1494. Typhus-fever, or war-fever with famine-fever, now begins to be a

familiar form of sickness--in 1498, 1505, 1510, 1528, and so on. Other forms are putrid sore throat, dysentery, and varieties of fever included under influenza. The various forms were apt to occur together or in succession, so that epidemiography has a “Protean” character. This epidemic Proteus is at once a great difficulty and a most instructive fact. It opens up the very old doctrine of “epidemic constitutions” of the air, which to many moderns savours of unscientific vagueness; and it brings us face to face with degrees or kinds of infectiveness which are, in matter of fact, more wonderful or more incomprehensible than the deadlier infections, such as the plague or Asiatic cholera. The most familiar instance of the kind is influenza. Influenza. Influenza enters undoubtedly into the Protean infections of the sixteenth century, and is itself no small part of the Proteus. But what is influenza? The name is comparatively modern--Italian of the 18th century--and appears to mean defluxion or catarrh, not in the familiar sense only, but as derived from the comprehensive pathological doctrine of humours: thus the Venetian envoy in London called the sweat of 1551 an “influsso.” It is open to us to include much or little under influenza; but the name itself, having its root in an obsolete doctrine of humours, can never be made exact or scientific. Usage has applied it to all universal colds and coughs; and it has been applied capriciously to some universal fevers, but not to others. There are two tolerably clear references to its prevalence in England before the peculiarly unwholesome state of Europe began with the modern age. Under the year 1173, the chronicle of Melrose enters “a certain evil and unheard-of cough” (_tussis quaedam mala et inaudita_), which affected everyone far and near, and cut off many. One of the St Albans chroniclers, an unknown writer who kept a record from 1423 to 1431 (reign of Henry VI.), has the following entry under the year 1427: “In the beginning of October, a certain rheumy infirmity (_quaedam infirmitas reumigata_) which is called ‘_mure_’ invaded the whole people, and so infected the aged along with the younger that it conducted a great number to the grave[804].” A good deal is said in this brief passage, and all that is said points to influenza--the rheumy nature of the malady, the universality of incidence, presumably the suddenness and brief duration, the deaths among the aged and the more juvenile. It is known also that a similarly general malady was prevalent the same year in Paris, where it bore the name of _ladendo_; the particulars given in the French record of it leave no doubt that it was influenza. The singular name of _pestilentia volatilis_ given by Fordoun to two epidemics in Scotland in his own lifetime, one which began at Edinburgh in February, 1430 (1431 new style), and the other at Haddington in 1432, suggests that they may have been influenzas, but there is nothing more than the name to indicate their nature. Those years are not known to have been years of influenza in any other country of Europe: the record of the malady passes direct from 1427 to 1510. There was certainly a great wave of influenza over Europe in 1510, under the names of _cocqueluche_ and _coccolucio_. It is said to have come up from the Mediterranean coasts and to have extended to the shores of the Baltic and North Seas; its prevalence in Britain is likely enough, and is indeed asserted in one foreign account, but there is no known native notice of it. Abroad, it had the usual character of suddenness, simultaneity and universality, and the symptoms of heaviness, prostration, headache, restlessness, sleeplessness, and for some time after a violent paroxysmal cough, like whooping-cough. None died except some children; in some it went off with a looseness, in others by sweating[805]. The mention of sweating in the influenza epidemic of 1510 is not without importance. It may serve to explain a remark by Erasmus, in a letter of 25th August, 1511, from Queens’ College, Cambridge, that his health was still rather doubtful “from that sweat” (_a sudore illo_[806]); the sweat can hardly have been the sweating sickness of 1508, three years before, but the still unsettled health of Erasmus in 1511 may perhaps have been the dregs of the influenza of 1510. The next great European epidemic of influenza was in 1557, for which I shall produce medical evidence of England sharing in it, probably during that year and certainly in the one following. But the intervening years afford some notices of sickness in England, which was neither so severe as plague at one end of the pestilential scale nor altogether mild at the other, being forms of illness which contemporaries pronounced to be “new” and “strange,” and