The Epidemics of the Middle Ages
CHAPTER II.
THE SECOND VISITATION OF THE DISEASE.—1506.
“The times were rough and full of mutations and rare incidents.”—_Bacon_.
SECT. 1.—MERCENARY TROOPS.
At the commencement of the sixteenth century, society was very differently constituted from what it was at the period when Henry the VIIth unfurled his banner for victory. The darkness of the middle ages had receded, as at the approach of a sun still hidden behind a cloud. The mind unconsciously expanded in the unwonted light of day—the whole earth was on the eve of renovation—new energies were to be called into action—events more stupendous had never occurred, nor had more creative ideas ever aroused the spirit of man. The invention of Gutenberg burst through the bonds of mental darkness, and gave to freedom of thought imperishable wings; unsuspected powers successively developed themselves; and, while in Western Europe an ardent desire arose boldly to overstep the ancient limits of human activity, the hopes of the more enlightened fell far short of the actual result of such unexpected events. The discovery of the New World, and the circumnavigation of Africa, laid the foundation for great improvements; yet the events in Central Europe, though less striking to contemporaries, were in their consequences, infinitely more important and beneficial. The establishment of civil order among all the nations of the West took place at this period, which forms so important a boundary between the middle ages and modern times. Regal power was fixed on a firm basis, and when the castles had fallen before the artillery of the princes and imperial cities, so that the petty feudal barons were compelled to swear obedience to the laws, an end was put to the incessant predatory feuds which had so long desolated Europe, and the establishment of internal peace was followed by the security of life and property—the first essential of refinement in manners and of the free development of human society.
This great result of a concatenation of circumstances was not, however, brought about without violent struggles and innovations, the effects of which were felt for centuries; but it was probably _the establishment of standing armies_ which had the greatest influence on European civilization. They became indeed the pillars of civil order, but having proceeded immediately from the pernicious mercenary system, they long nourished the seeds of unrestrained depravity, and transmitted to later generations the corruptions of the middle ages. The Lansquenets[402] (Landsknechte) of the emperor, and the mercenaries of the kings of France and England, who, during the war, had joined the smaller branches of the standing army, were homeless adventurers from every country in Europe, and were allured, not by military ambition, but solely by the prospect of booty[403]. In whatever country the drum beat to arms, they flocked together like swarms of locusts—no one knew from whence—and defying the feeble restraints of military discipline, indulged, during the continuance of the war, in all the unbridled licence of a predatory life.
Hence the unbounded barbarity of their mode of warfare, which was restrained only by the individual exertions of more humane commanders. There was, however, a decided contrariety between this system and the moral condition of the people of Western Europe: a contrariety which was never entirely removed by the subsequent introduction of a more strict military discipline, and which has been done away only in modern times, by the establishment of regular armies on a system more congenial to the feelings of the people. Hence the consequences were the more pernicious, for when the armies were disbanded on the conclusion of peace, the Landsknechts dispersed in all directions, not to follow the plough again, or to resume their former occupations, but to pass their time in idleness and dissipation, if enriched by booty, and if reduced to poverty by intemperance and gambling, to infest the country as mendicants or robbers, till a new war again summoned them from their dishonourable mode of life[404]. Probably but very few were ever able to rise from such deep degradation, and many fell early victims to their vices[405], while the infection of their example brought fresh accessions from every town and village to the mercenary legions.
SECT. 2.—NEW CIRCUMSTANCES.
It is evident that in such a condition of affairs, the effect which the plague produced on civil society must have been different from that of former times. Pernicious influences which, during the middle ages, had endangered the health of the inhabitants of towns, and had often rendered disorders, naturally slight, in the highest degree malignant, were for ever removed. Under this head may be mentioned more particularly the ill-contrived construction of the houses and streets, which even yet, in large cities, destroys the comfort of the inhabitants of whole districts, and those not of the poorest class only. As people acquired confidence in the security of peace, it ceased to be necessary to protect every country town by fortifications. The walls were thrown down, the stagnant moats were filled up, and as people were no longer limited to a narrow space, they built more convenient houses in airy streets; the dark alleys and damp dwellings under ground were gradually abandoned, and a more comfortable mode of living superseded the former misery. By this means the mortality was considerably diminished, and the power of epidemics was checked; nor can it be doubted, that the better administration of the laws greatly obviated the dissolution of social ties in times of plague, and the effects of superstition and religious animosity, which had formerly been so frightful. These inestimable national improvements, however, took place but gradually, and were not a little retarded for a time by the new evil of the employment of mercenaries. For as the germs of vice were scattered in all directions by the wandering Lansquenets, so also the infection of noxious diseases found easier entrance into the towns and villages through the medium of this dissolute and widely spread class of men. The Lansquenets of the sixteenth century, as spreaders of contagion, supplied the place of the former Romish pilgrims and flagellants; they even proved a more permanent scourge than those wanderers of the middle ages, who only made their appearance on extraordinary occasions. We need here only call to mind the malignant and beyond measure noisome lues which at the end of the fifteenth century spread with the rapidity of lightning over all Europe. It was not an importation from the innocent inhabitants of the New World, nor was it bred by the ill-treated Marrani[406], the victims of the Spanish Inquisition. It was the mercenary army of Charles the VIIIth in Naples (1495), whose excesses gave to the already existing poison a malignity till then unknown, and prepared for the deeply rooted depravity, a scourge at which all the world shuddered with horror. It is, moreover, in place here to observe that, in the larger armies which the new military system now brought into the field, the ordinary camp diseases, to which another very fatal one was added[407], were of course much more extensively propagated than in the less numerous forces of preceding centuries, and consequently that the peaceful inhabitants of the towns and of the country at large were thereby exposed to much danger.
