1675. In 1678 the “intermittent” constitution returned, having been absent

for thirteen years, and continued through 1779-80, until its “strength was broken.” In 1681 smallpox was unusually mortal, the deaths being more than in any previous year. Most of these constitutions fall to be dealt with fully in other chapters: but as we are here specially concerned with the succession to the plague, it is to be noted how largely the epidemic mortality in London fell upon the age of childhood for a number of years after the Great Plague of 1665. It was observed both by English and foreign writers that the next epidemic following the Black Death of 1348-49, namely, that of 1361 in England and of 1359-60 in some other parts of Europe, fell mostly upon children and upon the upper classes of adults. There is doubtless some particular application of the population principle in the earlier instance as in the later, but not the same application in both. The conditions at the beginning of the three hundred years’ reign of plague in Britain were different from those at the end of it. The increased prevalence of smallpox in the generation before the last great outburst of plague, and the infantile or puerile character of the epidemic fever of 1661, as described by Willis, show that the incidence of infectious mortality had already begun to shift towards the age of childhood. It looks as if the conditions of population, intricate and obscure as they must be confessed to be, were somehow determining what the reigning infectious maladies, with their special age-incidence, should be. Such a gradual change is the more probable for the reason that infectious mortality came in due time to be mostly an affair of childhood. The plague, which was the great infection of the later medieval and earlier modern period, was peculiarly fatal to adult lives; on the other hand, the mortality from infectious diseases in our own time falls in much the larger ratio upon infants and children. It looks as if this change, now so obvious, had begun before the end of plague in Britain, having become more marked in the generation following its extinction. The direct successor of plague, so far as concerns age-incidence and nosological affinity, was the pestilential or malignant typhus, which came into great prominence in 1685-86, in circumstances that seemed to contemporaries to forebode a return of the plague. But before we come to that, there remains a little to be said of some other fevers, especially of the comatose fever of 1673-76, which was largely an affair of childhood. Pepys says that he went on 3 May, 1668, to Old Street (St Luke’s) to see Admiral Sir Thomas Teddiman, “who is very ill in bed of a fever,” and, in a later entry, that he “did die by a thrush in his mouth” on the 12th of May. Next year, 1669, Pepys and his wife went on tour through several parts of Europe, and had hardly returned to their house in Seething Lane when the lady fell ill of a fever; on 2nd November, it was “so severe as to render her recovery desperate,” and on 10th November she died, in her 29th year,--a surprising sequel, as her husband felt, to a “voyage so full of health and content.” These two years, for which we have a sample of the London fevers, were marked in the Netherlands by epidemics of fevers which are among the most extraordinary in the whole history. At Leyden in 1669 the fever reached such a height as to cut off 7000--a mortality which would not have been surprising if the disease had been plague; but it was not plague, it wanted the buboes, carbuncles &c., was longer in its course, and, strangest of all, affected the upper classes far more severely than the poor, so much so “that of seventy men administering the public affairs, scarcely two were left[25],” while, according to Fanois, who was the Leyden poor’s doctor, the lower classes, “protected as it were by having survived the simpler forms of fever,” suffered from this malignant epidemic far less than the rich[26]. The mortality is said to have risen as high as three-fourths of the attacks. At Haarlem the burials in a week rose to three or four hundred (which was a fair week’s average for London itself in an ordinary season), the epidemic lasting four months and leaving hardly one family untouched. Among the symptoms were extreme praecordial anxiety, weight at the pit of the stomach, constant nausea and loathing, vomiting, in part bilious but chiefly “pituitous,” thirst and restless tossing. It was attended by an affection of the throat and mouth--an angina with aphthae or thrush of the palate. The pools and other sources of water for domestic use were unusually stagnant that summer in Holland, and were commonly blamed for the epidemic; but Fanois points out that at Haarlem and Emden, where similar fevers raged, “salubriores non desunt aquae[27].” After such an instance as the Leyden fever of 1669, nothing is incredible in the records of fever subsequent to the extinction of plague. Turning to Sydenham’s account of the continued fever which occurred in London during the same season, the latter half of 1669, as well as in the three years following, we find that it was characterized rarely by diarrhoea or sweats, commonly by pain in the head, by a moist white tongue which afterwards became covered by a dense skin, and by a greater tendency than Sydenham had ever seen to aphthae (the “thrush in the mouth” of Admiral Teddiman in 1668) when death threatened--the same being a “deposition from the blood of foul and acrid matter upon the mouth and throat.” But London in 1668 and 1669 suffered little from fevers in comparison to Leyden, Haarlem and other Dutch towns, its high mortality in the summer and autumn of 1669 being from infantile diarrhoea, cholera nostras and dysentery. Sydenham’s continued fever from 1673 to 1676 (he was absent from his practice in 1677 owing to ill health) was a malady which affected adults as well as children, but, it would appear, the latter especially. The only characteristic case given is of a boy of nine who did not begin to mend until the thirtieth day. Many recovered in a fortnight, while others were not clear of the fever in a month. On account of the remarkable stupor which almost always attended it, Sydenham called the fever of this constitution a comatose fever. It began with sharp pains in the head and back, pains in the limbs, heats and chills, etc. His account of the comatose state is exactly like that given by Willis for the fever of children in 1661--profound stupor, sometimes for a week long, so profound in some as to pass into absolute aphonia (the “acute fever with dumbness” of later writers), while others would talk a few words in their sleep, or would seem to be angry or perturbed by something (the chimaeras mentioned by Willis) and would then become tranquil again; when roused to take physic or to drink they would open the eyes for a moment and then fall back into stupor. When they began to mend, they would crave for absurd things to eat or drink. During convalescence the head, through weakness, could not be kept straight but would incline first to one side and then to the other[28]. The years 1678-1680 witnessed remarkable epidemics of ague, such as had occurred on several occasions before, the last in the years 1657-59. They engross so much of Sydenham’s writing, especially in connexion with the Peruvian-bark controversy, that we hear little of any other fever until the great epidemic of continued fever, or typhus, in 1685-6. But he does mention briefly that the interval between the decline of the agues in 1680 and the beginning of the “new fever” of 1685, was