appear to have been of the nature of pestilent fever and dysentery. Neither typhus nor dysentery was really new to England in the sixteenth century; on the contrary, they were (with putrid sore throat and lientery) the common types of disease in the great English famines which came at long intervals, as described in the first chapter. But on the continent of Europe typhus and dysentery and putrid sore throat (_angina maligna_) began with the modern age to appear as if capriciously, and independently of such obvious antecedents as want, although some of the epidemics of typhus and dysentery were clearly related to the hardships of warfare[807]. Typhus, indeed, was a disastrous malady on the Continent in those years, notably in 1528 in Spain, where it was known as “las bubas,” and in France, where it was called “les poches”--both names relating to the spots on the skin, and both more strictly applicable to the eruptions of the lues venerea, which was then also rampant. Apart from the gaol fever at Cambridge in 1522, the first mention of those new epidemics in England since the end of the medieval period is under the year 1540: “This said xxx and two year [of Henry VIII.] divers and many honest persons died of the hot agues and of a great lask throughout the realm[808].” The “lask” was dysentery, (Stow, in chronicling the epidemic in his much later _Annales_ calls it “the bloody flux”), and the “hot agues,” according to later references under that name, appear to have been influenza in the sense of a highly volatile typhus[809]. All that we know of the circumstances of this epidemic is that the summer was one of excessive drought, that wells and brooks were dried up, and that the Thames ran so low as to make the tide at London Bridge not merely brackish but salt. The spring and summer of 1551 were the seasons of the last outbreak of the sweat in England, which curiously coincided with another epidemic of influenza (_cocqueluche_) in France. The years from 1555 to 1558 were a sickly period for all Europe, the diseases being of the types of dysentery, typhus, and influenza. The most authentic particulars are given under the years 1557 and 1558; and those for England, which specially concern us, are now to be given. Wriothesley, a contemporary, enters under the year 1557: “This summer reigned in England divers strange and new sicknesses, taking men and women in their heads; as strange agues and fevers, whereof many died[810].” Under the year 1558, the continuator of Fabyan’s chronicle says: “In the beginning of this mayor’s year died many of the wealthiest men all England through, of a strange fever[811].” Some light is thrown upon the sickness, general throughout England in 1557-8, also by Stow in his _Annales_. Before the harvest of 1557 corn was at famine prices, but after the harvest wheat fell to an eighth part of the price (5_s._ the quarter), the penny wheaten loaf being increased from 11 oz. to 56 oz.! In the harvest of 1558, he goes on, the “quartan agues continued in like manner, or more vehemently than they had done the last year passed, where-through died many old people and specially priests, so that a great number of parishes were unserved and no curates to be gotten, and much corn was lost in the fields for lack of workmen and labourers[812].” Harrison, canon of Windsor, says that a third part of the people of the land did taste the general sickness, which points to influenza[813]. The year 1557 was certainly remarkable on the continent of Europe as a year of widely prevalent “pestiferous and contagious sickness,” which was described by numerous medical writers. That universal epidemic, or pandemic, is usually counted as one of the great historical waves of influenza; and in the annals of that wonderful disease it stands the first which was well recorded by competent foreign observers, including Ingrassias, Gesner, Rondelet, Riverius, Dodonaeus, and Foreest. The corresponding sickness in England in 1557 (still more severe in 1558), which carried off many of the wealthiest men, and made so great an impression that it is noticed by Stow and Speed, has missed being noticed by English physicians, with a single exception, and that a casual one. If the continental physicians had not been copious in writing on several occasions when our English physicians were silent, such as the epidemic of syphilis in 1494-6, the English sweat of 1529, and the influenza of 1557-8, it might appear ungracious to remark upon the scanty literary productiveness of the profession in the Tudor period. Whoever attempts medical history for England will soon feel our deficiency in materials, and become disposed to envy the easier task of the foreign historian. The academical physicians of the time hardly ever wrote. The men who wrote on medicine were laymen like Sir Thomas Elyot, who justified