SECT. 3.—SWEATING SICKNESS.
Meantime Europe was frequently and very severely visited by the epidemics of the middle ages, the terrors of the constantly recurring plague being borne with gloomy resignation to the inevitable evil with which, as a merited chastisement, the anger of God, according to the notion of the times, afflicted the human race. Even the English were not exempt from this fearful visitation, which, in the year 1499, carried off 30,000 people in London alone, so that the king found it advisable to retire with all his court to Calais[408]. Thus the recollection of the Sweating Sickness of 1485 was gradually obliterated. No one thought of its possible return, and all the world was occupied with other matters, when the old enemy unexpectedly again raised his head in the summer of 1506, and scared away this comfortable state of false security. The renewed eruption of the epidemic was not, on this occasion, connected with any important occurrence, so that contemporaries have not even mentioned the month in which it began to rage. Towards the autumn it had again disappeared, and as no new symptoms were added to the disease, the form of which was identified by a reference to the old descriptions, it was immediately treated by the same means, the efficacy of which those who had witnessed the epidemic of 1485 lauded with so much reason[409]. Every exposure to heat or cold was, as at that time, avoided, and the malignant fever was left to the curative powers of nature, the patient being kept moderately warm in bed; and no powerful medicines being administered. The result was beyond all expectation favourable, for in few houses did any fatal cases occur. The victory over this dreaded enemy was now, by a pardonable error, attributed more to human skill than to the mildness of the malady on this occasion, which, even under a less judicious treatment of the sick, would certainly not have been marked by any considerable degree of severity.
The disease broke out in London, but whether it penetrated to the west or not, contemporary writers, being soon convinced of its slight character, have left us no intelligence. However widely it may have spread, it certainly was confined to England, and nowhere occasioned any great mortality.
SECT. 4.—ACCOMPANYING PHENOMENA.
As the epidemic was on this occasion so very mild, it was not accompanied by any remarkable phenomena in England, but the case was otherwise in the rest of Europe, as will be proved by the following details. After a wet summer, in the year 1505, a severe winter set in[410]. Comets were seen in this as in the following year. An eruption of Vesuvius also took place in 1506[411], which may be mentioned, although it is well established that volcanic commotions are to be taken into account only in great pestilences, not in less extensive epidemics. In England there blew a violent storm from the south-west, from the 15th till the 26th of January, 1506, which drove the king of Castille, Philip of Austria, with his consort Johanna, from the Netherlands to Weymouth; and as, some days before, a golden eagle falling from St. Paul’s church, in London, had crushed a black eagle which ornamented some lower building, evil predictions were promulgated among the people respecting the fate of this son of the emperor[412]. This event, however, could not be considered as at all connected with the pestilence which broke out about half a year afterwards. More consideration is due to the gloom and anxiety which at that time depressed the spirit of the English nation. The reckless avarice of Henry the VIIth, named the English Solomon[413], gave just ground for doubts regarding the security of property; and the pious foundations—those accustomed means of softening the dreaded wrath of heaven, which the king, who became gradually more and more broken down by disease, established, could not efface the recollection of the arbitrary violence and extortions of his corrupt servants[414]. Although these extortions principally affected the wealthy nobility, who were much in need of restraint, yet dark mistrust was general, and all cheerfulness was banished from the minds of the people. This state of feeling might have been favourable to the propagation of the returning disease, but the genius of the year 1506 would not suffer it to be more than a slight and transient reminiscence of a mystically hidden danger, the import of which was not apparent to any medical inquirer of the 16th century.