occupied by “continued depuratory” fevers--depuratory of the dregs of the preceding intermittent constitution, and comparable in that respect to the fevers of 1661-64 which followed the agues of 1657-59[29]. Sydenham’s term “depuratory” does not help us much; but we learn something from Morton as to what fevers were prevalent, besides the epidemical intermittents, in the years preceding the epidemic of 1685-86. Morton classes them as continued συνεχής (_Synocha_), by which he means something less malignant than _Synochus_. A fever which began in the milder form would often degenerate into the more malignant, the cause assigned, in the usual recriminatory manner of the time between rival schools, being mistaken treatment. But sometimes the fever was malignant from the outset, with purple spots, petechiae, morbillous efflorescence, watery vesicles on the neck and breast, buboes, and anthraceous boils. All these fevers, says Morton, whether they were spurious forms of synocha, or malignant from the outset, were sporadic, “neque contagione, ut in pestilentiali constitutione, sese propagabant[30].” This points to their having been part of that strange aguish epidemic of which an account is given in another chapter. In Short’s abstracts of parish registers, the year 1680 seems to have been the most unhealthy of the series in country parishes, and that is borne out by one Lamport, or Lampard, an empiric who practised in Hampshire: “I will tell you somewhat concerning a malignant fever. In the year ’80 or ’81 there were great numbers of people died of such fevers, many whereby were taken with vomitings, etc., yet I had the good fortune to cure eighteen in the parish of Aldingbourn, not one dying, in that great compass, of that disease[31].” The moral is that the empiric recovered his cases, whereas the regular faculty lost theirs; which means that the fevers were of various degrees, some aguish, some typhus, as in the exactly similar circumstances a century after, 1780-85. In the London Bills from 1681 to 1684, the deaths from fever were many, with some from “spotted fever” nearly every week, while the annual mortalities from all causes were high. It is the more remarkable, therefore, that Sydenham should have discovered, in the beginning of 1685, the outbreak of a new fever, different from any that had prevailed for seven years before. The explanation seems to be that a malignant typhus fever, such as might have been discovered in any year in the crowded parishes where the working classes lived, broke out at the Court end of the town, where Sydenham’s practice lay. The epidemic fever of 1685-86. A letter of 12 March, 1685, says: “Sir R. Mason died this morning in his lodging at Whitehall. A fever rages that proves very mortal, and gives great apprehensions of a plague[32].” Sydenham also was reminded of the circumstances preceding the Great Plague of London in 1665. In his first account of the epidemic of fever in 1685[33], which began with a thaw in February, he points out that the thaw in March, 1665, had been followed by pestilential fever and thereafter by the plague proper. In a later reference, when the epidemic of fever was in its second year (1686) he says: “How long it may last I shall not guess; nor do I quite know whether it may not be a certain more spirituous, subtle beginning, and as if _primordium_, of the former depuratory fever (1661-64) which was followed by the most terrible plague. There are some phenomena which so far incline me to that belief[34].” However, no plague followed the malignant, if not pestilential, fever of 1685-86. The reign of plague, as the event showed, was over; the fever which had been on former occasions its portent and satellite, came into the place of reigning disease. It is true that Sydenham does not identify the fever of 1685-86 by name as pestilential fever; on the contrary, he entitles his essay “De Novae Febris Ingressu.” But the novelty of type was partly in contrast to the fevers immediately preceding, which admitted treatment by bark, and its principal difference from the pestilential fever of former occasions seems to have been that it was not followed by plague[35]. Its antecedents and circumstances were very much those of plague itself. Its mortality was greatest in the old plague-seasons of summer and autumn, it had slight relation to famine or scarcity, or to other obvious cause of domestic typhus. Sydenham can find no explanation of the new constitution but “some secret and recondite change in the bowels of the earth pervading the whole atmosphere, or some influence of the celestial bodies.” He enlarges, however, on the character of the seasons preceding, which would have affected the surface, if not the bowels, of the earth, and the levels of the ground-water. The winter of 1683-84 was one of intense frost; an ice-carnival was held on the Thames during the whole of January. The long dry frost of winter was followed by an excessively hot and dry summer, the drought being such as Evelyn did not remember, and as “no man in England had known.” For eight or nine months there had not been above one or two considerable showers, which came in storms. The winter of 1684-85 set in early, and became “a long and cruel frost,” more interrupted, however, than that of the year before. The spring was again dry, and it was not until the end of May 1685 that “we had plentiful rain after two years’ excessive drought and severe winters[36].” The two years of excessive drought, with severe winters, had their effect upon the public health, as will appear from Short’s abstracts of parish registers in town and country[37]; the years 1683-85 being conspicuous for the excess of burials over baptisms: _Country Parishes._ Year Registers Registers with Deaths in Births in examined excess of death them them 1683 140 37 923 685 1684 140 31 900 629 1685 140 19 574 478 1686 140 16 419 301 1687 143 19 522 427 1688 143 11 327 267 _Towns._ 1683 25 8 1398 1169 1684 25 8 1243 865 1685 25 4 1191 741 1686 25 2 555 418 1687 25 1 313 269 1688 25 2 191 146 There is no clue to the forms of sickness that caused the excessive mortality in country parishes and provincial towns. But in London it appears from the Bills that the one great cause of the unusual excess of deaths in 1684 was an enormous mortality from infantile diarrhoea, from the end of July to the middle of September, during the weather which Evelyn describes as excessively hot and dry with occasional storms of rain. It was in the second year of the long drought, February, 1685, that Sydenham dated the beginning of his new febrile constitutions. The mortality of 1685 was just twenty deaths more than in 1684 (23,222); but fever (with spotted fever) and smallpox had each a thousand more out of the total than in the year before. Sydenham says that the fever did not spare children, which might be alleged of typhus at all times; but a fever of the kind, even if it ran through the children of a household, seldom cut off the very young, the mortality being in greatest part of adults and adolescents. Excepting smallpox for the year 1685, infantile and children’s maladies were not prominent during the constitution of the “new fever;” the usual items of high infantile mortality, such as convulsions and “griping in the guts” or infantile diarrhoea, were moderate and even low. Hence, although the weekly fever-deaths in the following Table may not appear sufficient for the professional and other interest that they excited, it is to be kept in mind that they had been mostly of adult lives. It is probable also that a good many of them had been among the well-to-do, and