eminent men. The king himself contracted the disease, and had to be taken to Capua.[5]

The armies of the Crusades fared even worse; the mortality in the First Crusade, before and after the conquest of Antioch (1097–8), was terrible. The pestilence is said to have broken out first among the children and women who accompanied the armies, and its dissemination was favoured by a lack of sustenance and continual rainfall; from September to the 24th of November the pestilence carried away 100,000. The nature of the disease is not known, although it is known to have been very infectious. When a new army of 1,500 Germans arrived, it was quickly attacked by the disease and in a few days almost completely annihilated. Several hundred frequently died in a single day, and as the summer of 1099 was very hot and a number of bodies remained unburied, the pestilence lasted well into that year. In 1100 another pestilence raged among the crusaders. Again, during the Second Crusade a severe epidemic broke out in the army of the Emperor Louis VII at Attalia in Asia Minor; the pestilence spread rapidly among the inhabitants of the city, so that many houses, even entire streets, were depopulated.[6]

During the Third Crusade, shortly after the death of Frederick Barbarossa (June, 1190), a severe pestilence broke out in the army that was besieging Antioch; according to Michaux only 5,000 infantrymen and 700 cavalrymen survived out of the entire German army.[7] At the siege of Acre (Ptolemais), which lasted from August 1189, to July 1191, there broke out in the winter of 1191 a terrible pestilence which played havoc in the pilgrim army; it was caused by an inadequate supply of food, and its symptoms (enlargement of the limbs and falling out of the teeth) betoken scurvy. It also appeared in the army of Saladin, but was much worse in the Christian army, in which from 100 to 200 crusaders died every day. Duke Frederick of Swabia succumbed to this disease on January 20, 1191.[8]

At the time of the crusade against the heretics a serious pestilence broke out in Egypt in the army of the crusaders, which had already, on August 12, 1218, suffered from dysentery; it appeared in December during the siege of Damietta, after a heavy and continuous downfall of rain. ‘The patients’, says Wilken, ‘were suddenly seized with violent pains in the feet and ankles; their gums became swollen, their teeth loose and useless, while their hips and shin bones first turned black and then putrefied. Finally, an easy and peaceful death, like a gentle sleep, put an end to their sufferings. A sixth of the pilgrim army was carried away by this disease, which no medicine could cure.’[9] Only a few patients who survived the winter were helped to recovery by the warmth of spring. It was unquestionably a severe form of scurvy. The besieged, too, suffered from the destructive pestilence, and also from Egyptian ophthalmia. We read further in Wilken: ‘A horrible sight greeted the pilgrims when they took possession of Damietta. Not only the houses, but even the streets were filled with unburied corpses; in the beds dead bodies lay beside helpless and dying invalids, and the infection of the air was intolerable. Of 80,000 inhabitants which the city had had at the beginning of the siege only 3,000 were left, while only 100 of these were healthy.’[10] Other reports say that 10,000 inhabitants survived.

In 1270, during the Seventh and last Crusade, which strangely enough passed by way of Tunis, a pestilential disease broke out in Carthage, carrying away, in addition to many soldiers and men of rank, King Louis IX of France himself and his son, Jean Tristan. This pestilence was dysentery, and it spread even to Sicily, whither the king’s body was conveyed. After the king’s death conditions were even worse, since so many people died that it was impossible to bury all the bodies. The disease also attacked the enemy’s army.[11]

The increased prevalence of _leprosy_ in Europe in the Middle Ages is often attributed to the Crusades.[12] Leprosy was very widespread in Germany, France, Italy, and other countries of Europe before the Crusades; according to Hirsch it appeared in the Roman Empire in the first century before the birth of Christ, but did not become very prevalent until later. Legal regulations governing the marrying of lepers date back as far as the seventh century, while the earliest reports regarding leper-houses come down from the eighth and ninth centuries. Most leper-houses, however, were built between the eleventh and thirteenth centuries, and although the reverse opinion has been expressed, it is nevertheless improbable that the building of these houses was not due to the increased prevalence of the disease. Inasmuch as leprosy was very widespread in the Orient, where numerous crusaders contracted it, as indicated by the fact that institutions were founded there for its victims, many crusaders doubtless returned with the disease in their systems. But regarding this matter we shall never have absolutely reliable information; for it is assumed that many people suffering from other chronic skin diseases were placed in the leper-houses. A careful study of the available data, however, leads us to believe that wrong diagnoses were not so frequent as to account for the large number of cases of leprosy in the eleventh, twelfth, and thirteenth centuries. Admittance to leper-houses was regulated by many precautionary measures, and the diagnosis of the disease was made by churchmen, even bishops, who without doubt necessarily acquired a good eye for the disease in the course of time. Not until later, when we may be certain that leprosy was no longer brought from the Orient, was the disease probably now and then confused with syphilis.

