Part 5

The name of Sweating Sickness was given to the great epidemic of fever that appeared in England in the fifteenth century, and from thence extended over Continental Europe. This epidemic broke out in the month of September, 1486, in the army of Henry VII., encamped in Wales, and soon reached London, extending over the British Isles with frightful rapidity. Its appearance was alarming and during its duration, which was only a month, it made a considerable number of victims. “It was so terrible and so acute that within the memory of man none had seen its like.”

This epidemic reappeared in England in 1513, 1517 and 1551. It was preceded by very moist weather and violent winds. The mortality was great, patients often dying in the space of two hours; in some instances half the population of a town being carried off. The epidemic of 1529 can only be called murderous; King Henry VIII. was attacked and narrowly escaped death. Although flying from village to village the nobility of England paid an enormous tribute to the King of Terrors. The Ambassador from France to London, M. du Bellay, writing on the 21st of July, 1529, remarks, “The day I visited the Bishop of Canterbury eighteen of the household died in a few hours. I was about the only one left to tell the tale, and am far from recovered yet.”

This same year the sweating sickness spread all over Europe. It made terrible ravages in Holland, Germany and Poland. At the famous synod of Luther and Zwingle, held at Marburg, the Reformed ministers seized by fear of death prayed for relief from the pestilence. At Augsburg in three months eighteen thousand people were attacked and fourteen hundred died.

This epidemic did not extend as far as Paris, but it developed in the north of France and Belgium. Mezeray mentions this fact in the following terms: “A certain disease appeared this year (1529), commencing in England. It was of a contagious nature, and passed over from France to the Lower Countries, and thus spread over most of Europe. Those attacked sweated profusely; it was for this reason that the malady was called the _English Sweat_. First one had a hard chill, then a very high fever, which carried the patient off in twenty-four hours, unless promptly remedied.”

Fernel, physician to Henry II., who practiced in Paris, likewise speaks of this sudorific sickness in one of his works.[25] He says: “_Febres sudorificae quae insolentes magno terrore in omnem inferiorem Germaniam, in Galliam, Belgicam, et in Britanniam ab anno Christi millesimo quingentesimo vigesim autumno potissimum pervagatae sunt_.”

It prevailed almost always in summer and autumn, especially when the weather was moist and foggy. Contrary to what is seen in other epidemics, it was observed that the weak and poor, the old and infants were not attacked as often as robust persons and those in affluent circumstances.

The symptoms noted by physicians, such as Kaye and Bacon, may be classed into three distinct periods: 1. The period of chill, characterized by pains and formication in the limbs an extraordinary prostration of the physical forces—a tremulous, shaky period. 2. The period of sweat, preceded by a burning heat all over the body and an unquenchable feverish thirst. The patient was agitated, disquieted by terror and despair. Many complained of spasms in the stomach, followed sometimes by nausea and vomiting, suffocation and lumbar pains—a constant symptom ever—headache, with palpitation of the heart and præcordial anxiety. 3. This period was announced by a high delirium, sometimes muttering, sometimes loquacious; a fetid sweaty odor, irregular pulse, coma, and, in the last-named condition, death always occurred.

The duration of the disease was most frequently but a few hours, rarely exceeding a day, whether the termination was favorable or fatal.

Convalescence was always long, often being complicated by diarrhœa or dropsy. It has been remarked in this connection that the malady might be confounded with the miliary sweat observed in Picardy and central France, but in the first named disease no cutaneous eruption was observed. Fernel clearly affirms this statement, as he says: “In this affection there is no carbuncle, bubo, exanthema nor eczema, but simply a hypersecretion of sweat.”

Such was the sweating sickness of the sixteenth century, which made so few victims in France, but which destroyed so many people in England and Germany. The origin of this disease has been often discussed, and also its nature; but all theories emitted by various authors partake of the doctrines of other days and are too antiquated to be revamped. We will content ourselves with saying that the classification of periods made by us is logical, and we consider the sweating sickness of the fifteenth century as a pernicious fever, in which the sweating stage predominated and consequently became the characteristic symptom of the affection.