perhaps at first in the West End; for there is nothing in the height of the weekly bills for all London to bear out the remark of the letter of 12 March, already quoted, “A fever rages that proves very mortal and gives apprehensions of a plague.” _Weekly Mortalities in London._ 1685. Week Of spotted Of Of griping ending Dead Of fever fever smallpox in the guts March 3 376 49 0 11 35 10 458 73 2 30 31 17 367 53 1 25 17 24 441 63 3 33 27 31 366 53 5 24 36 April 7 421 47 10 28 30 14 433 64 8 32 27 21 473 66 6 47 45 28 470 68 3 49 45 May 5 385 50 6 35 39 12 447 75 3 59 41 19 437 79 4 58 43 26 452 61 2 74 39 June 2 469 65 8 65 36 9 521 88 14 62 41 16 499 91 9 66 34 23 478 76 12 71 53 30 526 82 13 84 45 July 7 497 81 8 87 53 14 478 82 11 78 51 21 464 79 11 87 47 28 488 62 6 68 54 Aug. 4 493 82 5 86 51 11 529 109 13 89 47 18 580 74 13 99 71 25 536 91 7 67 85 Sept. 1 556 94 13 53 104 8 539 82 10 81 77 15 485 90 7 63 70 22 459 90 10 37 51 29 502 114 3 58 53 Oct. 6 444 108 11 40 54 13 445 89 13 61 38 20 369 86 5 40 28 27 379 73 7 29 45 Nov. 3 443 96 8 55 43 10 410 84 7 26 35 17 432 103 8 35 39 24 471 107 6 56 31 Dec. 1 384 87 4 36 24 8 452 98 8 49 24 15 403 69 3 29 47 22 438 99 2 34 27 29 432 80 9 28 28 _Weekly Mortalities in London._ 1686. Week Of spotted Of Of griping ending Dead Of fever fever smallpox in the guts Jan. 5 394 80 5 28 29 12 400 80 3 27 48 19 396 67 5 36 32 26 366 76 2 21 30 Feb. 2 452 87 8 16 30 9 416 78 5 37 30 16 405 94 9 20 25 23 419 74 7 16 40 March 2 417 84 1 20 37 9 455 95 6 18 30 16 415 71 10 31 21 23 453 78 11 22 46 30 372 58 8 17 35 April 6 392 80 11 13 27 13 393 72 7 21 29 20 420 61 10 26 37 27 471 99 9 27 22 May 4 429 78 21 28 46 11 374 71 6 16 22 18 395 69 5 17 3 (sic) 25 395 66 11 24 36 June 1 383 63 4 15 49 8 404 66 6 26 38 15 523 88 9 43 64 22 503 99 9 25 73 29 473 90 10 31 62 July 6 430 71 6 18 62 13 401 76 2 19 56 20 464 87 14 24 74 27 508 99 3 23 76 Aug. 3 506 86 9 14 90 10 493 74 7 14 104 17 522 99 7 26 101 24 536 115 5 18 104 31 520 90 8 22 93 Sept. 7 531 94 4 21 104 14 498 84 6 18 110 21 540 100 3 17 101 28 443 90 5 13 67 Oct. 5 425 81 4 13 60 12 432 96 2 9 56 19 391 73 1 9 33 26 402 79 3 11 43 Nov. 2 373 64 1 23 39 9 456 85 1 19 31 16 401 73 2 9 23 23 359 61 4 10 54 30 397 68 1 7 34 Dec. 7 359 76 0 9 21 14 438 60 0 8 46 21 354 49 1 8 39 28 356 53 2 9 32 Sydenham says that he regarded the new fever at first as nothing more than the “bastard peripneumony” which he had described for previous seasons; but he had soon cause to see that it wanted the violent cough, the racking pain in the head during coughing, the giddiness caused by the slightest movement, and the excessive dyspnoea of the latter (Huxham likewise distinguished typhus from “bastard peripneumony”). The early symptoms of the “new fever” were alternating chills and flushings, pain in the head and limbs, a cough, which might go off soon, with pain in the neck and throat. The fever was a continued one, with exacerbation towards evening; it was apt to change into a phrensy, with tranquil or muttering delirium; petechiae and livid blotches were brought out in some cases (Sydenham thought they were caused by cordials and a heating regimen), and there were occasional eruptions of miliary vesicles. The tongue might be moist and white at the edges for a time, latterly brown and dry. Clammy sweats were apt to break out, especially from the head. If the brain became the organ most touched, the fever-heat declined, the pulse became irregular, and jerking of the limbs came on before death. Later writers, for example those who described the great epidemic fever of 1741, have identified the fever of 1685-86 with the contagious malignant fever afterwards called typhus, and Murchison, in his brief retrospect of typhus in Britain, has included it under that name. Sydenham mentions petechiae and livid blotches in some cases, and the Bills give a good many of the deaths in the worst weeks of the epidemic under the head of “spotted fever.” It is not at first easy to understand why Sydenham should have written an essay specially upon it, in September, 1686, to claim it as a new fever[38] and not rather as the old pestilential fever--“populares meos admonens de subingressu novae cujusdam Constitutionis, a qua pendet Febris nova species, a nuper grassantibus multum abludens.” It should be kept in mind that his motive was correct treatment, and that the fashionable treatment of the day by Peruvian bark was, in his judgment, unsuited to this fever, however much it may have suited the epidemical intermittents of 1678-79 and the “depuratory” dregs of them for several years after. Physicians, he says, had learned to drive off by bark the fevers of the former constitution, from 1677 to the beginning of 1685, even when the fever intermitted little and sometimes when it intermitted not at all; and they saw an indication for bark in the nocturnal exacerbations of the new fever. Sydenham found that even large doses of bark did not free the patient from fever, and that restoration to health under treatment with the bark was due “magis fortunato alicui morbi eventu quam corticis viribus.” He seeks to establish the indications for another treatment by setting forth the symptoms minutely; and as the question of bark in fevers was the great medical question of the time, this may well have been Sydenham’s motive for discovering in the epidemic of 1685-6 a “new fever” although he does not say so in as many words. We have a good instance of how the bark-craze was at this time influencing the very highest circles of practice in the case of Lord Keeper Guildford, in July, 1685, as related in another chapter. It will be seen from the table of weekly deaths that the second of the two hard winters was over before the fever began to attract notice. Sydenham compares its beginning after the thaw in February, 1685, to the beginning of the plague when the frost broke in March, 1665. If it had been merely the typhus of a hard winter, of overcrowding indoors, of work and wages stopped by the frost, and of want of fuel (which things Evelyn mentions as matters of fact), it would have come sooner than the spring of 1685. The Bills for years before have regularly a good many deaths from fever, and always some from spotted fever; but these may have come from parishes wholly beyond the range of Sydenham’s practice. The fever began definitely for him in February, 1685, and was at its worst in the old plague-seasons of summer and autumn. If the seasons had any relation at all to it, the epidemic was a late effect of the long drought, an effect which was manifested most when the rain came, in the summer of 1685 and throughout the mild winter and normal summer of 1685-86. It must have been for that reason that Sydenham traced the source of it to “some secret and recondite change in the bowels of the earth,” rather than to a change in the sensible qualities of the air. One must ever bear in mind that the physicians of the Restoration gave no thought to insanitary conditions of living; in that respect the later Stuart period seems to have been behind the Elizabethan or even the medieval; we cannot err in assuming, behind all Sydenham’s speculative causes, a great deal of unwholesomeness indoors. Sydenham’s fullest reference to the subterranean sources of poisonous miasmata occurs in his tractate on Gout: “Whether it be that the bowels of the earth, if one may so speak, undergo various changes, so that by the accession of vapours exhaled therefrom the air is disturbed, or that the whole atmosphere is infected by a change which some peculiar conjunction of certain of the heavenly bodies induces in