The notable pandemic outbreak of syphilis at the end of the fifteenth century was also largely attributable to warlike events. The rapid spread of the disease throughout Central Europe was due, according to contemporary notices, to the _Landsknechte_ (common foot-soldiers). The rough coincidence of this epidemic with the discovery of America has given rise to the view that the disease did not exist in Europe at earlier periods, but was borne thither from America. But we can point to numerous instances in the course of the last century, of how infectious diseases, hitherto unknown, or existing only sporadically, all of a sudden became pandemic (cholera, plague, diphtheria, influenza), although no satisfactory and comprehensive explanation of the phenomenon has been offered. It is generally known that infectious diseases break out in a mild form and last for years, and then suddenly change their character and cause virulent epidemics; this is positively confirmed by the epidemic of small-pox in 1870–2, which will be discussed later. At all events we cannot draw the conclusion from the sudden outbreak of an epidemic of syphilis, that the disease was not present in Europe before.

A serious epidemic of syphilis broke out in the army of Charles VIII of France during his expedition to Naples. Inasmuch as his advance was nowhere opposed, he was able to enter Naples on February 12, 1495. There the French army gave itself over to the most unbridled licentiousness, and the result was that the disease spread rapidly in both the French and Italian armies. Italians and Frenchmen accused each other of having brought the disease, so that the former called syphilis ‘French disease’ and the later ‘Neapolitan disease’. The disbanding of Charles’s army caused the disease to spread far and wide in Europe. ‘Those who had most to do with the further dissemination of the disease,’ says Häser,[13] ‘were the Albanian and Roumanian estradiots serving in the Venetian army, brutal and rapacious adventurers, and also the German and Swiss _Landsknechte_ returning from Italy, who spread the disease over a large part of Europe.’

A large number of writers of the beginning of the sixteenth century bear witness to the fact that the pestilence was borne into Germany by _Landsknechte_; e.g. Pastor N. Berler (_Ruffachische Chronik_ of 1510), Heinrich Brennwald (1519), Johann Haselbergk (1533), Valentin Müntzer (1550), _Nuremberg Chronicle_ of 1580.[14] In the year 1495 the pestilence broke out in many places in France and Germany; in Strassburg, for example, the disease was planted by _Landsknechte_ who had served in, and been discharged from, the army of Charles VIII; Hans Schott testifies to this fact in his _Weltlich Leyenbuch_ (Strassburg, 1541). The city of Metz tried in vain to ward off the disease; according to the _Metz Chronicle_, many Burgundians (500 cavalrymen and 700 infantrymen) came to Metz in May 1495, and since the most of them were suffering from _mal de Naples_, they were not allowed to enter the city. But the soldiers infected the women in the vicinity, and the disease was later borne by them into the city, where it prevailed for four years, not beginning to abate until the year 1500.[15] We also have testimony to the fact that the outbreak of the disease in Nördlingen (1495) was caused by the arrival of _Landsknechte_.

In a supplementary way we may add here that later wars also caused frequent epidemics of syphilis within narrow confines; instances of this kind are cited by A. Hirsch[16] and H. Schwiening.[17]

In August of the year 1486 _English sweating-sickness_ appeared in England for the first time; it broke out among the troops of Henry VII shortly before his victory at Bosworth on August 22, 1486. And when Henry landed at Milford the disease spread, carrying away many victims wherever it went. ‘Strong and well-nourished people were particularly susceptible to it—more so than old men, children, and poor people. From three to nine, sometimes all the inmates of a house caught it, and it gradually spread over half the inhabitants of the town. The first appearance of the disease is said to have caused more devastation in London (where it broke out on September 21), Bedford, and Cambridge, than the sword, which had been ruling for thirty years in a fearful civil war. According to Forest, an incredible number of people died from it, while Thomas Moore also speaks of the dangerous character of this epidemic. In many places a third of the inhabitants are said to have died from it, scarcely one in a hundred of its victims recovering.’[18] The subsequent appearance of the disease, especially the transplantation of it to the continent in the year 1529, was not attributable to warlike events. In the year 1551 it disappeared as suddenly as it had appeared in 1486.

The disease usually began with a chill, headache, palpitation of the heart, difficulty in breathing, and later a profuse, very malodorous emission of sweat from all parts of the body. The patient quickly lapsed into a state of lethargy. The progress of the disease was uncommonly rapid; ‘in one day either the disease or the patient came to an end,’ says Fracastorius. Any patient who did not succumb, recovered completely after one or two weeks.

