introduction of a third term, _punctilli_, which Gruner, however, takes to

be merely a synonym for _morbilli_. As Gaddesden’s passage is of some importance for the history of the familiar name of the disease in England, I shall translate it at length, so far as it can be made into sense:-- “Variolae are so called, as if variously choosing the skin itself, because in the skin they occupy divers parts, by apostematising and infecting; they are caused by corruption of blood, and therein they differ from morbilli and punctilli. Morbilli are small apostemata in the skin generated of bile; and they are a diminutive of apostematous diseases because they occupy less space by reason of the sharpness of choleric matter. They are in fact variolae of choleric matter, and the smallest of pustules. But punctilli are infections commonly sanguineous, as if they had arisen from a fleabite, only they remain continually. And punctilli are of two kinds, large and small. Of the small I have already spoken [under the name of morbilli?]. But the large are broad, red and opaque infections in the legs of poor and wasting persons, (_pauperum et consumptuorum_), who sit as if continually at the fire without boots; and they are called in English _mesles_[879].” The rest of Gaddesden’s chapter on smallpox and measles contains nothing that is not to be found in Avicenna or in any medieval compend on medicine. But the passage quoted is of interest as using the old word “mesles” to mean one of the two forms of _morbilli_ or _punctilli_. We are here enabled to see a little way into the confusion of mind which attended the medievalists in their verbalist dealing with disease. The syntax of Gaddesden’s sentence implies that the broad, red and opaque infections on the legs of poor and wasted persons were called in English _mesles_. In other writers, both before and after his date, the name of mesles or mesels or meseals was given, not to a form of disease, but to a class of sufferers from disease. It is the name applied to the inmates of leper-houses by Matthew Paris (circa 1250)--_miselli_ and _misellae_, being diminutives of _miser_[880]. It is the word used for the same class in the Norman-French entries in the Rolls of Parliament in the reign of Edward I. fixing the taxation of leper-houses: if the head of the house was himself a _meseal_, the hospital was to pay nothing, but if the head were a whole man, the hospital had to pay[881]. The same use of mesles, as meaning the leprous, in the generic sense, occurs several times in the 14th century poem, ‘The Vision of Piers the Ploughman[882].’ Thus, Christ in His ministrations, “Sought out the sick and sinful both, And salved sick and sinful, both blind and crooked; And comune women converted, and to good turned. Both meseles and mute, and in the menysoun bloody, Oft he heled such. He ne held it for no mystery, Save tho he leched Lazar that had ylain into grave.” Or again: “Ac old men and hore that helpless ben of strength, And women with child that worche ne mowe, Blind and bedred and broken their members, That taketh their mischief mekely, as meseles and other.” It is this old English word “mesles,” meaning the leprous in the generic sense, that Gaddesden brings into his Latin text in connexion with _morbilli_ (or _punctilli_). It is useless to look for precision in such a writer; but if his introduction of “mesles” in the particular context mean anything at all, it means that the English word represented a variety of _morbilli_,--the large, broad and opaque variety. That it should have occurred to him to bring these blotches or spots on the legs of poor people even remotely into relation with the _morbilli_ of the Arabians, probably means that Gaddesden had a merely verbal acquaintance with the latter, or that he knew them only in books. It is certainly improbable that anyone, even in the Middle Ages, who had ever seen a case of measles should bracket that transitory and insubstantial mottling of the skin, with the large, broad and “obscure” spots (or nodules, or what else) on the legs of poor and wasted persons, which were called, in the vernacular, mesles. But Gaddesden, though a verbalist and a plagiary, was a great name in medicine, a name usually joined (as in Chaucer) with more solid reputations than his own. If he identified “mesles” with a variety of _morbilli_ (which variety no one but himself seems to have heard of), it was an easy transition for the name in English usage to become what it now is, measles meaning _morbilli_, in the correct and only real sense of the latter[883]. History of the name “Pocks” in English. Gaddesden’s case of _variola_ which he cured without pitting by means of red cloth stands alone in English records until the 16th century; probably he was as little able to diagnose variola as _morbilli_, and it is more than probable that he would not have scrupled to call some infantile malady by the book-name _variola_, on the principle of “omne ignotum pro terribili,” when there was anything to be gained by so doing. There is no independent evidence that smallpox or measles existed in England in the 14th and 15th centuries. There are extant various medieval prescription-books, in which