it;--the matter so falls out that at this or that time the air is furnished with particles that are adverse to the economy of the human body, just as at another time it is impregnated with particles of a like kind that agree ill with the bodies of some species of brute animals. At these times, as often as by inspiration we draw into the naked blood miasmata of this kind, noxious and inimical to nature, and we fall into those epidemical diseases which they are apt to produce, Nature raises a fever,--her accustomed means of vindicating the blood from some hostile matter. And such diseases are commonly called _epidemical_; and they are short and sharp because they have thus a quick and violent movement[39].” It was Sydenham’s intimate friend Robert Boyle who worked out the hypothesis of subterraneous miasmata as a cause of epidemic (and endemic) diseases. An account of his theory will be found in the chapter on Influenzas and Epidemic Agues. It may be said here that it needs only a few changes, especially the substitution of organic for inorganic matters in the soil, to bring it into line with the modern doctrine of miasmatic infective disease as expounded by the Munich school. It has not been usual to think of spotted fever, (or of influenzas), in that connexion; but a telluric source of the epidemic constitution of 1685-86 was clearly Sydenham’s view; and as the fever came in circumstances like those of the last great plague, and was thought at the time to be the forerunner of another great plague, its connexion with recondite decompositions in the soil, dependent on the phenomenal drought of two whole years before, cannot be set aside as a possibility, the less so that the fever, although of the type of typhus, was not a fever of cold, hunger, and domestic distress, but mainly of the warm, or mild, or soft weather following the long drought, and of many well-to-do-people, as in the great Netherlands fever of 1669. My view of it is that it was the modified successor of plague, the _pestis mitior_, which used to precede and accompany the plague, now become the dominant constitution. The authentic figures of its mortality come from London; but Sydenham says that its “effects were felt far more in other places”; although Short’s abstracts of parish registers, given above, do not indicate excessive mortality throughout England. Retrospect of the great Fever of 1623-25. The most instructive instance of _pestis mitior_ in Britain is not the pestilential fever which led up to the last plague (1665-6), but the great epidemic of fever all over England and Scotland which reigned for two or three years before the great outburst of plague in 1625. I go back to this because it was not wholly or even mainly a famine fever (although it was as general as one of the medieval famine-fevers), and because in that respect it furnishes a close parallel to the fever of 1685-86, which I regard as the successor of the plague. After this interlude in the history, we shall proceed to consider the question of the final extinction of plague. In Scotland the fever of 1622-23 was directly connected with famine, but in England it was not obviously so according to the records that remain. The dearth in Scotland began as early as the autumn of 1621: “Great skarsitie of cornes throw all the kingdome,” the harvest having been spoiled by wet weather and unheard of river floods; however, abundance of foreign victual came in, and the scarcity was got over[40]. In England the same harvest of oats was abundant, and probably yielded the “foreign victual” which relieved the Scots; but the price of wheat rose greatly[41]. It was the year following, 1622, that really brought famine and famine-sickness to Scotland, as the second of two bad harvests had always done. On 21 July, 1622, a fast was proclaimed at Aberdeen for “the present plague of dearth and famine, and the continuance thereof threatened by tempests, inundations and weets likely to rot the fruit on the ground[42].” In an entry of the Chronicle of Perth, subsequent to July, 1622, it is said: “In this yeir about the harvest and efter, thair wes suche ane universall seikness in all the countrie as the ellyke hes not bene hard of. But speciallie in this burgh, that no familie in all the citie was frie of this visitation. Thair was also great mortalitie amonge the poore.” From which it appears that the autumnal fever of 1622 was among all classes in Scotland. The famine in Scotland became more acute in the spring and summer of 1623; the country swarmed with beggars, and in July, says Calderwood, the famine increased daily until “many, both in burgh and land, died of hunger.” At Perth ten or twelve died every day from Midsummer to Michaelmas; the disease was not the plague, but a fever[43]. At Dumfries 492 died during the first ten months of 1623, perhaps a ninth part of the inhabitants, about one hundred of the deaths being specially marked as of “poor[44].” The “malignant spotted fever” which caused numerous deaths in 1623 in Wigton, Penrith and Kendal is clearly part of the famine-fever of Scotland extending to the Borders and crossing them. This is a famine-fever of the old medieval type, like that of 1196 which, according to William of Newburgh “crept about everywhere,” always the same acute fever, putting an end to the miseries of the starving, but attacking also those who had food. The same spotted fever was all over England in 1623, but it did not, as in Scotland, come in the wake of famine. It is true that the English harvest of 1622 was a good deal spoiled; a letter of 25 September says[45]: “Though the latter part of this summer proved so far seasonable, yet the harvest is scant, and corn at a great price by reason of the mildews and blasting generally over the whole realm,” rye being quoted a few weeks later at 7/- the bushel and wheat at 10/-, although the average of wheat for the year, in Rogers’s tables, is not more than 51/1_d._ per quarter, while the average of next year falls to 37/8_d._ These were not famine-prices in England, and there is no evidence of general sickness directly after the harvest of 1622, when corn was dearest. Also, although the autumn of 1623 was a time of “continual wet” in England[46], the price of wheat remained moderate, and even low as compared with the rather stiff price of the winter of 1622-23. But it was not until the summer and autumn of 1623 that the spotted fever became epidemic in England. Short’s abstracts of the registers of market towns show how sickly that year was: Year. No. of No. with Buried Baptised registers excess of in the in the examined. burials. same. same. 1622 25 4 442 345 1623 25 16 2254 439 (sic) 1624 25 9 978 714 1625 25 9 666 563 In September, 1623, the corporation of Stamford made a collection “in this dangerous time of visitation,” and sent £10 of it to Grantham, the rest to go “to London or some other town, as occasion offered.” A London letter of 6 December, 1623, from Chamberlain to Carleton says[47]:-- “Here is a contagious spotted or purple fever that reigns much, which, together with the smallpox, hath taken away many of good sort, as well as meaner people.” He then gives the names of notables dead of it, and adds: “Yet many escape, as the dean of St Paul’s [Dr Donne, who used the occasion to compile a manual of devotion] is like to do, though he were in great danger.” One of the Coke family writes early in January, 1624, from London[48]: “Having two sons at Cambridge, we sent for them to keep Christmas with us, and not many days after their coming my eldest son Joseph fell suddenly into the sickness of the time which they call the