From the sixteenth century on notices are more abundant; we now hear of epidemics of typhus fever throughout all Europe, although we do not know positively where the disease first appeared. ‘At all times,’ says Hirsch,[19] ‘as far back as historical investigation is able to follow the course of typhus fever at all, the disease has always been bound up with the most dismal calamities of the nations. The supposition is therefore justified that, in the numerous war-pestilences and famine-pestilences of antiquity and the Middle Ages, regarding which we have no medical reports and must rely only upon the chronicles, typhus fever has played a conspicuous rôle.’ By this, however, Hirsch does not mean to say that the specific disease in all the so-called war-pestilences was typhus fever; on the contrary, he adds: ‘In saying this I by no means wish to imply that I always identify “war-pestilences” and “famine-pestilences” with epidemics of typhus fever; those pestilences, appearing at epochs of general misery, for the most part represent a mixture of diseases, especially catarrh of the stomach, dysentery, scurvy, typhus fever, and frequently malaria and typhoid fever, which not only by chroniclers, but also by medical statisticians, have quite often been lumped together as _one disease_.’ It is to-day almost impossible to analyse these accounts, in which we can distinguish only individual characteristics of those various diseases. This appears most distinctly in the reports of the chroniclers and historians regarding the war pestilences and famine pestilences of antiquity, and it also explains the futile effort of the historians to reduce to one disease known to us the numerous and complicated symptoms which they have looked upon as the expression of a single disease-process—an effort which has led some of them to the somewhat extravagant conclusion, that they were diseases which are now extinct. The same backwardness, furthermore, characterizes—though to a lesser extent—the descriptions which the physicians of the seventeenth and eighteenth centuries wrote of the epidemics of ‘putrid fever’, ‘bilious fever’, and ‘mucous fever’ occurring at that time. Here, too, in many cases it was evidently a question of the simultaneous outbreak of various diseases, the nature of which even the most expert critic could not afterwards determine with certainty.

At the end of the fifteenth century typhus fever was prevalent in many parts of Europe; the first scientific account of it comes from the pen of Fracastorius, who had an opportunity to observe the disease during the epidemics in Italy in 1505–8, and who described it as a disease indigenous to Cyprus and the neighbouring islands and appearing for the first time in Italy.

The names given to the disease were numerous and cannot all be mentioned here; the name ‘Hauptweh’ (headache) or ‘Hauptkrankheit’ (head-disease) was current in Germany, while the additional words ‘ohne Sterbedrüsen’ (without death glands) expressly distinguish the disease from bubonic plague. T. von Györy[20] mentions a large number of synonyms—Hungarian disease, lazaret fever, spotted fever, petechial disease, &c.

In 1490 the disease was borne by Spanish soldiers, who had fought in the Venetian army against Turkey, from Cyprus to Spain, and during the war of Ferdinand the Catholic against the Moors it spread to Granada and did more damage to the Spanish army than the swords of the Moors.[21]

In the year 1490 a serious epidemic broke out in Lorraine, which Maréchal and Didion[22] think was typhus fever; it appeared in that bitter and indescribably cruel conflict between René, Duke of Lorraine, and the people of Metz. Despite the armistice proclaimed on June 18, the pestilence spread far and wide and in August entered Metz, compelling the inhabitants to take to flight; the nobles retired to their castles, and the citizens went out into the country. And although the city was strictly quarantined, the disease spread throughout Lorraine and northern Alsace.

In the year 1528 an epidemic of typhus fever occurred in connexion with warlike events. This pestilence broke out in Upper Italy and spread to Lower Italy, where a war was going on between French troops on the one side and German and Spanish troops on the other. The loss of human life was uncommonly large, 30,000 French soldiers and twice as many non-belligerent inhabitants are said to have died. And the pestilence was also borne from Italy to Germany.

