CHAPTER III.

THE THIRD VISITATION OF THE DISEASE.—1517 “This learned Lord, this Lord of wit and art, This metaphysick Lord, holds forth a Glasse, Through which we may behold in every part This boisterous prince.”—HOWELL[443]. SECT. 1.—POVERTY. The ordinances of Henry the VIIth, which, although adapted to the times, bore hard upon the people, soon produced their fruits. The great diminished the number of their servants, and as, moreover, many of the peasantry were thrown out of employment in consequence of a conversion of large tracts of arable land into pasture[444], the population of towns increased even to an overflow, and the consequent activity of trade gradually rendered the towns flourishing. But this change took place too rapidly. Wealth and luxury engendered, it is true, numerous wants which were a source of gain, so that the English were at this time considered luxurious and effeminate[445], but there was a general scarcity of workmen and artists, and hence it happened, that from Genoa, Lombardy, France, Germany and Holland, innumerable foreigners immigrated and took possession of the most lucrative branches of employment. This was a peculiar hardship on the natives, who from their imperfect knowledge of the arts, could not compete with the more skilful foreigners, and were besides treated by them with insolence and contempt. The distresses of the poor thus increased yearly, and their indignation at length broke out. A great insurrection of the English artisans arose throughout London, and might have proved destructive to the foreigners, had affairs been in a less orderly state. The popular commotion was, however, suppressed without any considerable sacrifice, and Henry the VIIIth on a solemn day, appointed at Westminster, for passing judgment upon the prisoners, bestowed a pardon on them; for he saw into the causes of their discontent, and very soon after caused restrictive alien laws to be enacted[446]. SECT. 2.—SWEATING SICKNESS. All this took place in April and May of the ever memorable year 1517, and London was again indulging in hopes of better days, when the Sweating Sickness once more broke out quite unexpectedly in July, and in spite of all former experience, and the most sedulous attention, inexorably demanded its victims. On this occasion it was so violent and so rapid in its course, that it carried off those who were attacked in two or three hours, so that the first shivering fit was regarded as the announcement of certain death. It was not ushered in by any precursory symptoms. Many who were in good health at noon, were numbered among the dead by the evening, and thus as great a dread was created at this new peril as ever was felt during the prevalence of the most suddenly destructive epidemic: for the thought of being snatched away from the full enjoyment of existence without any preparation, without any hope of recovery, is appalling even to the bravest, and excites secret trepidation and anguish. Among the lower classes the deaths were innumerable[447]. The city was moreover crowded with poor; but even the ranks of the higher classes were thinned, and no precaution averted death from their palaces. Ammonius of Lucca, a scholar of some celebrity, and in this capacity private secretary to the king, was cut off in the flower of his age, after having boasted to Sir Thomas More, only a few hours before his death, that by moderation and good management he had secured both himself and his family from the disease[448]. Also of those immediately about the king, Lords Grey and Clinton were carried off, besides many knights, officers and courtiers. Mourning supplanted the hilarity and brilliancy of the festivals, and the king, while in miserable solitude, into which he had retired with a few followers, received message after message from different towns and villages, announcing, that in some a third, in others even half the inhabitants were swept off by this pestilence. It had never before raged with so much fatality. The minds of men had never before been so frightfully appalled. The festival of Michaelmas, (29th September,) which in England was always kept with much religious pomp, was of necessity postponed; nor was the solemnity of Christmas observed, for there was a dread of collecting together large assemblies of people[449], on account of the contagion; and just about this time, when the Sweating Sickness had abated, the plague, according to the account of some historians, began, which, although probably not very virulent, prevailed during the whole winter in most English towns, and continued to keep up the distress of the people. The king on this occasion also quitted his capital, and retreated, in company with a few attendants, before the contagion, frequently shifting his court from place to place. It was during this period of trouble (11th of February, 1518) that the Princess Mary, afterwards Queen, was born[450]. Thus the Sweating Sickness lasted full six months, reached its greatest height[451] about six weeks after its appearance, and probably spread from London over the whole