spotted fever, and which after two days’ extremity took away his life.” From another letter it appears that one of his symptoms was “not being able to sleep,” the unmistakable vigil of typhus. Although there is no word of the epidemic continuing in Scotland in 1624, it was undoubtedly as prevalent in England in that year as the year before, and prevalent in country houses as well as in towns and cities. Thus, on 7 August, 1624, Chamberlain writes: “The [king’s] progress is now so far off that we hear little thence, but only that there be many sick of the spotted ague, which took away the Duke of Lennox in a few days. He died at Kirby,” a country house in Northamptonshire[49]. On 21 August he writes again: “This spotted fever is cousin-german to it [the plague] at least, and makes as quick riddance almost. The Lady Hatton hath two or three of her children sick of it at her brother Fanshaw’s in Essex, and hath lost her younger daughter, that was buried at Westminster on Wednesday night by her father; a pretty gentlewoman, much lamented.” A letter of 4 September says there was excessive mortality in London, in great part among children (doubtless from the usual infantile trouble of a hot autumn, diarrhoea), while “most of the rest are carried away by this spotted fever, which reigns almost everywhere, in the country as ill as here.” Sir Theodore Mayerne, the king’s physician, confirms this, under date 20 August, 1624: the purple fever, he says, was “not so much contagious as common through a universal disposing cause,” seizing upon many in the same house, and destroying numbers, being most full of malignity[50]. It was clearly an inexplicable visitation. The summer was hot and dry, from which character of the season, says Chamberlain, “some have found out a far-fetched speculation, which yet runs current, and would ascribe it [the spotted fever] to the extraordinary quantity of cucumbers this year, which the gardeners, to hasten and bring forward, used to water out of the next ditches, which this dry time growing low, noisome and stinking, poisoned the fruit. But,” adds Chamberlain, “that reason will reach no farther than this [London] town, whereas the mortality is spread far and near, and takes hold of whole households in many places.” He then gives the names of several eminent persons dead of it, and speaks of others who were “still in the balance[51].” On 9 October, “the town continues sickly still,” and Parliament had been put off, “in consideration of the danger,” from 2 November, 1624, to 15 February, 1625. On Ash Wednesday, 1625, the Marquis of Hamilton died of the pestilent fever at Moor Park, Rickmansworth. Thus far there had been no plague; and if the spotted fever were cousin-german to the plague, as Chamberlain said, it was remarkable in this that it prevailed in the mansions of the rich in town and country and took off more victims among the upper classes than the plague itself even in its most terrific outbursts. However, a plague of the first rank followed in London and elsewhere in the summer and autumn of 1625. The cucumber-theory, above mentioned, shows how puzzled people must have been to account for the spotted fever, or “spotted ague” as it was also called, in 1624. Sir Theodore Mayerne did not think contagion from person to person could explain it, but referred it to “some universal disposing cause.” It is conceivable that the famine-fever of 1622 and 1623 in Scotland and the Marches may have spread by contagion into England in the latter year; but in 1624 there is nothing said of fever in Scotland or of scarcity as a primary cause in England. Besides the famine-fever of Scotland in 1622-23, there was another associated thing which should not be left out of account. Before the famine and fever had begun in that country, the notorious Hungarian fever was raging in the Palatinate, and continued to rage for four years. “Hungarian fever” had become the dreaded name for war-typhus of a peculiar malignity and diffusive power. It had been so often engendered since the 16th century in campaigns upon Hungarian soil as to have become known everywhere under the name of that country. Its infection spread, also, everywhere through Europe; thus it is said to have even reached England in 1566, and again in 1589, although it is not easy to find English evidence of it for either year. It was this type of fever which broke out in the Upper Palatinate, occupied by troops of the Catholic powers, in 1620, and continued through the years 1621, 1622 and 1623; as the title of one of the essays upon this outbreak somewhat fantastically declares, it spread “ex castris ad rastra, ex rastris ad rostra, ab his ad aras et focos[52].” Was the epidemic constitution of “spotted ague” in England in 1623 and 1624 derived from the centre of famine-fever in Scotland, or from the centre of camp-fever in the Palatinate? In the last years of James I. communications were frequent with the latter country, and there was of course much intercourse with Scotland. The spotted fever or spotted ague of 1623-24, the plague of 1625, and the country agues of the same autumn make really a more instructive series of epidemic constitutions than any that fell under Sydenham’s observation, so instructive, indeed, that it has seemed worth while to revert to it for the sake of illustrating the doctrine of epidemics then in vogue. That doctrine made little of contagion from person to person; yet the idea of contagion was familiar, and had been so since medieval times. If we might assume contagion to explain such cases as those that occurred in the houses of squires and nobles, we might find a source of it either in the famine-fever of Scotland or in the war-fever of the Palatinate. But the teaching of the time was that it was in the air; and if the infective principle had been generated either in Scotland or on the upper Rhine it had diffused itself in some inscrutable way. The doctrine of epidemic constitutions seems strange to us; but some of the facts that it was meant to embrace are also strange to us. Were it not for an occasional reminder from influenza, we should hardly believe that any fevers could have travelled as the Hungarian fevers, the spotted fevers or “spotted agues” of former times are said to have done. On the other hand, we have now a scientific doctrine of the effects of great fluctuations of the ground-water upon the production of telluric miasmata, which may be used to rationalize the theory of emanations adopted by Sydenham and Boyle. From this modern point of view the remarkable droughts preceding the pestilential fevers and plagues of 1624-25 and 1665, and preceding the fever of 1685-86, which is the one that immediately concerns us, may be not without significance. The London fever of 1685-86 having been suspected at the time to be the forerunner of a plague, as other such fevers in the earlier part of the century had been, and no plague having ensued, the question arises most naturally at this stage, why the plague should have never come back in London or elsewhere in Britain after the great outbreak of 1665-66. The extinction of Plague in Britain. Plague had been the grand infective disease of Britain from the year of the Black Death, 1348-9, for more than three centuries, down to 1666. The last of plague in Scotland was in 1647-8, in the west and north-west of England about 1650 (in Wales probably in 1636-8), in Ireland in 1650, and in all other parts of the kingdom including London in 1666, the absolute last of its provincial prevalence having been at Peterborough in the first months of 1667[53], while two or three occasional