remedies are given for all the usual diseases. If the name of _variola_, or any English form of it, occur therein, we should draw the same inference as from the prescriptions for maladies of children such as “the kernels,” and “the kink” (or whooping-cough)[884]. In the Anglo-Saxon “leechdoms,” which have been collected in three volumes, the word _poc_ occurs once in the singular in the phrase “a poc of the eye” (probably a hordeum or sty of the eyelid), and once in the plural (_poccan_) without reference to any part of the body and with no indication that a general eruption was meant. Willan, indeed, has found in a manuscript of uncertain date a Latin incantation against disease, in which the words _lues_, _pestis_, _pestilentia_, and _variola_ occur; at the end of it is written in Anglo-Saxon an invocation of certain saints to “shield me from the _lathan poccas_ and from all evil[885].” This looks as if _poccas_ had been the Anglo-Saxon translation of _variola_. But it remains to be seen in what sense the word “pokkes” was used in the earliest English writings. In the ‘Vision of Piers the Ploughman’ (passus XX) the retribution of Nature or “Kynde” upon the wickedness of the times is thus mentioned: “Kynde came after with many keen sores, As pokkes and pestilences, and much people shent; So kynde through corruptions killed full many.” In the lines immediately preceding there occur some other names, equally generic: “Byles and boches and brennyng agues Frensyes and foul evils, foragers of kynde.” “Boche” is botch,--the name given to the plague as late as the Stuart period, from its chief external sign, the bubo; and “byles” is merely the Latin _bilis_ = _ulcus_. “Pokkes” may be the Anglo-Saxon word; but it is known that many of Langland’s colloquialisms are of Norman or French origin, and in that language there is a term _poche_, which is not far from the English “boche.” Whether “poche” be the same as “boche” or not, “pokkes and pestilences” may be taken to be synonyms for “byles and boches.” The generic or elastic use of such terms received a striking illustration in 1528, when spotted fever (typhus), perhaps mixed with plague, became exceedingly common among French and Spanish troops. Among the French the disease was called _les poches_ and among the Spaniards _las bubas_[886], although both names had been assigned to syphilis at the time of its epidemic outburst in the end of the 15th century. In those times diseases were called by their external marks; so that diseases essentially most unlike, but having certain spots, or blemishes, or botches, or pustules of the skin in common, were called by a common name. The plague itself was known by certain spots on the breast or back called tokens: hence the figure of John Stow and others that “many died of God’s tokens.” There was certainly laxity of naming to that extent in the case of modern languages. As to Willan’s inference from the medieval incantation, it is by no means clear that _variola_ in medieval Latin may not have been used generically also; although, in the school of Salerno it appears to have had its meaning fixed, in the Arabic sense of smallpox, from the time of Constantinus Africanus, who introduced the teaching of Bagdad into that school about the year 1060. The next use of “pokkes” that I have found is in a manuscript chronicle of England down to the year 1419[887], one of the series known as the chronicle of the Brute (from its commencing with the mythical landing of Brutus in England after the siege of Troy); this manuscript, known as the “Fruit of Times,” was afterwards printed at the St Albans press about 1484[888], the history being carried down to Edward IV., and the passage in question reproduced exactly as it stands in the handwriting. Under the 40th year of Edward III. (1366) there is the following entry: “Ther fell also such a pestalence that never none such was seen in no man’s tyme or lyf, for many men as they were gone to bede hole and in gude poynte sodanly thei diede. Also that tyme fell a seknes that men call ye pokkes, slogh both men and women thorgh ther enfectyne.” It is clearly the same passage that occurs condensed in the chronicle of William Gregory, mayor of London, which was written probably in 1451-52[889]. Under the 40th of Edward III., after referring to a “grete batille of sparows” just as the earlier chronicle does, he proceeds: “Also the same yere men and bestys were grettely infectyd with pockys, wherfore they dyde, bothe men and bestys.” The variation of “men and beasts,” instead of men and women, is curious, and suggests that there may have been a common source for the story. The chronicle contemporary with 1366, which is of best authority, was that kept at St Albans Abbey; but it gives nothing under that year. Shortly after 1361, however, and probably about 1362 or 1363 it has a singular entry, which may have been the source of these references to “pockys.” The Latin may be translated thus: “Numbers died of the disease of lethargy prophesying troubles to many; many women also died of the flux; and there was a general murrain of cattle[890].” Here we have men, women, and cattle; also lethargy, flux, and murrain; and it is conceivable