THE SCURVY.

It has been supposed by many that Hippocrates described scurvy under the name of _enlarged spleen_, an affection attributed to the use of stagnant water and characterized by tumefaction of the gums, foul breath, pale face, and ulceration of the lower limbs. But the study of this Hippocratic passage leads us to think that these symptoms were more of the character of scrofula than of scurvy. The recital by Pliny of the diseases of the Roman soldiers while on an expedition to Germany seems to indicate scurvy, which Coelius Aurelianus, and after him the Arabian physicians, claims presented only a slight analogy to that affection.

Springer thinks that we may find the first traces of scurvy in the expedition of the Normans to Wineland, in the first years of the eleventh century. In admitting that the men commanded by Eric Thorstein were obliged to winter on the western shores of Wineland and almost all succumbed to an endemic malady of that country, proves that it was nothing but scurvy, although that word’s only signification, in Danish, is ulceration of the mouth.

We have, besides, another document, which has great authentic value, a proof transmitted to us by our earliest and best chronicler of the Middle Ages, by Joinville, the friend and companion of Saint Louis in his Crusade into Palestine. In his memoirs he gives a very succinct recital of the epidemic of famine and scurvy which attacked the French army on the banks of the Nile in 1248, just after the battles of Mansourah. Says Joinville: “After the two battles just mentioned, commenced our great miseries in the army; at the end of nine days the bodies of our dead soldiers arose to the surface of the water (their tissues were corrupted and rotten), and these corpses floated to a point between our two camps (those of the King and the Duke of Bourgogne), at a point where a bridge touched the water. So many had been slain that a great crowd of corpses floated on the stream for a long distance. The bodies of the dead Saracens were sickening; the army servants threw open a portion of the bridge and permitted the dead infidels to float down the river, but they buried the dead Crusaders in great pits dug in the ground. I saw among other dead the body of the Chamberlain of the Count D’Artois, and many other friends among the slain.

“The only fish we had eaten for four months were of the variety called _barbus_, and these _barbus_ fed on the dead bodies, and for this cause and other miseries of the country where never a drop of rain fell sickness entered our army of such a sort that the flesh on the limbs dried and the skin on the legs became black and like old leather boots, and many sick rotted in their groin; and all having the last named symptom died. Another sign of death was when the nose bled.”

The relation of Joinville leaves no doubt as to the nature of the epidemic that attacked the Crusaders. Here we have a pen picture of the debility, the hemorrhages, the livid ecchymosis of the skin, the fungous tumefaction and bleeding of the gums, which characterize the disease known as scurvy.

According to the writings of some German physicians of the fifteenth century, this malady was endemic in the septentrional portions of Europe upon the shores of the Baltic Sea. In Holland numerous epidemics of scurvy were observed among the lower classes of the population, coinciding with bad conditions of public hygiene. Food consisting of salt and smoked meats, dwellings located on marshy ground, cold atmospheres charged with fogs, etc., etc.

This was the same affection that attacked our colonies in Canada, but at that time we had no knowledge of the therapeutic indications in such emergencies, and quote as a proof of this a remarkable observation inscribed on the registers of Cartier on his vessels during his sojourn in Canada: “The disease commenced in our midst in a curious and unknown manner; some patients lost their flesh and their limbs grew black and swollen like charcoal, and some were covered over with bloody splotches like purpura; after which the disease showed itself on the hips, thighs, arms, and neck, and in all the mouth was infected and rotten at the gums, so that all the flesh fell off to the roots of the teeth, which also most often dropped out; and so terrible was this plague that on my three ships by February only ten healthy men were about out of a crew of over a hundred.