deaths continued to occur annually in London down to 1679. False reports of plague, contradicted by public advertisement, were circulated for Bath in 1675[54], and for Newcastle in 1710[55]; while in London as late as 1799, during a bad time of typhus fever, the occurrence of plague was alleged[56]. It is not easy to say why the plague should have died out. It had been continuous in England from 1348, at first in general epidemics, all over the country in certain years, thereafter mostly in the towns, either in great explosions at long intervals or at a moderate level for years together. The final outburst in 1665, which was one of the most severe in its whole history, had followed an unusually long period of freedom from plague in London, and was followed, as it were, by a still longer period of freedom until at last it could be said that the plague was extinct. In some large towns it had been extinct, as the event showed, at a much earlier date; thus at York the last known epidemic was in 1604, and it can hardly be doubted that many other towns in England, Scotland and Ireland would have closed their records of plague earlier than they did had not the sieges and military occupations of the Civil Wars given especial occasion for the seeds of the infection to spring into life. Plague seemed to be dying out all over England and Scotland (in Ireland it is little heard of except in connexion with the Elizabethan and Cromwellian conquests) for some time before its final grand explosion in London in 1665. In seeking for the causes of its decline and extinction we must keep prominently in view the fact that the virus was brought into the country from abroad as the Black Death of 1348-9. But for that importation it is conceivable that there would have been no signal history of plague in Britain. Its original prevalence was on a great scale, and there were several other widespread epidemics throughout the rest of the 14th century. In the first volume of this history I have collected evidence that plague was endemic or steady for long periods of the 15th and 16th centuries in London, with greater outbursts at intervals, and that in the 17th century it came chiefly in great explosions. Something must have served to keep the virus in the country, and more especially in the towns, until at length it was exhausted. An exotic infection, or one that had not arisen from indigenous conditions, and would probably never have so arisen, does not remain indefinitely in the country to which it is imported. Thus Asiatic cholera, imported into Europe on six, or perhaps five, occasions in the 19th century, has never become domesticated; and yellow fever had a career in the southern provinces of Spain during some twenty years only. Plague did become domesticated for about three centuries in England, and for longer in some other countries of Europe; but it died out at length, and it would almost certainly have died out sooner had it not found in all European countries some conditions not altogether unsuited to it. What were the favouring conditions? If, as I believe, the virus of plague had its habitat in the soil, from which it rose in emanations, and if it depended therein, both remotely for its origin in some distant country, as well as immediately for its continuance in all countries, upon the decomposition of human bodies, then it is easy to understand that the immense mortalities caused by each epidemic would preserve the seeds of the disease, or the crude matters of the disease, in the soil. Buried plague-bodies would be the most obvious sources of future plagues. But if the theory given of the Black Death be correct, bodies dead of famine or famine-fever would also favour in an especial way the continuance of the plague-virus in certain spots of ground, although they would probably never have originated it in this country. Moreover, the products of ordinary cadaveric decomposition would be so much pabulum or nutriment for the continuance of the virus. But all those things being constant, the continuance of plague would largely depend upon the manner in which the dead, after plague, or after famine and fever, or in general, were disposed of. The soil of all England in 1348-9 was filled with multitudes of the dead laid in trenches, and there were several general revivals of plague in the fifty or sixty years following. In London there were plague-pits opened in the suburbs in many great epidemics during three centuries. Even when there was no epidemic the dead were laid in the ground in such a manner that their resolution was speedy, and the diffusion of the products unchecked. But it is undoubted that greater care in the disposal of the dead did at length come into vogue. Thus, in the Black Book of the Corporation of Tewkesbury there is an entry under the year 1603, that all those dead of plague, “to avoid the perill, were buried in coffins of bourde,” the disease having carried off no fewer than 560 the year before (1602) and being then in its second season.[57]. The reason given is “to avoid the peril,” and it is beyond question that burial in a coffin did in fact delay decomposition (unless in peculiar circumstances which need not be particularized), and kept the cadaveric products from passing quickly and freely into the pores of the ground. Again, if the burial were in such coffins as the Chinese commonly use, the decomposition would proceed almost as slowly as if the body had been embalmed, and with as little risk of befouling the soil. For a long time in England such burials were the privilege only of the rich; but as wealth increased by commerce they became the privilege of all classes; and in the last great plague of London, as I said in my former volume, “even at the worst time coffins would seem to have been got for most.” Defoe’s account of the burials in heaps in plague-pits is so exactly like that of Dekker for the plague of 1603, and of other contemporaries for the plague of 1625, that one may reasonably suspect him to have used these earlier accounts as his authority for the practice in 1665, which he had no direct knowledge of. However, I do not contend that there were no such burials in 1665; just as one learns from Dekker that the coffin-makers in 1603 were busily employed and grew rich, although he also describes how a husband “saw his wife and his deadly enemy whom he hated” launched into the pit “within a pair of sheets.” In ordinary times, as we learn from the tables of burial-dues, there were poorer interments without coffins as late as 1628, according to a document printed by Spelman, the name of the parish being withheld, and even as late as 1672 in the parish of St Giles’s, Cripplegate. Spelman’s object in writing in 1641 was to protest against the mercenary practices of the clergy in the matter of burial, recalling the numerous canons of the medieval Church directed against all such forms of simony; and incidentally he mentions that it was testified before the Commissioners that a certain parson “had made forty pound of one grave in ten yeeres, by ten pounds at a time”[58]--a “tenancy of the soil” short enough to satisfy even the so-called Church of England Burial Reform Association. The use of coffins in the burial of the very poorest is now so universal that we hardly realize how gradually it was introduced. I am unable to say when burial in a sheet or cerecloth ceased; but it became less and less the rule for the poorer classes throughout the 17th century. In 1666 was passed the Act for burial in woollen, which was re-enacted more strictly in 1678[59]. The motive of it was to encourage the native woollen