of England. In Oxford and Cambridge it raged with no less violence than in the capital. Most of the inhabitants of those places were, in the course of a few days, confined to their beds, and the sciences, which then flourished, for they were never more zealously cultivated in England than at that time, suffered severe losses by the death of many able and distinguished scholars[452]. Scotland, Ireland and all other countries beyond sea, were on this occasion spared. The neighbouring town of Calais alone was reached[453] by the pestilence; and according to later observations, it may be considered as certain, that only the English who resided there, and not the French inhabitants, were affected, as it is also ascertained that the rest of France continued throughout free from the disease. Had this not been the case, contemporary writers would undoubtedly not have omitted to make mention of so important an occurrence. SECT. 3.—CAUSES. The influences which gave rise to this third eruption of the disorder among the English nation are obscure, and do not altogether correspond with those of the years 1485 and 1506. Thus it is especially remarkable, that, on this occasion, there is no express mention of the humidity which had so decided a share in the origin of the two former visitations of the Sweating Sickness, and the year 1517 was in most respects one of an ordinary kind. The English Chronicles state nothing remarkable on the subject, and from those of Germany we only learn that the winter of 1516 was very mild, and that a fruitful summer with an abundant vintage[454] and a cold winter followed. The summer of 1517 was unfruitful, although not on account of wet weather, so that in some parts, especially in Swabia, provision was made against a scarcity[455]. A great comet appeared in 1516[456], and in 1517 an earthquake was felt at Tübingen, Nördlingen, and Calw, during a violent storm, whereupon the “Haupt Krankheit”[457] (encephalitis), accompanied by fever, became more prevalent, although not remarkably fatal[458]. This phenomenon (the earthquake) was by no means unimportant[459] in its effects, and there is reason to suppose that it was followed by subterraneous commotions of still greater extent, for earthquakes occurred also in Spain[460]. As the date of this event is specified as the 16th of June, and as earthquakes occurring in unusual localities, that is to say, in districts not volcanic, are frequently cited as prognostics of great diseases, although in volcanic districts they evidently betoken nothing of the kind, we may hence with some reason assume a telluric influence, which perhaps reached the locality of the pestilence that broke out at the beginning of July, if not earlier. Besides, we cannot find any greater phenomenon, which, according to human conception, could have had a more immediate connexion with the English Sweating Sickness; and in this instance too, inquiry the most circumspect does not penetrate through the thick veil which envelopes the inscrutable causes of epidemics. SECT. 4.—HABITS OF THE ENGLISH. That next to the peculiar constitution which England imparts to her inhabitants, the predisposing causes of the Sweating Sickness lay in the habits of the English of those times, no one can possibly doubt. The limitation of the pestilence to England plainly indicates this. Not a single ship conveyed it to the French, or to the Dutch, who breathed a much moister atmosphere; and yet the intercourse between the English seaports and these immediately neighbouring nations was very frequent. Of intemperance, which most generally lays the foundation for disorders, both high and low were at this time accused. This vice of the English was proverbial in foreign countries[461]. Flesh meats highly seasoned with spices were indulged in to excess; noisy nocturnal carousings were become customary, and it was also the practice to drink strong wine[462] immediately after rising in the morning. Cyder, which in some parts, as for instance in Devonshire, is the common beverage[463], was, even in those times, considered by medical men as injurious, for it was observed that its use caused debility with paleness, and sapped the vigour of youth in both sexes[464]. Other similar facts respecting the mode of living at that time might perhaps be adduced, from which it would appear that, owing to the total want of refinement in diet, much that was improper was employed in English cookery, and that on this account the constitution was much injured. Horticulture, which the French had already brought to a state of great improvement[465], was still quite in its infancy in England. It is even said that Queen Catherine had pot-herbs brought from Holland for the preparation of salads, as they were not procurable in England[466]. Allowing that this account may not be strictly true, since it admits of other explanations, still it proves in itself what we would here enforce, and leaves us to draw conclusions from it beyond the mere fact of there being a scarcity of culinary vegetables. Much more important, however, as respects