that later compilers of English chronicles may each have used this contemporary Latin entry of composite events to put their own gloss upon it, or to amplify the history into what each conceived to be the probable meaning. But the most singular enlargement was that made by Holinshed in his chronicle of 1577. Having copied word for word, sparrows and all, the entry under the year 1366 in the “Fruit of Times” (as printed at St Albans about 1484), he takes leave to amend the sense in the part that chiefly concerns us--he changes “pockys” into “smallpocks,” and “men and women” into “men, women, and children[891].” Holinshed was dealing with an event two hundred years before his own time, and had no more first-hand knowledge of it than we have; but his authority has been accepted for the fatal prevalence of smallpox in 1366 by modern writers on the history of that disease, such as James Moore[892], who have not sought for the contemporary authority nor exercised a critical judgment upon the lax ways of verbalist compilers. Thus is history made--but not so easily unmade. One other reference to “pockys” has to be noticed before we leave the philological part of the subject and come to the unambiguous history of the realities. Fabyan, in his _Chronicle_ written not long before his death in 1512, says that Edward IV. during an expedition to the Scots Marches “was then vysyted with the syknesse of pockys[893].” It is futile to conjecture what the king’s illness may really have been. The word in Fabyan’s time had already acquired a technical sense, which it has ever since retained; but that well-understood meaning was some twenty years later than the year 1474 (although the disease itself doubtless existed all through the Middle Ages); while, in its earlier generic sense, as in the ‘Vision of Piers the Ploughman,’ it seems to have meant botches or other tokens of pestilential disease. In a Latin glossary of English words, published a hundred years after[894], “a pocke” is still defined as _phagedaena_, and “the French pocke” as _morbus Gallicus_, while “smallpox” is not given at all. Smallpox in England in the 16th Century. The earliest references to smallpox in England, apart from the probably incorrect one by Gaddesden early in the 14th century, occur in letters of the years 1514 and 1518. Another letter of 1514 will serve to bring out the ambiguity of the names given to diseases at the time. On June 30, 1514, Gerard de Pleine writes from London to Margaret of Savoy that he had been asked by the bishop of Lincoln why the marriage between the princess Mary and Louis XII. had been broken off (it took place shortly after), and by another great peer whether Louis XII. “avoit eu les pocques,” which last sentence has a marginal note in the printed collection of letters: “c’est la petite verole[895].” But _les pocques_ in a letter written from London in 1514 did not mean the smallpox. In a letter of March 3, 1514, Peter Martyr writing in Latin from Valladolid to Ludovico Mendoza, says that the King of England has had a fever, and that the physicians were afraid it would turn to the pustules called _variolae_, but he is now well again and rises from his bed[896]. This illness of Henry VIII. happened at Richmond previous to 7th February. Although in the letter quoted there was only a fear that the illness might have turned to the pustules called smallpox, yet in the instructions of Henry VIII. to Spinelly, English ambassador in the Low Countries, sent in February, the twelfth item instructs him to say that the English king has lately been visited by a malady “nommée la petitte verolle[897].” Four years after, on July 14, 1518, Pace writes to Wolsey from Wallingford, where the court then was, that the king was to leave next day for Bisham “as it is time; for they do die in these parts in every place, not only of the small pokkes and mezils, but also of the great sickness[898].” These are the earliest known instances of the use of the words _pocques_, _variola_, _petite verolle_, “small pokkes and mezils,” as applied to particular cases of sickness, in correspondence from or relating to England. The remarks to be made upon the early usage are: first, that the word _pocques_, as used by one writing in French from London in 1514, did not mean smallpox, but pox; second, that the first authentic mention of smallpox happens to have been in the French form--“une maladie nommée la petitte verolle;” third, that, in the political gossip of the time the opinion of the physicians regarding the illness of the young king is given as of a fever which they feared might have turned to the pustules called “_variolae_;” and fourthly, that in the very first mention of the disease _variola_ by an English name “small pokkes,” the name is modelled on the French, being coupled with the old English name “mezils.” It is impossible to infer from these references anything as to the amount of smallpox in England at the time, or even to be sure of the correctness of the diagnosis. The lax usage as between “pox” and “smallpox” is shown in a book of the year 1530 called ‘Prognosticacions out of Ipocras and Avicen,’ in which a brief reference to _variola_ in the Latin original