his interest therein by the example of men of his own rank like Juba, king of Mauritania, and Mithridates, king of Pontus; or they were irregular practitioners desirous to advertise themselves; or booksellers’ hacks like Paynel; or such as Cogan, a schoolmaster and a physician in one. The modern reader will be surprised at the common burden of the prefaces of medical (and perhaps other) books in the Tudor period,--the intolerable nuisance of “pick-faults,” “depravers,” and cavillers, who sat in their chairs and criticised; and if the modern reader happen to be in quest of authentic facts, he can hardly fail to sympathise with Phaer, when he addresses the academical dog-in-the-manger with the Horatian challenge: “Si quid novisti rectius istis, candidus imperti; si non, his utere mecum.” It is possible, however, to collect a few particulars of the prevalent sickness of 1558 in England from casual notices of it. Thus, it comes into a letter to the queen, of September 6, by Lord St John, governor of the Isle of Wight, from his house at Letley, near Southampton: sickness affected more than half the people in Southampton, the Isle of Wight and Portsmouth (those places being filled with troops under St John’s command), and the captain of the fort at Sandown was dead[814]. Curiously enough we get an intimate glimpse of this epidemic from a book published some years after, the _Dyall of Agues_ by Dr John Jones. In his chapter “Of the Sweating Fevers” (chapter xiv), after illustrating from Galen the proposition that a sweat may not be critical and wholesome, but τυφώδης or typhus-like, attending the seizure from its outset and “the same said sweat little or nothing profiting,” he proceeds to point his remarks by his own experience: “I had too good experience of myself in Queen Mary’s reign, living at Lettlé in my good lord’s house, the right honourable Lord St John, beside Southampton, the which, notwithstanding the great sweat, it was long after before I recovered of my health, so that the said sweat did nothing profit.” He then proceeds to compare the sweat, almost certainly the epidemic mentioned in St John’s despatch of 6th September, 1558, with the sweating sickness of 1551: “So in our days, even in King Edward VI.’s reign, it brought many to their long home, as some of the most worthy, the two noble princes of Suffolk, imps of honour most towardly, with others of all degrees infinite many; and the more perished no doubt for lack of physical counsel speedily[815].” The next that we hear of this epidemic of the autumn of 1558, is in a despatch from Dover, 11 p.m. 6th October: the writer has “learnt from the mayor of Dover that there is no plague there, but the people that daily die are those that come out of the ships, and such poor people as come out of Calais, of the new sickness[816].” A despatch of 17th October, 1558, from one of the commissioners for the surrender of Calais, Sir Thomas Gresham, at Dunkirk, to the Privy Council, says that he “returned hither to write his letter to the queen, and found Sir William Pickering very sore sick of this new burning ague. He has had four sore fits, and is brought very low, and in danger of his life if they continue as they have done[817].” Here we have the same term “new sickness” and “new burning ague” as in the two English chronicles under the year before--the “strange and new sicknesses” which “took men and women in their heads,” and the “strange agues and fevers.” The very general prevalence in Southampton, Portsmouth and the Isle of Wight suggests influenza; the symptom of sweating described by Jones for his own case during that prevalence is in keeping with what we hear of the influenzas of the time from foreign writers, and so is the long and slow convalescence; the fact of one person having had four sore fits of “this new burning ague” is more like influenza than typhus. The severe mortalities in the autumn of 1558 at Loughborough and Chester are put down to “plague,” and they may, of course, have been circumscribed outbursts of the old bubo-plague. If, however, they were part of the general prevalence of hot or burning agues, which we may take to have been influenza or a very volatile kind of typhus, they would indicate a degree of fatality in the latter somewhat greater than more recent influenzas have had. A high death-rate is, indeed, demonstrable for the year 1558, from parish registers, by comparing the deaths in that year with the deaths in years near it, and by comparing the deaths with the births in 1558 itself. The registers of christenings and burials, which had been ordered first in 1538, were kept in a number of parishes from that date; and from 1558, when the order for keeping them was renewed by queen Elizabeth, they were generally kept. Dr Thomas Short, a man of great industry, about the middle of last century