our subject, was the custom of wearing immoderately warm clothing, of which we have accounts worthy of credence. From youth upwards the head was covered with thick caps, in order to secure it from every chance of cold, and from the least draught of air; and as, by this injurious practice, the brain was subjected to a continual determination of blood, and a tenderness of the skin was induced, there was no disorder more frequent among the English in this century than catarrh[467], which was constantly reproduced by relaxing perspirations and heating medicines. If this malady be complicated with a scorbutic habit, or if it befall persons of debauched habits, whose vessels contain nourishment not properly concocted, the preservative vital power seeks a vent through the relaxed skin, and that which in itself is a needful and alleviating excitement of this tissue becomes a disease; the wholesome excretion degenerates into a colliquative drain, which forcibly carries off with it unusual animal matters that ought not to pass away through such an outlet, and the body yields to an attack to which it has been thus long predisposed. When we consider this debilitated state of the skin as the general complaint in England, taking into account the prejudicial influence of hot baths[468], which were much in use, and the diaphoretic medicines employed in most disorders; when we bear in mind the rare use of soap at that time, and the high price of linen, as also the extreme indigence of the lower classes, which almost always breeds pestilences, the utterly miserable condition and truly Scythian filth of the English habitations[469], and finally, the crowded state of London in the year 1517, we shall, as far as human research can penetrate, find the origin of the Sweating Sickness in this very year explicable from causes which have long been known to be capable of producing such effects. Something remains in the background, of which hereafter. SECT. 5.—CONTAGION. The rapid spread of the Sweating Sickness all over England as far as the Scottish borders, and across to Calais, now demands a more especial consideration. Most fevers which are produced by general causes, as well transient (epidemic) as constant and peculiar to the country (endemic), or a union of both, which almost always takes place, and was here evidently the case, propagate themselves for a time spontaneously. The exhalations of the affected become the germs of a similar decomposition in those bodies which receive them, and produce in these a like attack upon the internal organs; and thus a merely morbid phenomenon of life shews that it possesses the fundamental property of all life, that of propagating itself in an appropriate soil. On this point there is no doubt,—the phenomena which prove it have been observed from time immemorial, in an endless variety of circumstances, but always with a uniform manifestation of the fundamental law. All nations too, and from the most ancient times, have invented ingenious designations for these occurrences, which, however, seldom represent the general notion, but commonly only the peculiar propagation of individual diseases. Certainly one of the best and the most ingenious is that which is conveyed by the German word “Ansteckung,” “setting on fire,” which compares the exciting a disease in the appropriate body, with the inflammation of combustible matter by the application of fire, or with the kindling of powder by a spark. But how various are these “Ansteckungen!”, from the purely mental, on the one hand, which, through the mere sight of a disagreeable nervous malady—through an excitement of the senses that shakes the mind, penetrates into the nerves, those channels of its will and of its feelings, and produces the same disorder in the beholder, to those, on the other hand, which propagate diseases that principally operate only upon matter, and are distinguishable but little, if at all, from animal poisons. The reader must not here expect all the features of a doctrine which extends through the whole immeasurable domain of life. They are clearly derived from the confirmed and well applied experience of _the past_, and have been delineated by men[470] who had not forgotten, like their modern successors, to take a comprehensive view of epidemic diseases. It may, however, be permitted me just to call to mind the difference between those infectious diseases which are _permanent_ and for centuries together _unchangeable_, and those which are _temporary_ and _transient_. The infecting matter of the former may aptly be called the perfect or unchangeable in contradistinction to the imperfect or mutable character of the latter. The former, when once formed, whether in diseased persons or inanimate substances (fomites), are always in existence, and are but called into activity by those causes of general disease (epidemic constitutions) which are favourable to their propagation; and it is to be remarked that under all circumstances, and at all times, they excite the same unchangeable diseases, and, varying only in particular ramifications