Well known in history is the great pestilence which in 1552 forced Emperor Charles V to raise the siege of Metz, which had been going on for two months (November and December). Maréchal gives us detailed information about this;[23] the Emperor’s army, he says, which consisted of 80,000 German, Spanish, and Italian troops, in addition to the enormous camp-following that always accompanied armies at that time, was reduced one-third by the end of December through desertion, disease, and disablement. According to the report of the Venetian physician, Andreas Gratiolo, the widespread diseases were typhus fever and dysentery. The appearance of these diseases was favoured by the congregating of such enormous numbers of people in tents and inadequate places of shelter, and also by the great dampness and the lack of the necessaries of life. The extreme cold, which prevented the dispersion and isolation of the patients, also favoured the dissemination of the disease. More than 200 men died in the barracks every day, while 10,000 men, all told, are said to have succumbed. It was also observed that the Spaniards and Italians suffered more than the _Landsknechte_ and other German troops, since they could not stand the severity of the climate so well. During the siege, hospital-fever and scurvy raged in the city itself, and after the siege was raised, in the night of January 1, 1553, typhus fever broke out there, having been borne into the hospitals by wounded soldiers from the enemy’s camp, or else brought back by citizens who had been out to inspect the position of the besiegers. During the siege the surrounding country had been most terribly ravaged by the enemy’s soldiers, so that the inhabitants were in the greatest misery, without food and without any source of help. For the spread of typhus fever this afforded a very favourable soil, and it raged furiously in the months of June and July in the villages surrounding Metz.

The battles with the Turks in the east did a great deal toward spreading typhus fever throughout Europe; for that reason the name ‘Hungarian disease’ came into existence. Toward the end of the fifteenth century, hitherto prosperous Hungary, by endless wars with Turkey and by international strife, was brought to the very verge of ruin. Agriculture ceased almost entirely, the development of the country came to a standstill, large tracts of land, such as the Banat region, assumed the appearance of a vast swamp, while at the same time the alternate cold nights and hot days, together with the great dampness, were very unhealthy for the foreign soldiers, who were not accustomed to such a climate. Partly this, and partly the utter lack of sanitation, increased the baneful effects of camp-life. Dirt and refuse accumulated in heaps, vermin multiplied so rapidly that it was impossible to get rid of them, corpses were inadequately buried, while enormous numbers of flies and gnats molested the soldiers and did a great deal toward spreading infectious diseases. The hospitals were in a pitiable condition, and since the soldiers, after their previous experiences, had little hope of leaving the country alive, they gave themselves over to a most dissolute life, in consequence of which the country suffered terribly. Several contemporaries bear witness to the fact that a large part of the German troops never once faced the enemy, for the reason that they succumbed beforehand to ‘Hungarian disease’, which killed more of them than the swords of the Turks. Hence Hungary was called at that time the ‘Cemetery of the Germans’.

‘Hungarian disease’ was typhus fever, which manifested certain unusual characteristics for the reason that the German troops, being unaccustomed to the local foods, inclined considerably toward intestinal catarrh and scurvy, while many of them also suffered from malaria, which weakened their power of resistance. The sudden beginning with a chill, the appearance of lenticular spots on the fourth, fifth, or sixth day, the duration of about fourteen days, the sudden fall of temperature—all these symptoms, mentioned by witnesses, definitely stamp the disease as typhus fever. If the disease has been identified by many historians with bubonic plague, the reason is that in serious cases of typhus fever suppuration of the salivary glands, gangrene of the lower extremities, of the nose and ears, &c., are not infrequent occurrences.

According to Györy,[24] the pestilence which raged so furiously in the army of Joachim, Margrave of Brandenburg, when the latter was in Hungary in 1542, was typhus fever. He assumes that the disease was borne thither by the Italian troops which the Pope had sent to help fight against the Turks, although he cannot base his assumption on any argument save that typhus fever was no rare disease in Italy. It is much more probable, however, that the disease was already endemic in Hungary at that time, whether from of yore, or whether the Turks had brought it there. So much, however, is certain, that the Germans suffered a great deal more from it than did the Hungarians and Turks, who had probably already survived attacks of the disease and had thus become immune.

‘Hungarian disease’ acquired greater importance in the year 1566, when it spread from Hungary over a large part of Europe. It was then that this name first came into fashion. According to Thomas Jordanus, who took part in the expedition, the disease broke out on the island of Komorn during the war of Maximilian II against the Turks; from there it spread further west and forced the Emperor to conclude a treaty of peace which favoured the Turks. After the dispersion of the army the discharged soldiers carried the disease in all directions.[25] Vienna was hit very hard; not only separate houses, but also entire streets, were filled with victims of the disease. The returning Italians brought the disease first to Carinthia, where it broke out severely in Villach, and then to Italy. In the year 1567 the pestilence carried away 400 people in the little town of Villach, and from there it spread to Styria. In the same way it was carried to Bohemia, Germany, Burgundy, Belgium, and Spain.

At the end of the sixteenth century typhus fever appeared in Hungary with renewed virulence; during the siege of Papa it raged with particular severity among the Italian troops, and according to Coberus all the patients in the field-hospital died.