SECT. 5.—PETECHIAL FEVER IN ITALY, 1505.
Thus, if we paid attention, as usual, only to the palpable occurrences which take place on the earth and beneath its surface, the Sweating Sickness of the above-mentioned year might appear to be unconnected with more considerable commotions of organic life. The powers of nature, however, are in their operations too subtle to be comprehended by our dull senses and by the coarse mechanism of our organs; nay, precisely at a time when neither the one nor the other indicate any alteration around us, those operations bring to light the most extraordinary phenomena in the human frame—that most sensitive index of secret influences on life. This observation was fully confirmed at the time of the first return of the sweating fever. For whilst this disease remained confined to England, there appeared in the southern and central parts of Europe a new and fatal epidemic, which thenceforth visited these nations almost continually with intense malignity. This was the petechial fever, a disease unknown to the older physicians, which was first observed in 1490, in Granada, where it threatened to annihilate the army of Ferdinand the Catholic, and made great havoc also among the Saracens[415]. The bubo plague had immediately preceded it, (1483, 1485, 1486, 1488, 1489, and 1490[416],) and it may with no small probability be assumed that the petechial fever had resulted from this as a peculiar variety, since in other countries also, fifteen years later, the bubo plague degenerated in various ways, and examples are not wanting in which particular forms or constituent parts of great epidemics thus branch off from them, in the same manner as, under favourable circumstances, these will combine together, and united into one destructive whole, multiply the sources of danger.
Yet some contemporaries were of opinion that the petechial fever had been brought over to Granada[417] by Venetian mercenaries from Cyprus, where they had fought against the Turks, and where this disorder was said to have been indigenous. Notwithstanding some good works[418] already existing, this matter has need of a more thorough examination, which might bring to light important and instructive results, respecting the rise and spread of the petechial fever, and especially respecting its relation to other plagues. Whatever may be held with regard to the true origin of this fever, thus much is established, that it was at first an independent European disease, and that, at the commencement, having occupied the southern part of this quarter of the world, it then became connected, in a manner as extraordinary as it was worthy of observation, with the sweating sickness of the north; since the nearly simultaneous eruption of the sweating fever in England, with the great epidemic petechial fever in the year 1505, may be justly attributed to an influence common to both, although unquestionably of greater power in the latter.
The epidemic petechial fever, of which we are now treating, prevailed principally in Italy, and is described by Fracastoro as the first plague of this kind which ever appeared in that country. Of this new disease[419], which was placed by this great physician midway between the bubo plague and the non-pestilential fever, the contagious quality showed itself from the beginning; yet it was plainly perceived, that the contagion did not take effect so quickly as in the bubo plague, that it was not conveyed so easily by means of clothing and other articles, and that physicians and attendants on the sick were the only persons who incurred much danger of infection. The fever began insidiously, and with very slight symptoms, so that the sick in general did not so much as seek medical aid. Many persons, and even physicians among the number, suffered themselves to be deceived by this circumstance, and thus, not being aware of the danger, they hoped to effect an easy cure, and were not a little astonished at the sudden development of malignant phenomena. The heat was inconsiderable, in proportion to the fever, yet those affected felt a certain inward indisposition, a general depression of all the vital powers, and a weariness as if after great exertion. They lay upon their backs with an oppressed brain, their senses were blunted, and in most cases delirium and gloomy muttering, with bloodshot eyes, commenced from the fourth to the seventh day. The urine was usually clear and copious at the beginning, it then became red and turbid, or resembling pomegranate wine, (granatwein,) the pulse was slow and small, the evacuations putrid and offensive, and either on the fourth or seventh day red or purple spots, like flea-bites, or larger, or resembling lentils, (lenticulæ,) which also gave a name to the disorder, broke out on the arms, the back, and the breast. There was either no thirst at all, or very little; the tongue was loaded, and in many cases a lethargic state came on. Others, on the contrary, suffered from sleeplessness, or from both these symptoms alternately. The disease reached its height on the seventh or on the fourteenth day, and in some cases still later. In many there existed a retention of urine with very unfavourable prognosis. Women seldom died of this fever, elderly people still more rarely, and Jews scarcely ever. Young people, on the other hand, and children died in great numbers, and especially from among the higher ranks, while the plague, on the contrary, used generally to commit its ravages only among the poorer classes. An inordinate loss of power in the commencement betokened death, as also a too violent effect from mild aperient means, and a failure in alleviation after a complete crisis. Patients were seen to die who had lost to the extent of three pounds of blood from the nose. It was also a very bad sign when the spots disappeared, or broke out tardily, or were of a blackish-blue colour. Phenomena of an opposite character, on the contrary, afforded hope of recovery.
