The Epidemics of the Middle Ages by J. F. C. Hecker and John Caius
CHAPTER II.
3538 words | Chapter 36
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
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