is translated “to prognosticate of the pockes.” In Sir Thomas Elyot’s _Castel of Health_, published in 1541, children after their first infancy are said to suffer from a number of maladies, and in “England commonly purpyls, meazels and smallpockes.” That is perhaps the first use of the terms in a systematic work on medicine, not indeed by one of the faculty, but by a layman. About the same time we hear of smallpocks in an infant of noble family: a letter of May 26, 1537, from Charles duke of Suffolk to Cromwell, written from Hoxun in Suffolk, excuses his not repairing to Lincolnshire, as the king had ordered, on the ground that “his son fell sick of the smallpox and his wife of the ague[899].” “His son” was Henry Brandon, born September 18, 1535, so that he was then an infant of some twenty months; he is the same that died, with his younger brother, of the sweating sickness in July 1551. The reference to smallpocks and meazels by Elyot in his _Castel of Health_ is repeated in the almost contemporary _Book of Children_ by Thomas Phaer. Whether Phaer translated that also “out of the French tongue” as he did the _Regiment of Life_, with which it is bound up in the edition of 1553, we have nowhere any information. In a list of forty infirmities of children, the 32nd in order is “small pockes and measels.” A later passage in the _Book of Children_ shows how much, or how little, intelligent meaning Phaer attached to these terms: “Of smallpockes and measels. This disease is common and familiar, called of the Greeks by the general name of exanthemata, and of Plinie papulae et pituitae eruptiones. It is of two kinds:--varioli, ye measils; morbilli, called of us ye smal pocks. They be but of one nature and proceed of one cause. The signs of both are so manifest to sight that they need no farther declaration;”--but he does add some signs, such as “itch and fretting of the skin as if it had been rubbed with nettles, pain in the head and back etc.: sometimes as it were a dry scab or lepry spreading over all the members, other whiles in pushes, pimples and whayls running with much corruption and matter, and with great pains of the face and throat, dryness of the tongue, hoarseness of voice, and, in some, quiverings of the heart with sownings.” He then gives the four causes, three of them being intrinsic states of the humours, and the fourth “when the disease commenceth by the way of contagion, when a sick person infecteth another, and in that case it hath great affinity with the pestilence.” The treatment is directed towards bringing out the eruption; all occasions of chill are to be carefully avoided. More special directions are given for cases in which “the wheales be outrageous and great;” also, “to take away the spots and scarres of the small pockes and measils,” a prescription of some authors is given, to use the blood of a bull or of a hare. The whole of Phaer’s section on smallpox and measles bears evidence of a foreign source, namely the same stock chapter from which Kellwaye drew most of his section upon the same two diseases appended to his book on the plague in 1593. Not only does Phaer speak of smallpox and measles conjointly as leaving spots and scars, but he actually renders _variolae_ by measles, and _morbilli_ by smallpox. Phaer was more of a literary compiler than a physician with original knowlege of diseases and their pathology. But he is not singular among the Tudor writers in taking measles to be the equivalent of _variolae_. William Clowes, of St Bartholomew’s Hospital, one of the most experienced practitioners of his time, does the same. His _Proved Practice for all Young Chirurgeons_ has an appendix of Latin aphorisms “taken out of an old written coppy,” to each of which aphorisms Clowes has added an English translation: in the aphorism on _variolae_, that term is translated “measles,” the name of “smallpox” nowhere occurring in the book. Clowes’s translation is exactly in accordance with the English-Latin glossary of the time by Levins (1570). Levins was an Oxford fellow who had graduated in medicine and afterwards become a schoolmaster, just as Cogan, of _The Haven of Health_, had done. He wrote the _Pathway of Health_, and also compiled the _Manipulus Vocabulorum_. His definitions in the latter may be taken, therefore, to stand for the medical usage of the time. In this glossary, “ye maysilles” is rendered by _variole_, while the name of “smallpox” is omitted altogether, “a pocke” having its Latin equivalent in _phagedaena_, and “ye French pocke” in _morbus Gallicus_. In the Elizabethan dictionary by Baret, “the maisils” is defined as “a disease with many reddish spottes or speckles in the face and bodie, much like freckles in colour;” and that was the disease which the English profession then understood to be the same as the _variolae_ of medieval writers. I leave readers to draw their own conclusions, whether there was much or little smallpox or measles in England in the Tudor period. They may be reminded that Pace, dean of St Paul’s, in a letter from Berkshire in 1518, asserts the fatal prevalence of “smallpox and mezils,” and that the duke of Suffolk called the illness of his infant son by the name of smallpox in