manufactures, or to prevent the money of the country from being expended on foreign-made linen; and its clauses ordained that woollen should be substituted for linen in the lining of the coffin and in the shrouding of the corpse, but that no penalty should be exacted for burying in linen any that shall die of the plague. Whether it prohibited in effect the use of linen cerecloths to enshroud corpses where no coffin was used does not appear clearly from the terms of the Act; but, as the intention was to discourage the use of linen, and to bring in the use of woollen, for all purposes of burial, it is probable that it served to put an end to coffinless burials altogether, wherever it was enforced, inasmuch as the prescribed material was wholly unsuited for the purpose of a cerecloth. The history of the London plague-pit between Soho and the present Regent Street shows that, after the last great plague of 1665-66, more caution was used against infection from the buried plague-bodies. Macaulay says it was popularly believed that the earth was deeply tainted with infection, and could not be disturbed without imminent risk to human life; and he asserts that no foundations were laid in the pest-field till two generations had passed and till the spot had long been surrounded with buildings, the space being left blank in maps of London as late as the end of George I.’s reign[60]. After 1666 the old churchyards were not less crowded than before, but more crowded, perhaps because coffined corpses occupied more space and decayed more slowly. On 17 October, 1672, Evelyn paid a visit to Norwich: “I observed that most of the churchyards (tho’ some of them large enough) were filled up with earth, or rather the congestion of dead bodys one upon another, for want of earth, even to the very top of the walls, and some above the walls, so as the churches seemed to be built in pitts.” The same day he had visited Sir Thomas Browne, the author of the famous essay on urn burial or cremation, (suggested to him by the digging up of forty or fifty funeral urns in a field at Old Walsingham). The essay is full of curious learning and equally curious moralizing. But Sir Thomas, though a physician, has not a word to say on so proximate a topic as the state of the Norwich churchyards, which came under his eyes and perhaps under his nose every day of his life[61]. The practice of burying in coffins, which came at length within the means of all classes, may seem too paltry a cause to assign, even in part, for so remarkable an effect as the absolute disappearance of plague after a duration of more than three centuries. My view of the matter is that the virus would have died out of itself had it not been continually augmented, or fed by its appropriate pabulum, and that the gradual change in the mode of interment helped to check such augmentation or feeding. But the more elaborate interment of the dead was itself an index of the greater spending power of the community, and it may be said that it was the better condition of the people, and not this one particular thing in it, which put an end to the periodical recurrences of plague. In all but its earliest outbursts in the fourteenth, and perhaps the fifteenth century, plague had been peculiarly an infection of the poor, being known as “the poor’s plague.” Perhaps the chief reason why the richer classes usually escaped it was that they fled from the plague-tainted place, leaving the poorer classes unable to stir from their homes, exposed to the infectious air, and all the more exposed that their habitual employments and wages would cease, their sustenance become precarious, their condition lowered, and their manners reckless. Again, it was not unusual for the plague to break out in a season of famine or scarcity, during which the ordinary risks of the labouring class would be aggravated. Famines ceased (except in Ireland, where there had been comparatively little plague), and scarcities became less common. The sieges and occupations of the Civil Wars in the middle of the 17th century, which undoubtedly were the occasion of the last outbursts of plague in many of the towns, were a brief experience, followed by unbroken tranquillity. Whatever things were tending to the removal of plague in all its old seats had free course thereafter. On the other hand, one may make too much of the increase of well-being among the labouring class which coincided with the cessation of plague. As a check upon population plague worked in a very remarkable way. In London, as well as in towns like Newcastle and Chester, plague towards the end of its reign arose perhaps once in a generation and made a clean sweep of a fifth or a fourth part of the inhabitants, including hardly any of the well-to-do. It destroyed, of course, many bread-winners and many that were not absolutely sunk in poverty; but its broad effect was to cut off the margin of poverty as if by a periodical process of pruning. The Lord Mayor of London wrote to the Privy Council at the end of the great plague of 1625: “The great mortality, although it had taken many poor people away, yet had made more poverty by decay of tradesmen”--a decay of trade which they might reasonably expect to recover from before long. No such ruthless shears was ever applied at intervals to the growing fringe of poverty in after times. The poor were a more permanent residue, pressing more upon each other; but they did not press more upon the rich, except through the poor rate; on the contrary, the separation of classes became more marked. Perhaps I ought to give an illustration of this, so as not to leave so radical a change in the vague and disputable form of a generality. I shall take the instance of Chester; its circuit of walls, remaining from the Roman conquest, is something fixed for the imagination to rest upon amidst changes within and without them. Passing over its medieval and its not infrequent Tudor experiences of epidemic sickness, let us come to the beginning of the 17th century. In two or three successive seasons from 1602 to 1605 it lost 1,313 persons by plague, as well as about 250 from other causes. The population was then mostly within the walls, and probably did not exceed 5000. There was a shipping quarter on the west side, with egress by the Water-gate to the landing-places on the Dee; a millers’ quarter, with corn-market and hostelries, on the south, connecting by the South gate and bridge with a hamlet across the river along the road to Wales; a Liberty or Freedom of the city outside the walls on the east, along the road to Warrington and Manchester, with a Bar, a short distance out, as in London, to mark the limit of the mayor’s jurisdiction; and on the north side, within the walls, the cattle-market and shambles, with the market for country produce, and a few straggling houses without the gate on the road leading to Liverpool. Chester was a characteristic county town, with its cathedral clergy, its garrison, its resident nobility and gentry, its professional classes, its tradesmen, market people and populace, with the addition of a shipping trade to Ireland and afterwards to foreign and colonial ports. Plague continuing from 1602 to 1605 cut off a fourth or a fifth of its population, and these the poorest. The gaps in the population would gradually have filled up, and the fringe of poverty grown again[62]. The plague came again in 1647, and cut off 2053 in the short space of twenty-three weeks from 22 June to 30 November. The bills of it are extant[63], and show on what parishes the plague fell most. All the parishes were originally within the walls but one, St John’s, the