obtained access to a large number of parish registers, and worked an infinite number of arithmetical exercises upon their figures[818]. His abstract results or conclusions are colourless and unimpressive, as statistical results are apt to be for the average concrete mind; nor can they be made to illustrate the epidemic history of Britain with the help of his companion volumes, ‘A General Chronological History of the Air, Weather, Seasons, Meteors etc[819].’, for these extraordinary annals are for the most part loosely compiled from foreign sources, bringing into one focus the most scattered references to disease in any part of Europe, and that too without criticism of authorities but often with surprising credulity and inaccuracy. That so much statistical or arithmetical zeal and exhaustiveness (in the work of 1750) should go with so total a deficiency of the critical and historical sense, (in the work of 1749) is noteworthy, and perhaps not unparalleled in modern times. Short’s history is mostly foreign, but his statistics, which are English, may be used to illustrate and confirm what can be learned of sicknesses in England in the ordinary way of historical research. Thus, the period from 1557 to 1560 stands out in Short’s table as one of exceptional unhealthiness both in country parishes and in market towns, the unhealthiness being estimated by the excess of burials over christenings. _Country Parishes._ Registers Unhealthy Baptised Buried Year examined Parishes in same in same 1557 16 7 62 181 1558 26 11 171 340 1559 34 12 145 252 1560 38 6 100 162 1561 41 1 19 32 _Market Towns._ Registers Unhealthy Baptised Buried Year examined Towns in same in same 1557 4 2 262 381 1558 4 2 104 159 1559 5 3 102 149 1560 8 3 134 201 1561 8 3 276 399 1562 8 1 58 71 Short’s collection of parish registers appears to have represented many English counties, although there is no clue to their identity in the tables from which these figures are taken. The heavy mortalities in the registers correspond exactly to the epidemic years as otherwise known, and may be said to bear witness to the extent or generality of the epidemic infection. The next that we hear of malignant fevers in England is the outbreak at Oxford in 1577, following the Assizes. Anthony Wood says of it: “Some thought that this Oxford mortality was the same that Leonard Fuchsius styles sudor Anglicus.” Cogan, a contemporary, says: “And certainly after that sudden bane at Oxford, the same year and a year or two following, the same kind of agues raged in a manner all over England, and took away very many of the strongest sort in their lustiest age, and for the most part men and not women nor children, culling them out here and there, even as you should choose the best sheep out of a flock. And certain remedy was none to be found.... And they that took a moderate sweat at the beginning of their sickness, and did rid their stomachs well by vomit, sped much better.” This is partly confirmed by Short’s abstracts of the parish registers. Thus in 1580, of sixty registers examined, ten showed unhealthiness, the births being to the deaths as 248 to 284. In 1582, seven country parishes were markedly unhealthy, the births being to the deaths as 140 to 244. In market towns the incidence is not so striking: in 1580, four towns out of sixteen examined showed an unhealthy birth-rate, 237 births to 276 deaths. It is in 1583 that the disparity becomes greatest in these towns: three out of the sixteen in the list were notably unhealthy, the deaths being 1062 and the births 467. But it is the obvious defect of Short’s method that we have no means of knowing whether that mortality may not have been largely from plague, and not from fever or other form of epidemic sickness. The only year between 1558 and 1580 in Short’s tables, which stands out as decidedly unhealthy both in country parishes and market towns is 1570, while the years from 1573 to 1575 are less healthy than the average. Those were years of war, and of war-typhus, on the Continent, as the foreign writings show, but there are no records of the kind of sickness in England. One glimpse of the prevalence of those fevers of 1580-82 is got from a letter of the earl of Arundell to Lord Burghley, October 19, 1582. The earl had left his house in London because it was so “beset and encompassed” by plague; while, as to his country house: “The air of my house in Sussex is so corrupt even at this time of the year as, when I came away, I left xxiv sick of hot agues.” He therefore begs the loan of the bishop of Chichester’s house till such time as the vacancy in the see should be filled up[820]. The widespread volatile sicknesses of 1557-8 and 1580-2, which are grouped under the generic name of influenza, were related in time to great epidemics of the far more deadly bubo-plague. These plague outbursts