or degenerations and mild forms, never lose their proper essence. Examples are furnished in the small-pox, the plague, the measles, and, if we may include diseases not febrile, the leprosy, the itch, and the venereal disease. The latter, on the other hand, are not always in existence, they are called forth from nonentity by the causes of general diseases or epidemic constitutions, and they disappear again after the extinction of the epidemic diseases by which they were bred; they likewise vary in their development and their course in each particular epidemic. Examples are found in the yellow fever, in catarrh or influenza, in nervous and putrid fever, and, among many other disorders, in miliary fever, a disease which first grew to a national pestilence in the 17th century, and which, in the kind and manner of its infecting power, approaches nearest to the sweating fever. To this latter category the English Sweating Sickness likewise belongs; a disease altogether of a temporary character, which, after its cessation, left no infecting material behind, and consequently was incapable of propagating itself after the manner of those diseases which are completely contagious. The animal matters, which were expelled along with the profuse perspiration, and spread so horrible a stench around the sick, contained amid their alkaline salts, (probably ammonia in various states of combination,) and their superabundant acid, the ferment of the disease; and this penetrated into the lungs of the bystanders as they breathed, and provided they were but predisposed for its reception, as above stated, continually produced it. It may be considered as certain that mere manual contact was not sufficient to communicate the infection, and that this was propagated, either by the pestilential atmosphere which surrounded the beds of the sick, or by exhalations generated in unclean situations where there was no vent for their escape. On this account it was that the residence at common inns and public-houses was looked upon as dangerous[471]. I would not, however, be understood to maintain that, during the three epidemics with which, up to the present stage of our inquiry, we have become acquainted, the spread of the sweating fever alone was occasioned by infection; for if the general epidemic causes were powerful enough to excite the disease, without any previously existing poison, why might they not produce the same effect still more independently throughout the course of the pestilence, since, as is the case in all epidemics, those causes in all probability continued to increase in intensity? That the plague grew worse on the occasion of any great assemblages of the people, was at that time known, and the notion of contagion thence very naturally arose. Yet, must it here be taken into account, that even without this notion, and merely from the assemblage itself of many people in whom the like malady was germinating, and already had shewn tokens of its approach, that approach might easily be accelerated, and the disease increased among those merely slightly indisposed, by the reciprocal communication of morbid exhalations. For as the predisposition to any malady, which is an intermediate condition between that malady and the previous state of good health[472], plainly displays the properties of the disease in those whom it _threatens_ to attack, so these exhalations (or epidemic causes which give rise to Sweating Sickness in the first instance) certainly differ from those which occur in a sweating sickness which has already broken out, only in unessential respects, and might consequently stimulate the mere disposition to the disease more and more, even to the actual eruption of the disease itself. Yet a contagion was likewise in operation at the same time which was destructive even to the temperate, and to those who were apparently in health, nay, even to foreigners, who were living in an English atmosphere and on English food, as the example of the Italian Ammonius plainly proves[473]. In all epidemics which increase to such a degree as to become contagious, it is of importance to distinguish which of these causes are the more powerful, the predisposing or epidemic causes, which originate the proneness to the disease, or the proximate causes, among which, in the generality of cases, contagion is the most prominent. The predisposing were here evidently the more operative; contagion was not added till the disease was at its height, and although it contributed not a little to its spread, yet it always remained subordinate to the other sources of the disease, and all the matter of infection vanished without a trace, on the cessation of the disorder, so that the subsequent eruptions of it were always produced by the renewal of those general causes which are in operation upon and under the earth. It is, however, as little within the compass of human knowledge to discover the essential foundation of this renewal, as the proximate causes of the appearance of the mould spots at the commencement of the sixteenth century, or any other of those processes which are prepared and brought into activity by the hidden powers of nature. SECT. 6.