“And, as the disease was unknown to us, the Captain of the ships was asked to open a few bodies to see if we could possibly detect the lesion and thus be able to protect the survivors. We found the hearts of the dead to be white and withered, surrounded by a rose colored effusion; the liver healthy, but the lung black and mortified and all its blood retired to the sac of the heart. The spleen likewise was impaired for about two finger-lengths as though rubbed by a rough stone.”

From this autopsy rudely made[26] it is true we discern most of the signs of scrofula; a profound alteration of the blood and an effusion of the liquids into certain viscera, denoting a diminution in the amount of fibrin and the number of globules, alterations that also serve to explain the tendency to hemorrhages observed in very serious cases of scurvy.

LEPROSY.

Leprosy is a disease originating in the Orient; Egypt and Judea were formerly the principal infected centers. It was the return of an expedition to Palestine, under Pompey, that imported the malady to Italy. In the first years of the Christian Era it is mentioned by Celsus, who advised that it should be treated by sweating, aided by vapor baths. Some years later Areteus used hellebore, sulphur baths, and the flesh of vipers taken as food, a treatment adopted by others, as, for instance, Musa and Archigenes.

In the second century the disease was in Gaul; Soranus treated the lepers of Aquitaine, who were numerous.[27]

According to Velly, leprosy was common in France in the middle of the eighth century epoch, when Nicholas, Abbot of Corbeil, constructed a leper hospital, which was never much frequented until after the Crusades of the eleventh and fourteenth centuries. At this period the number of lepers, or _ladres_, a name given to the unfortunates in remembrance of their patron saint, St. Lazarus, became so great that every town and village was obliged to build a leper house in order to isolate the afflicted. Under Louis VIII. there were 2,000 of these hospitals; later the number of such asylums reached 19,000.

According to the historians of this time, when a man was suspected to be a leper he could have no social relations without making full declaration as to what the real nature of his complaint might be. Without this precaution his acts were void, from the capitulary of Pepin, which dissolved all marriage contracts with lepers, to the law of Charlemagne, that forbade their associating with healthy persons. The fear of contagion was such that in places where no leprosy existed they built small houses for any one who might be attacked; these houses were called _bordes_.[28] A gray mantle, a hat and wallet, were also supplied the victims, also a _tartarelle_, a species of rattle, or a small bell, with which they warned all passers near not to approach. They also had a cup placed on the far side of the road, in which all persons might drop alms without going near the leper.

Leper houses were enriched, little by little, by the liberality of kings and nobles and the people, and to be a leper became less inhuman and horrible than at the beginning.

Lepers, however, were forced to submit to severe police regulations. They were forbidden under the severest penalties from having sexual relations with healthy persons, for such intimacy was considered as the most dangerous method of conveying the contagion. After entering a leper house the victim was considered as dead under the civil law, and in order to make the patients better understand their position the clergy accompanied them to their asylum, the same as to their funeral, throwing the cemetery dust on them while saying: “Enter into no house save your asylum. When you speak to an outsider stand to the windward. When you ask alms sound your rattle. You must not go far from the asylum without your leper’s robe. You must drink from no well or spring save on your own grounds. You must pass no plates nor cups without first putting on your gloves. You must not go barefooted, nor walk in narrow streets, nor lean against walls, trees, or doors, nor sleep on the edge of the road,” etc.

When dead they were interred in the lepers’ cemetery by their fellow-sufferers.

Separated from society, these pariahs, living together, sometimes reproduced their own species, and finished their days in the most frightful cachexia, awaking only contempt, disgust, and repulsion among the healthy of the outside world.