were less noticeable in England than abroad. Thus in 1557 there were most disastrous epidemics of true bubo-plague in several towns of the Low Countries, and in 1580 there was at Cairo one of the worst epidemics in the whole history of plague from its beginning. The years preceding 1580 were also plague-years in many parts of Europe (Padua, Mantua, Venice, Messina, Palermo, Lisbon, Brussels). Those years were also the occasion of the first great and disastrous epidemics of diphtheria (_garottillo_) in Spain. Then come the epidemics of typhus; and at the far end of the pestilential scale the flying waves of influenza. A relation of influenza to other prevalent infections has been one of the theories of its nature, especially the relation to epidemics of Asiatic cholera. In that view influenza looks as if it were a volatile product, a swifter and more superficial wave on the top of some slower and more deadly earth-borne virus. As the old writers said, it was a _levis corruptio aeris_, a diluted virus as it were, mild in proportion to its volatility and swiftness, but in universality equalling in its own milder way the universality of the plague of Justinian’s reign or of the Black Death. Now, the same century and the same state of society which witnessed the most remarkable of those flying ripples of infection over the whole surface of Europe witnessed also some waves of infection which did not travel so far, nor were mere influenzas. The English sweat travelled over England in that way; it was called the posting sweat, because it posted from town to town: thus in 1551 it suddenly appeared one day in Oxford, and next day it was in the villages around, as if carried in the air; in like manner it posted to Devonshire, to Leicestershire, to Cheshire, and doubtless all over England, like the influenzas of recent memory. And while the English sweat was thus flying about in England, influenza was flying about the same year (1551) in France, a country which never suffered from any of the five sweating sicknesses of 1485-1551. Again, the influenza in England in 1558 had the symptom of sweating so marked that it was compared to the true sweat of 1551 by Dr Jones, who himself suffered from it. Also the influenza of 1580 all over Europe had so much of a sweating character that in some places they said the English sweat had come back. Lastly, the gaol-fever of Oxford in 1577 was thought by some to present the symptoms described by Leonard Fuchs for _sudor Anglicus_; and Cogan, an English medical writer then living, specially mentions the phenomenon of sweating (as well as the intestinal profluvium called a “lask”), both at Oxford and in the more widely prevalent diseases of that year and the years following. The gaol-fever of Exeter in 1586 illustrates still another side of the question; it diffused itself--probably by other means than contact with the sick--all over the county of Devon, and had not ceased six months after it began in the month of March at Exeter. The Devonshire diffusion was like the spreading circles in a still pool. The spread of influenza was like the flying ripples on a broad surface of water. The spread of plague, on the occasions when it was universal, was like the massive rollers of the depths, the onward march of cholera from the East having, in our own times, illustrated afresh the same momentum. In using hitherto the name of influenza for the universal fevers in England in 1557-58 and in 1580-82, I have done so because those years are usually reckoned in the annals of influenza. But the name is at best a generic one, and need not commit us to any nosological definition. I shall have to deal at more length with this question in the tenth chapter, when speaking of the fevers of 1657-59 described by Willis and Whitmore, two competent medical observers; in those years the vernal fever was a catarrhal fever, or influenza proper, while the fever of the hot and dry season, autumnal or harvest-fever, was a pestilential fever, a spotted fever, a burning ague, a contagious malignant fever. There were also differences in their epidemological as well as in their clinical characters, the influenza wave being soonest past. But so far as regarded universality of diffusion and generality of incidence, both types were much alike. Molineux, writing in 1694, a generation after Willis, “On the late general coughs and colds,” brought into comparison with them another epidemic which he had observed in Dublin in the month of July, 1688: “The transient fever of 1688 ... I look upon to have been the most universal fever, as this [1693] the most universal cold, that has ever appeared[821].” When we come to the 18th century, to great epidemics not only in connexion with famine in Ireland, but also in England, we shall find the same diffusiveness associated with the clear type of