—INFLUENZAS. Several epidemics thus originating in causes beyond human comprehension appeared in the 16th century. Among the most remarkable was a violent and extensive catarrhal fever in 1510, of that kind which the Italians call Influenza, thus recognising an inscrutable influence which affects numberless persons at the same time. It prevailed principally in France, but probably also over the rest of Europe, of which, however, the accounts do not inform us, for in those times they took little pains to record the particulars of epidemics which were not of a character to affect life. According to recent experience we should be warranted even in supposing that this malady had its origin in the remotest parts of the East. During the whole of the winter, which was very cold, violent storms of wind prevailed, and the north and middle of Italy were shaken by frequent earthquakes; whereupon there followed so general a sickness in France, that we are assured by the historians that few of the inhabitants escaped it. The catarrhal symptoms, which on the appearance of disorders of this kind usually form their commencement, seem to have been quite thrown into the background by those of violent rheumatism and inflammation. The patient was first seized with giddiness and severe headache; then came on a shooting pain through the shoulders, and extending to the thighs. The loins too were affected with intolerably painful dartings, during which an inflammatory fever set in with delirium and violent excitement. In some the parotid glands became inflamed, and even the digestive organs participated in the deep-rooted malady; for those affected had, together with constant oppression at the stomach, a great loathing for all animal food, and a dislike even to wine. Among the poor as well as the rich many died, and some quite suddenly, of this strange disease, in the treatment of which the physicians shortened life not a little by their purgative treatment and phlebotomy, seeking an excuse for their ignorance in the influence of the constellations, and alleging that astral diseases were beyond the reach of human art[474]. From this prejudicial effect of our chief antiphlogistic remedy, bleeding, as well as of evacuations from the bowels, we may conclude that the disease, though in its commencement rheumatic, yet had an essential tendency to produce relaxation and debility of the nerves, and in this respect, as well as in its extension to all classes, accorded with the modern influenzas, in which the same phenomena have manifested themselves only much less vividly and plainly. The French, who, from the levity of their character, have always called serious things by jocose names, designate this disease “Coqueluche” (the monk’s hood), because, owing to the extreme sensibility of the skin to cold and currents of air, this kind of hood was generally necessary, and was a protection against an attack of the malady, as well as against its increase. That in the accounts, which are, to be sure, very incomplete, there should be no express mention of any affection of the air-passages, is remarkable, since this could not in all likelihood have failed to exist; although it might perhaps have been only slightly manifested. Nearly a century before (1414), this affection appeared far more prominently on the occurrence of a no less general disorder of the same kind; so that all those who had the complaint, suffered from a considerable hoarseness, and all public business in Paris was interrupted on this account[475]. It was on that very occasion that the name Coqueluche was first employed, and this having, as is well known, been transferred to the whooping-cough, it is easier to suppose, with respect to the influenza of 1510, which was similarly named, an omission in the account, than the real absence of a symptom so very generally prevalent; for in these kinds of comparisons and denominations, the common sense of the people errs much less than the learned profundity of political historians. We must not omit here to remark that three years before (1411), and thirteen years afterwards, two diseases entirely similar and equally general, made their appearance in France, of which we nowhere find that any notice has been taken up to the present time. The first was called _Tac_, the second _Ladendo_, which designations have since entirely gone out of use. Both were accompanied by very severe cough, so that in the former, ruptures not unfrequently occurred, and pregnant women were in consequence prematurely confined, and by the latter, from its universality, the public worship was disturbed. In the ladendo, there seems to have been an affection of the kidney of an inflammatory character, and much more severe than in the coqueluche of 1510, a memorable example of epidemic influence, and without a parallel in modern times. This pain in the kidneys, which was as severe as a fit of the stone, was followed by fever with loss of appetite, and an incessant cough