The best physicians were agreed on the importance of the petechiæ as an indication of the nature of the crisis; for those cases in which they were abundant and of a good quality were cured much more easily than those in which the eruption was suppressed. An abundant perspiration also was particularly conducive to recovery, whereas all other evacuations, especially a flux from the bowels, proved to be injurious and even fatal.
If we keep these phenomena in view, and consider, moreover, that in the widely extending lues venerea of those times cutaneous eruptions predominated over the other symptoms, the English sweating sickness in the north of Europe will appear, as in connexion with this circumstance, of a very important character; and the supposition, that the morbid activity of the system during the whole of this age, maintained a decided determination to the skin, may thence be fairly considered as something more than a mere conjecture.
This fact speaks for itself, but the causes of this altered temperament of the body it is not an easy matter to discover. Fracastoro, who knew much better than his modern followers how to manage his sagacious doctrine of contagion, looked for these causes in the quality of the air, which was manifest by much more evident phenomena in the epidemic petechial fever of 1528 than in that of 1505, and he traced an active connexion between this quality, which he called “infection of the atmosphere,”[420] and the condition of the blood; thus indicating unknown influences by an obscure notion. He considered the altered quality of the blood according to the established views of that period, which the petechial spotted fever seemed clearly to confirm, as a putrefaction; and he even assumed that, in the non-epidemic petechial fevers, which, from the year 1505 forward, frequently occurred, isolated causes must have given rise to changes in the blood, as well as that quality of the air, to which this great physician attributed the general and continued alterations which take place in the nature of diseases.
The petechial fever made the same impression on the physicians of Italy as new disorders have ever made; for although they were the best in Europe, their view was bounded by the horizon of Galen, within the limits of which the novel phenomenon was not to be found. They were therefore soon perplexed, and whilst they sought to entrammel the dreaded enemy with scholastic doctrines of repletion and acrimony and occult qualities, and betook themselves first to one remedy and then to another, they exposed themselves to the derision of the people, who soon perceived their disagreement and indecision, and, as usual, charged on the whole medical profession the well merited blame of individuals[421].
SECT. 6.—OTHER DISEASES.
About the same period, in October, 1505, a very fatal disease broke out in Lisbon, the further progress of which was marked by the terror, the flight, and the confusion of the inhabitants[422]. Of what kind it was, whether a petechial fever or a bubo plague, and what connexion it had with a pestilence in Spain which had just preceded it, it would perhaps be difficult now to ascertain. This latter pestilence had spread from Seville, following an earthquake, and violent storms of wind and rain in 1504, and may very likely have been a bubo plague. Similar notices are met with of pestilences occurring in that country in 1506, the year of the English Sweating Sickness, in 1507 and 1508, in which years mention is made of swarms of locusts in the neighbourhood of Seville, and finally in 1510, the year of a great influenza[423], and 1515. Exact descriptions, however, of these disorders are entirely wanting[424].
With all the above phenomena, the epidemics which took place in Germany and France at the commencement of the sixteenth century, evidently unite to form a connected whole. Varying in intensity and extent, they continued without intermission for full five years, and moreover were accompanied by unusual circumstances, such as occur only in the time of great pestilences. The century was ushered in by the appearance of a comet[425], which, on this occasion, seemed to confirm the long cherished belief that the appearance of these heavenly bodies was prognostic of evil. For mankind are in the habit of concluding that phenomena which are simultaneous must have some internal connexion, and many examples were called to mind in which great pestilences affecting the whole world had been either preceded or accompanied by comets[426]. Immediately afterwards a great murrain among cattle took place, which may have proceeded from some injurious quality in their food. A notion immediately arose that the pastures were poisoned, and of this there was so firm a conviction, that the most violent resentment, as of old, in the time of the Black Death, prevailed against the supposed poisoners, and in the neighbourhood of Meissen some “böse Buben” (wicked knaves) who had fallen under suspicion, were actually executed[427].
A very considerable blight of caterpillars which, in the north of Germany, stripped the gardens and woods far and wide of their foliage, deserves to be here mentioned as a phenomenon appertaining to the lower grades of the animal kingdom[428]. Natural history has shewn that occurrences of this kind are by no means occasioned by new and wonderful influences, but rather by unusual combinations of circumstances, appearing to occur together almost accidentally, at a given time; especially by the simultaneous union of warmth and humidity in the atmosphere, whereby sometimes one and sometimes another of the lower grades of animal existences becomes extraordinarily developed. It is on this account that unusual phenomena in the insect world, whether it be the appearance or the disappearance of particular kinds, take place much more frequently when the order of succession in the seasons and the condition of the atmosphere are in a greater degree than usual and more permanently disturbed; and thus those phenomena have, with much reason, ever been considered as forerunners of pestilences, whenever the human frame has become, through atmospherical causes, generally susceptible of disease. Swarms of locusts have appeared before and during most great pestilences, and indeed the exuberant production of this insect appears, at least in Europe, to require the most unusual combination of causes.