disease which we now call typhus. Influenza is the only sickness familiar to ourselves which shows the volatile character, and we are apt to conclude that no other type of fever ever had that character. But, without going farther back than the 18th century we shall find epidemics of spotted typhus resting like an atmosphere of infection over whole tracts of Britain and Ireland, town and country alike; and even if we give the name of influenza to the epidemical “hot agues” with which we are here immediately concerned, in the years 1540, 1557-8, and 1580-82, we may also regard them as in a manner corresponding to, if not as embracing, the types of fever that prevailed from time to time over wide districts of country in the centuries following. The term “ague,” often used at the time, is no more decisive for the nosological character than the term “influenza.” Ague originally meant a sharp fever (_febris acuta_, ὄξυς), and in Ireland, from the time of Giraldus Cambrensis down to the 18th century, it meant the acute fever of the country, which has not been malarial ague, in historical times at least, but typhus. “Irish ague” was in later times a well-understood term for contagious pestilential fever or typhus. In the _Dyall of Agues_ by Dr John Jones (1564 ?), just as in the writings of Sydenham a century later, intermittents were mixed up with continued fevers which had nothing malarial in their cause or circumstances. Thus, Jones has a chapter on “Hot Rotten Agues,” which he identifies with the synochus or continued fever of the Greeks; in another chapter on “The Continual Rotten Ague,” he locates the continued fevers within the vessels and the “interpolate” without their walls, and proceeds: “It happeneth where all the vessels, but most chiefly in the greatest which are annexed about the flaps of the lungs and spiritual members, all equally putrefying, which often happeneth, as Fuchsius witnesseth, of vehement binding and retaining the filth in the cavity or hollowness of the vessels, inducing a burning heat. Wherefore, this kind of fever chanceth not to lean persons, nor to such as be of a thin constitution and cold temperament, nor an old age (that ever I saw), but often in them which abound with blood and of sanguine complexion, replenished with humour, fat and corpulent, solemners of Bacchus’ feasts,--gorge upon gorge, quaff upon quaff--not altogether with meat or drink of good nourishment but of omnium gatherum, as well to the destruction of themselves as uncurable to the physician, as by my prediction came to pass (besides others) upon a gentleman of Suffolk, a little from Ipswich, who by the causes aforesaid got his sickness, and thereof died the ninth day, according to my prediction, as his wife and friend knoweth.” Again, in his eighth chapter, “Of the Pestilential Fever, or Plague, or Boche [Botch],” he remarks upon the varying types of pestilential diseases, mentioning among other national types the English sweat: “As we, not out of mind past, with a sweat called stoupe galante, as that worthy Doctor Caius hath written at large in his book _De Ephemera Britannica_,” adding the remark that here concerns us:--“and sethence [since then], with many pestilential agues, and, lastly of all, with the pestilential boche [botch or plague rightly termed].” These continued fevers, pestilential agues, or hot rotten agues, Jones distinguishes from quotidians, tertians and quartans. Of the last he says: “and when quartans reign everywhere, as they did of no long years past; of the which then I tasted part, besides my experience had of others,”--probably the fevers of 1558, elsewhere called by him the sweating sickness, and by Stow called “quartan agues.” He mentions also quintains, which he had never seen in England, “but yet in Ireland, at a place called Carlow, I was informed by Mr Brian Jones, then there captain, of a kerne or gentleman there that had the quintain long.” Not only the term “ague,” but also the terms “intermittent,” “tertian,” and more especially “quartan,” can hardly be taken in their modern sense as restricted to malarial or climatic fevers. An intermittent or paroxysmal character of fevers was made out on various grounds, to suit the traditional Galenic or Greek teaching; but the paroxysms and intermissions were not associated specially with rise and fall of the body-temperature. The curious history of agues, and of the specialist ague-curers, properly belongs to the time of the Restoration, when Peruvian bark came into vogue, and will be fully dealt with in the first chapter of another volume. The last years in the Tudor period that stand out conspicuously in the parish registers for a high mortality, not due to plague, are 1597-8. The year 1597 was a season of influenza in Italy, and perhaps elsewhere in Europe; so that the epidemic in England that year may