that terminated in disagreeable eruptions about the mouth and nose. The disorder ran a course of about fifteen days, and was generally prevalent throughout October, being unattended with danger, notwithstanding the severity of its symptoms. One might almost be tempted to regard the tac of 1411 as the coqueluche of 1414, which is only slightly alluded to by Mezeray, and whereof the author from whom we are now quoting, has made no mention; for a false date might easily occur here. Yet this must remain undecided until we can obtain fuller information, for we have experienced, even in the most recent times, an example of influenzas (1831 and 1833) following each other in quick succession. Gastric symptoms and an inordinate degree of irritability accompanied the spasmodic cough, and the complaint terminated with evacuations of blood. However, the disease was unattended with danger, and lasted upon the whole only three weeks[476]. Four other epidemics similar to that of 1510 appeared in the sixteenth century, two which were quite general in the years 1557 and 1580, and two less extensively prevalent in the years 1551 and 1564[477]. Of the two former we possess accurate descriptions; it will therefore aid us in forming a correct judgment respecting the influenza of 1510, if we here take a review of these also, since the most experienced contemporaries classed all these disorders together as of a similar kind. During the dry unfavourable summer of 1557, invalids were suddenly seized with hoarseness and oppression at the chest, accompanied with a pressure on the head, and followed by shivering and such a violent cough, that they thought they should be suffocated, especially during the night. This cough was dry at first, but about the seventh day, or even later, an abundant secretion took place either of thick mucus or of thin frothy fluid. Upon this the cough somewhat abated, and the breathing became freer. During the whole course of the disorder, however, patients complained of insufferable languor, loss of strength, want of appetite and even nausea at the sight of food, restlessness and want of sleep. The malady ended in most cases in abundant perspiration, but occasionally in diarrhœa. Rich and poor, people of every occupation and of all ages, were seized with this disease in whole crowds simultaneously, and it passed easily from a single case to a whole household. On this occasion death rarely occurred, except in children who had not power to endure the severity of the cough, and medicine was of little avail, either in alleviating the disorder or arresting its destructive course. The already established name of this disease was immediately called to mind again in France. It was not, however, confined to that kingdom, but prevailed as generally, with some considerable varieties of form, in Italy, Germany, Holland, and doubtless over a still wider range of country[478]. The same was the case with the influenza of 1580, which spread over the whole of Europe, and seems to have been less severe; thus bearing a closer resemblance[479] to that of 1831 and 1833, which is still in the recollection of most of our readers from their own experience. A more elaborate research into this very important subject would far surpass the limits of this treatise, for phenomena deeply affecting the whole system of human collective life are here to be considered, which can only become apparent when received as a connected whole, yet we must at least point out the relation which the influenzas bear to the greater epidemics. This is quite apparent; for as catarrhs are not unfrequently the forerunners, accompaniments or sequelæ of important diseases in individual cases[480], excitement of the mucous membrane being often merely an outward sign of more deeply seated commotion, so also are influenzas usually only the _first manifestations, but sometimes also the last remains of extensive epidemics_. The most recent example is still fresh in our memories. The influenza of 1831 was immediately followed by the Indian cholera, and scarcely had this, after its revival in Eastern and central Europe, vanished, when the influenza of 1833 appeared, as if to announce a general peace. After the influenza of 1510, a plague followed in the north of Europe, which in Denmark carried off the son of King John[481]; 1551 was the year of the fifth epidemic sweating sickness. In 1557, the influenza in Holland, was followed by a bubo plague, which lasted the following year, and carried off 5000 of the inhabitants at Delft[482]. In 1564, a very destructive plague raged in Spain, of which 10,000 people died at Barcelona, and finally, in 1580, the last year of influenza in that century, a plague of which 40,000 died in Paris, appeared over the greater part of Europe and in Egypt[483]. SECT. 7.