SECT. 7.—BLOOD SPOTS.
Of rarer occurrence, but quite as important in reference to the general tendencies of life, are _the luxuriant growths of the minutest cryptogamic plants in the water, and on damp things of all kinds_, which, from their spots of various forms and colours, produced the utmost horror both before and during great pestilences, and excited superstitious fears, as appearing to be something miraculous. These spots (signacula), and especially the _blood-spots_, were seen at a very early period, as for instance during the great general plague in the sixth century[429], and again, during the plague of the years 786[430] and 959, when it is said to have been remarked, that those on whose clothes they frequently appeared, and seemingly imparted to them a peculiar odour, were more susceptible than other people of attack from leprosy, on which account this spotted appearance was inconsiderately called the clothes leprosy[431], (Lepra vestium;) not to mention other examples[432] in which plagues affecting the human species did not take place. The same signs also, in the years from 1500 to 1503, threw the faithful into great consternation, because, as on former occasions, they fancied they recognised in them the form of the cross[433]. The phenomenon on this occasion spread throughout Germany and France, and from its great extent and long duration, may be reckoned among the most remarkable of the kind. The spots were of different colours, principally red, but also white, yellow, grey, and black, and arose, often in a very short time on the roofs of houses, on clothes, on the veils and neck handkerchiefs of women, on various household utensils, on the meat in larders, &c. A historian, who speaks also of blood-rain[434], recounts that they could not be got rid of in less than ten or twelve days, and that they frequently occurred in closed chests, on linen and on articles of clothing[435]. Much information is not to be expected from the researches of the naturalists of those times, but there is no doubt that what is described was some one or more kinds of mould[436], inasmuch as the whole phenomenon evidently corresponds with modern observations[437]. Scientific physicians of the sixteenth century, among whom the naturalist George Agricola, who was born in 1494, and died in 1555, ought especially to be mentioned, recognised, even then, these spots as lichens, and without seeking to account for them by supernatural agencies, or lending credence to popular superstition, they gave them their just interpretation as indications of extensive disease[438]. Should the too bold notion of Nees v. Esenbeck, that fungi of the most minute forms have their origin in the higher regions of the firmament, and descending to the surface of the earth, produce spots and stains, be confirmed, which is not yet the case, these “signacula” would have a much more important connexion with epidemics than can be otherwise conceded to them; for though it be highly probable that they have their origin only in the dissemination of germs in the lower strata of the atmosphere, it must yet be granted, that if they appear over a considerable space, and during a long time, as at the commencement of the sixteenth century, the causes favouring their generation and spread, must be ranked among those of an extraordinary kind, and on this very account may exercise an influence over human organism, as was then evident.
For so early as the fruitful year 1503, the plague, which had already appeared partially, made great advances, and France in particular was visited by so fatal a pestilence, that the inhabitants of towns and villages, in order to escape the infection, fled in bodies to the woods, and even the house-dogs became wild, which never happens, unless a country be extensively depopulated[439]. They were obliged to establish great hunts, in order to free the country from these new beasts of prey, and from wolves which appeared in great multitudes[440]. The dry and continued heat of the following year, 1504, having given rise to still more extensive sickness, and caused a failure in the crops, the bubo plague raged in Germany with such violence, that in some places a third part, and in others as many as half the inhabitants perished. Various kinds of fevers accompanied this overwhelming disease, among which there was one distinguished by headache and phrensy similar to that which appeared in France, in 1482[441]. Various putrid fevers and putrid inflammations of the lungs with bloody expectoration, are also no less plainly discernible from the accounts[442]. This diversified and general sickness throughout the whole of Germany, terminated in the cold winter of 1504–5 and the following summer, during which there was a continued murrain among cattle. It is certain, that at that time the petechial fever in Italy, had not yet passed the Alps.
_From all these facts it is a probable conjecture, that the Sweating Sickness which visited England in the year 1506, although accompanied in that country itself by no prominent circumstances, was not without connexion with the morbid commotion of human and animal life in the south and middle of Europe, and may perhaps be regarded as having been the last feeble effort of mysterious agencies in the domain of organized being._