It is true that each time that sanitary measures were relaxed by the authorities—such, for instance, as the perfect isolation of the patients—an increase in the number of lepers was noticeable. When this was observed the old-time ordinances were enforced again with vigor. It was thus in 1371 the Provost of Paris issued an edict enjoining all lepers to leave the Capital within fifteen days, under heavy corporal and pecuniary penalties; and in 1388, all lepers were forbidden to enter Paris without special permission; in 1402 this restriction was renewed, “under penalty of being taken by the executioner and his deputies and detained for a month on a diet of bread and water, and afterwards perpetual banishment from the kingdom.” Finally, in April, 1488, it was announced “all persons attacked by that abominable, very dangerous and contagious malady known as leprosy, must leave Paris before Easter and retire to their hospitals from the date of issuance of this edict, under penalty of imprisonment for a month on bread and water; and, where they had property, the sequestration of their houses and jewels and arbitrary corporal punishment; it was permitted them, however, to send things to them by servants, the latter being in health.”

We can understand from this how these poor wretches, at different epochs, were accused of horrible crimes, among other things poisoning rivers, wells, and fountains. As regards this accusation, says the author of the _Dictionnaire des Mœurs des Francais_, Philip le Long burned a certain number of these poor devils at the stake and confiscated their wealth, giving it to the Order of Malta and St. Lazare.

The historians and chronicalers of the eleventh and twelfth century often designated the person attacked by leprosy by the name of _mesel_, _mezel_, _meseau_ or _mesiaus_. Meantime Barbazin pretends that it is necessary to make a distinction.[29]

_Mesel_, according to Barbazin, was a person covered with sores and ulcers, while the leper was an insensible man. He thinks that _mesellerie_ was at its origin a different affection than leprosy, and that these two diseases have been wrongly confounded. “They have both served,” says he, “to designate a frightful disease, that is reputed the most dangerous of all maladies.”

As supporting this assertion of Barbazin, we have found in the Romanesque tongue some documents strongly confirming this point. They appear more interesting, inasmuch as they have heretofore been unknown to medical literature, as, for instance:

“Seneschal, I now demand of you, said he (Saint Louis), which you love better, whether you be _mesiaus_, or whether you commit a mortal sin; and I, who never have lied, responded that rather would I commit thirty mortal sins than be _mesiaus_.” (Joinville, _Histoire de Saint Louis_.)

The leprosy, however, was not an absolute cause for divorce, as we note in the following passage: “A man can leave his wife only for fornication, and not alone for leprosy, and lepers may marry; and one may cancel marriage if the husband become leper, and the same may be said of the bride.”

In the same manuscript another analogous fact shows the invalidation of the marital act for the reason of _mesellerie_ complicated by impotence or barrenness.

“A woman who through impotence has lost that which is necessary to her, so that he cannot cohabit with her, for the reason that he is _mesiaus_, may marry another, telling the latter, however, that the first she married was worth nothing, not even an infant, as he could not cohabit; that nothing can prevent cohabitation in marriage nor the begetting of children.”

Individuals attacked by _mesellerie_ were in reality outside the pale of the law. For we read in fact in the “_Coutume de Beauvoisis_, cap. 39,” that “_mesiaus_ must not be called on as witnesses, for custom accords them no place in the conversation of gentlemen.”

“The second reason is that when a _mesiaus_ calls on a healthy man, or when a healthy man calls on a _mesel_, the _mesiaus_ may put in the defense that he is beyond the reach of worldly law, and cannot be held responsible in such a case.”

These unfortunates besides could not inherit nor dispose of their own wealth during their lives. The following passage from the “ancient customs of Normandy” bears witness, _i. e._:

“The _mesel_ can be no man’s heir from the time his disease is developed, but he may have a life interest, as though he were not a _mesel_.”

The same as in many other diseases the leprosy presented itself under different forms and various degrees of gravity, as is proved from the following passage from _Le Pelerinage de l’humaine lignee_:

“Homs, qui ne scet bien discerner Entre sante et maladie, Entre le grant mesellerie Entre le moienne et le meure.”