—EPIDEMICS OF 1517. We now revert to the year 1517, and shall consider the epidemics which accompanied the English sweating sickness. First of all, the _Hauptkrankheit_, that brain fever which so often recurred in the central parts of Europe, appeared extensively throughout Germany. Many died of this dangerous disease, and we are assured by contemporaries that other inter-current inflammatory fevers were also very fatal[484]. Such was the case in Germany, the heart of Europe. Another disease, however, much more important, and till that time wholly unknown to medical men, appeared in Holland, which broke out in January, 1517, and from its dangerous and quite inexplicable symptoms, spread fear and horror around. It was a malignant, and, according to the assurance of a very respectable medical eye-witness, an infectious inflammation of the throat, so rapid in its course that, unless assistance were procured within the first eight hours, the patient was past all hope of recovery before the close of the day. Sudden pains in the throat, and violent oppression of the chest, especially in the region of the heart, threatened suffocation, and at length actually produced it. During the paroxysms the muscles of the throat and chest were seized with violent spasm, and there were but short intervals of alleviation before a repetition of such seizures terminated in death. Unattended by any premonitory symptoms, the disease began with a severe catarrhal affection of the chest, which speedily advanced to inflammation of the air passages, and where death did not occur on the day of the attack, ran on to a dangerous inflammation of the lungs, which followed the usual course, but was accompanied by a very high fever. Occasionally a less perilous transition into intermittent fever was observed, but in no case did a sudden recovery take place; for even when the fever subsided, the patient continued to suffer, for at least a month, from pain in the stomach and great debility, which symptoms admit of easy explanation to a medical man of the present day, from the fissures and small ulcers of the tongue, which appeared when the fever was at its height, and obstinately resisted the usual treatment. The remedies employed shew the circumspection and ability of the Dutch physicians. They had recourse, as soon as possible, at the latest within six hours, to venesection, and followed this up immediately by purgatives, of which, however, some eminent men disapproved, and this to the great detriment of their patients, for without the combined effect of both these means, the sudden suffocation could not be averted. Moreover, the employment of detergent gargles, whereby the extension of the affection to the lungs was prevented, as also of demulcent pectoral remedies, was decidedly beneficial, and it is affirmed that all who were thus treated were easily restored[485]. Extraordinary and peculiar as this disease, for which contemporaries found no name, was, its rapid onset and its sudden disappearance were still more so. Most of those affected were taken ill at the same time, and eleven days of suffering and misery had scarcely elapsed when not another case occurred; the numbers who had fallen victims were buried; and but for the journal of the worthy Tyengius[486], no distinct record would have existed of this remarkable epidemic, which however, it is certain, spread further than merely over the misty territory of Holland, and apparently with still greater malignity; for in the same year we find it in Basle, where, within the space of eight months, it destroyed about 2000 people, and its symptoms would seem to have been still more strongly marked. Respecting the intermediate countries, which it is highly probable that the disease passed through from Holland before it reached Basle, we unfortunately have no information. The tongue and gullet were white as if covered with mould, the patient had an aversion to food and drink, and suffered from malignant fever, accompanied with continued headache and delirium. Here also, in addition to an internal method of cure which has not been particularly detailed, the cleansing of the mouth was perceived to be an essential part of the treatment: the viscous white coating was removed every two hours, and the tongue and fauces were afterwards smeared with honey of roses[487], whereby patients were restored more easily than when this precaution was omitted[488]. It appears, according to modern experience, to admit of no doubt that this disease consisted of an inflammation of the mucous membrane which, accompanied by a secretion of lymph, spread from the œsophagus to the stomach, and likewise through the air passages to the lungs, being thus identical with pharyngeal croup, which was represented a few years ago as a new disease, and has in consequence been designated by a special name[489]. Its subsequent appearance in the memorable year 1557, respecting which we have a still more complete account, gives additional weight to this supposition. In that year it broke out in October, and was observed by Forest, who was himself the subject of it, at Alkmaar, where it attacked whole families, and in the course of a few weeks destroyed more than 200 people. It was not, however, so excessively rapid in its course as in 1517, but began with a slight fever like a common catarrh, and shewed