have been the same, but more probably was famine-fever. In the parish register of Cranbrooke the deaths for the year are 222, against 56 births; and 181 of the deaths are marked with the mark which is supposed to mean plague proper. The register of Tiverton has 277 deaths, against 66 births, but it is almost certain that the cause of the excess was not plague, of which the nearest epidemic in that town was in 1591. In a country parish of Hampshire, with a population of some 2700, the deaths in 1597 were 117, against 48 births, the mortality being about twice as great as in any year from the commencement of the register in 1569, and after until 1612[822]. In the north of England the type of disease in 1597-8 was plague proper. The parish register of Finchley has a remarkable entry under the year 1596 which introduces us to other considerations: “Hoc anno moriebantur de dysenteria xix,” the whole number of burials for the year having been 28. Next year, 1597, there are 23 deaths from dysentery, the burials in all having been 48--an enormous mortality compared with the average of the parish. The year 1597, if not also 1596, was a year of great scarcity, apparently all over England; in Northumberland, Durham, and Cumberland, the scarcity was attended by plague proper; but in other parts of England, it would seem, by other types of sickness, of which dysentery was one. One of the 16th century English names used for flux was the obsolete word lask, which occurs often enough in writings of the period to suggest that the malady was common; it is sometimes called a choleric lask (cholera morbus), or a vehement lask, as in Elyot’s _Castel of Health_ and in Cogan’s _Haven of Health_. Lasks, or lienteries, or dysenteries have not been dealt with in a chapter by themselves because the records of them are too few and meagre, so far as we have gone in the history; but it may be convenient to bring together here the better known instances. In the period of famine-sicknesses, dysentery and lientery must have been common types, the latter being specially mentioned by Rishanger of St Albans for the year 1294. Trokelowe, another St Albans chronicler, writing of the famine-sickness of 1315-16, uses the singular phrase “morbus enim dysentericus ex corruptis cibis fere omnes maculavit” and says it was followed by “acuta febris vel pestis gutturuosa.” Dysentery from corrupt food is again specially named for the year 1391. The “wame-ill” was the prevalent type of sickness in the great Scots famine of 1439, a year of famine in England and France. When we next hear of it in English history it is among the troops of the marquis of Dorset in Gascony and Biscay in 1512, some 1800 of them having died of “the flix.” Then comes the “great lask throughout the realm” in 1540, associated with “strange fevers.” The sickly years 1557-58 and 1580-82 had probably some dysentery, or lientery, either as primary maladies or as complications of the fevers: Cogan’s generalities imply as much for 1580-82, and we know that the corresponding sickly period a century after (1657-59) was so characterised in the description by Willis. The fatal infection in the fleet after the defeat of the Spanish Armada, in August, 1588, was probably dysentery and ship-fever. Many other instances of the kind remain to be given in the chapter on the sicknesses of voyages and colonial settlements. Dysentery begins to be heard of more frequently in the Stuart period, as a malady of London. It is a prominent item, along with summer diarrhoea, in the London bills of mortality from the year 1658, under the name “griping of the guts,” and is occasionally mentioned in letters from London about the same years. The dysentery of London in 1669 was the subject of Sydenham’s observations, who says that it had been rarely seen in the preceding ten years[823]. On the other hand he speaks of “the endemic dysentery of Ireland,” although he is not sure as to its type or species[824]. Statements as to the Irish “country disease,” are as old as Giraldus Cambrensis[825]; but as the whole question of dysentery is intimately bound up with that of typhus-fever, I shall reserve consideration of its prevalence in Ireland on the great scale, as well as of the annual mortality from it in the London bills of the 17th century, until that section of the work in which fevers and the maladies akin to them come into the first rank as if in lieu of the plague. * * * * * NOTE. A sweating character in the “hot agues” or fevers of the Elizabethan period, in those of 1580-82 as well as in those of 1557-58, is asserted in several passages in the text. It is noteworthy that in _Measure for Measure_, one of Shakespeare’s early comedies, the bawd says: “Thus, what with the war, what with the sweat, what with the gallows, and what with poverty, I am custom-shrunk” (Act I. Scene 2).