This gravity of different forms of leprosy has likewise been mentioned by the Arabian school, and notably by Avicenna, who had seen numerous cases complicated with ulcerations of the genital organs; also, by the Englishman, Gilbert, who wrote in the thirteenth century regarding the existence of several species of leprosy, which could not always be easily distinguished by reason of the uncertainty of their symptoms. As to its character as a constitutional malady we have the word of the Syrian Jaliah ebn Serapion, who attributes its connection to the predominance of certain humors; finally, Valescus of Tarentum insists on the heredity of the disease.

The leprosy, the pork measles and the _mesellerie_ were then only clinical forms of a single affection of a contagious nature—a hereditary disease whose symptoms appeared successively on the skin, in the mucous membranes, the viscera and in the nervous system. It then required a diathesis, which resembled greatly in its evolution that of syphilis, with which it has often been confounded.

The physicians of leper hospitals have left behind a great number of medical documents bearing on the characteristics of the disease, but their observations are so confused that we can only conclude that they considered all cutaneous maladies as belonging to the same constitutional vice.

They recognized, however, the _ladrerrie_ (disease arising from measly pork), by the following symptoms, the same being laid down by Guy de Chauliac:

“Eyelids and eyebrows swollen, falling of eye-lashes and eyebrows, which are replaced by a finer quality of hair; ulceration of septum of the nose, odor of ozoena, granulated tongue, fœtid breath, painful breathing, thickening and hardness of the lips, with fissures and lividity of same; gums tumefied and ulcerated; furfuraceous scales in the hair, purple face, fixed expression, hideous aspect; forehead smooth and shiny like a horn; pustules on face; veins on chest much developed; breasts hard.”

“Thinness of muscles of the hand, especially thumb and index finger; lividity and cracking of the nails; coldness of the extremities; presence of a serpiginous eruption; insensibility of the legs, collections of nodosities around the joints; under the influence of cold elevations appeared on the cutis, making it appear like goose-skin.”

“Sensation of pricking, ulcerations of skin; sleep uneasy, fetidity of sweat; feeble pulse, bad odor of blood, which is viscid and oily to the touch and gritty after incineration, likewise of a violet black color.”

The contagious characteristic of leprosy through sexual relation was noticed by physicians attached to hospitals, and was the subject of police restriction by public sanitary officers. Thus in the thirteenth century the celebrated Roger Bacon, surnamed the admirable doctor, wrote that commerce with a leprous woman could be followed by very serious consequences. This opinion was corroborated by a physician of the University of Oxford, his contemporary John of Gaddsen, and by the observations of Bernard Gordon, a celebrated practitioner of Montpellier. We all know the history of a Countess who came to be treated for leprosy at Montpellier, when a Bachelor in Medicine charged with the task of dressing her sores, fell desperately in love with the leper lady, and from his _amours_ contracted most serious cutaneous disease.

At this period the leprosy had already begun to assume a venereal type of marked character, and many prostitutes suffered from attacks. As we all are aware, Jean Manardi, an Italian doctor, has fully expressed his opinion on this subject. In a letter addressed to a friend, Michel Santana, one of the first specialists who treated pox, Manardi remarks: “This disease has attacked Valencia, in Spain, being spread broadcast by a famous courtesan, who, for the price of fifty crowns, accorded her favors to a nobleman suffering from leprosy. This woman having been tainted, in her turn contaminated all the young men who called on her, so that more than four hundred were affected in a brief space of time. Some of these, having followed the fortunes of King Charles into Italy, carried and spread this cruel malady in their track.”

Another Italian physician, Andre Mathiole, likewise shows the identity of leprosy with syphilis,—in the following terms: “Some authors have written that the French have taken this disease from impure commerce with leprous women while traversing the mountains of Italy.”[30]

We could easily multiply such citations to complete the facts observed by Fernel and Ambroise Pare in France, and also by many Italian physicians, from whence it would be easy to understand why Manardi came to the following conclusion: “Those who have connection with a woman who has had recent _amours_ with a leper, a courtesan in whose womb the seeds of disease may linger, sometimes contract leprosy and at other times suffer from other maladies of a more or less serious nature, according to their predispositions.”