its great malignity only by degrees. Sudden fits of suffocation then came on, and the pain of the chest was so dreadfully distressing that the sufferers imagined they must die in the paroxysm. The complaint was increased still more by a tight convulsive cough, and until this was relieved by a secretion of mucus, proved dangerous, especially to pregnant women, sixteen of whom died within the space of eight days, whilst those who survived were all prematurely brought to bed. The fever which accompanied the inflammation was very various in its course. It was rarely observed to continue without intermission, but where this was the case, was attended with the greatest peril. Yet death did not take place on this visitation until the ninth or fourteenth day, whereas in the year 1517 as many hours would have sufficed to produce a fatal termination. After this period the danger diminished, and those patients were most secure from suffocation, provided they had good medical attendance, whose complaint had been accompanied throughout its course by fever of only an intermittent character. So marked was the influence of the Dutch soil, that until this intermittent passed into continued fever of different gradations, it appeared of the purest and most unmixed type. In these cases the inflammation was less completely formed, so that even bleeding, a remedy otherwise indispensable, was sometimes unnecessary. Those affected all suffered most at night and in the morning, the latter generally bringing with it the inflammation of the larynx and trachea, which, however, they had not at that time experience enough to recognise as such, perceiving as they did only a slight redness in the fauces. The painful affection of the stomach was also in this epidemic very distinctly marked, so that a sense of pressure at the præcordia, accompanied by continual acid eructations, continued to exist even after a succession of six or seven fits of fever; and convalescents were troubled for a long time with dyspepsia, debility and hypochondriasis. The inflammation of the mucous membrane, no doubt, affected the nervous plexuses of the abdomen, as is usually the case, and totally changed the secretion. This was proved by the treatment, for, by administering the necessary purgative remedies, a vast quantity of offensive mucus, mixed with bile, was evacuated. Our excellent eye-witness assures us that the people sickened as suddenly as if they had inhaled a poisonous blast, so that more than a thousand people in Alkmaar betook themselves to their beds in a single day, a thick stinking mist having previously for several days spread over the land. This pestilence did not terminate so speedily as that of the year 1517; on the contrary, it delayed until the winter, and seems to have formed the conclusion of a whole series of morbid phenomena, particularly of the already mentioned influenza throughout Europe, and of the bubo plague in Holland, which had occurred in the middle of the summer,—phenomena that were accompanied by the usual attendants of epidemics, namely great scarcity, and unusual occurrences in the atmosphere, such, for instance, as electric illuminations of prominent objects, and so forth[490]. The close connexion between this inflammation of the air-passages and gullet and the epidemic catarrh is quite apparent; for these are but gradations and gradual transitions in the affection of the mucous membrane, as also in the power of atmospherical causes, which especially influence the organs of respiration. We believe, therefore, that we are fully justified in classing the epidemic described to have taken place in Holland and Germany in 1517, with the influenzas; and in declaring the morbid commotion in human collective life which thus manifested itself, to have been a forerunner of the English pestilence, which was simultaneously prepared by the altered condition of the atmosphere, and broke out a few months later. We ought not to omit here to mention that, in this same year, 1517, the small-pox, and with it, as field-poppies among corn, the measles, was conveyed by Europeans to Hispaniola, and committed dreadful ravages at that time, as afterwards, among the unfortunate inhabitants. Whether the eruption of these infectious diseases in the new world was favoured by an epidemic influence or not, can no longer be ascertained; yet the affirmative seems probable from the fact, that the small-pox did not commit its greatest ravages in Hispaniola[491] until the following year, and, according to recent experience, those epidemic influences which extend from Europe westward, always require some time to reach the eastern coasts of America. But even without this phenomenon in the New World, which is now for the first time placed within the pale of observations on epidemics, we have facts at hand sufficiently numerous and worthy of credit to prove—_that the English Sweating Sickness of 1517, made its appearance, not alone, but surrounded by a whole group of epidemics, and that these were called forth by general morbific influences of an unknown nature_.