ancient collegiate church of Mercia, built upon a rocky knoll in the south-east angle made by the walls with the river. The other nine parish churches and their graveyards were within the walls; but the parishes of three of them extended beyond the gates, just as the three parishes dedicated to St Botolph at the gates of London did. These three were St Oswald’s, which included the Liberty on the east side, Trinity, which included the shipping quarter on the west as well as the houses along the Liverpool road on the north, and St Mary’s, which included the millers’ suburb across the Dee on the south. Hollar’s map, made a few years after the plague of 1647, shows very few houses beyond the walls, except in the ancient Liberty on the east. But it will appear from the following table that the parishes which had extended beyond the walls must either have been very crowded close up to the walls (as the Gate parishes were always apt to be), or there must have actually been a greater population outside the gates than the contemporary map shows: _Burials from Plague in the several Parishes of Chester in 23 weeks, June 22-Nov. 30, 1647._ _5 parishes wholly within the walls._ Total. First Worst (7th) week. week. St Peter 75 0 14 St Bridget 85 7 9 St Martin 173 9 23 St Michael 133 26 9 St Olave 59 3 5 _3 parishes extending beyond the walls._ St Oswald 396 11 37 St Mary 314 5 20 Trinity 232 1 32 _1 parish wholly without the walls._ St John 358 2 26 Pesthouse 228 0 34 ---- -- --- 2053 64 209 This was the last plague of Chester, but for a small outbreak in 1654. The next vital statistics that we get for the city are more than a century after, in 1774[64]. The population of 14,713 was then divided into two almost distinct parts, separated by the wall. The old city was being rebuilt, all but some ancient blocks of buildings held in the dead hand of the cathedral chapter; it was becoming a model 18th century place of residence for a wealthy and refined class, who were remarkably healthy and not very prolific, the parishes wholly within the walls having 3502 inhabitants. The poorer class had gone to live mostly outside the walls in new and mean suburbs, the three parishes at the Gates and extending now far beyond the walls, together with the original extramural parish of St John’s, having a population of 11,211. There was no town in Britain where the separation of the rich from the poor was more complete; there was hardly another town of the size where the health of the rich was better; and although the health of the populace was not so bad as in the manufacturing towns of Lancashire and Cumberland, close at hand, yet it is hardly possible to find so great a contrast as that between the clean and wholesome residential quarter within the walls and the mean fever-stricken suburbs as described by Haygarth in 1774: “The inhabitants of the suburbs,” he says, “are generally of the lowest rank; they want most of the conveniences and comforts of life; their houses are small, close, crowded and dirty; their diet affords very bad nourishment, and their cloaths are seldom changed or washed.... These miserable wretches, even when they go abroad, carry a poisonous atmosphere round their bodies that is distinguished by a noisome and offensive smell, which is peculiarly disgustful even to the healthy and vigorous, exciting sickness and a sense of general debility. It cannot therefore be wondered that diseases should be produced where such poison is inspired with every breath.” The case of Chester shows by broader contrasts than anywhere else the change from the public health of plague-times to that of more modern times. But it can hardly be said to show the populace better off than before; it shows them changed into a proletariat, and separated from the richer classes by walls several feet thick. Such, at least, was the result after four generations of immunity from plague, a result which indicates, as I have said, that we may easily make too much of the improved well-being of the poorer classes as a cause of the cessation of plague. An easy explanation of plague ceasing in London has long been current, and just because it is an easy explanation it will probably hold the field for many years to come. It is that the fire of 1666 burnt out the seeds of plague. Defoe, writing in 1723, ascribed this opinion to certain “quacking philosophers,” but he would hardly have said so if he could have foreseen the respectable authority for it in after times. The plague had ceased in most of its provincial centres after the Civil Wars, and in some of them, such as York, from as early a date as 1604. It ceased in all the principal cities of Western Europe within a few years of its cessation in London. In London itself it ceased after 1666, not only in the City which was the part burned down in September of that year, but in St Giles’s, where the Great Plague began, in Cripplegate, Whitechapel and Stepney, where it was always worst, in Southwark, Bermondsey and Newington, in Lambeth and Westminster. Nor can it be said that the City was the source from which the infection used to spread to the Liberties and out-parishes. All the later plagues of London, perhaps even that of 1563, began in the Liberties or out-parishes and at length invaded the City. The part of London that was rebuilt after 1666 contained many finer dwelling-houses than before, built of stone, with substantial carpentry, and elegantly finished in fine and rare woods. The fronts of the new houses did not overhang so as to obstruct the ventilation of the streets and lanes; but the streets, lanes, alleys and courts were somewhat closely reproduced on the old foundations. A side walk in some streets was secured for foot-passengers by means of massive posts, which, with the projecting signs of houses and shops, were at length removed in 1766. The improvements in the City after the fire were mostly in the houses of the richer citizens. The City was the place of residence of the rich, with perhaps as many poorer purlieus in close proximity as the residential districts of London now have. But four-fifths of London at the time of the fire were beyond the walls of the City. It is in these extramural regions that the interest mostly lies for epidemical diseases. They remain, says Defoe in 1723, “still in the same condition they were in before.” Unfortunately we know little of their condition, whether in the 17th century or in the 18th. But there must have been something in it most unfavourable to health; for we find from the Bills of Mortality that the cessation of plague made hardly any difference to the annual average of deaths, the increase of population being allowed for. This fact makes the disappearance of plague all the more remarkable. Fevers to the end of the 17th century. The epidemical seasons of 1685-86 were the last that Sydenham recorded; he was shortly after laid aside from active work by gout, and died in 1689. Morton, who made notes of fevers and smallpox until 1694, is more a clinical observer than a student of “epidemic constitutions”; and although his writings are of value to the epidemiologist, he does not help us to understand the circumstances in which epidemic diseases prevailed more at one time than another. To the end of the century there is no other medical source of information, and little besides generalities to be collected from any source. It is known that the years from 1693 to 1699 were years of scarcity all over the kingdom, that the fever-deaths in London reached the high figure of 5036 in 1694, and that there was a high mortality in many country parishes and market towns during the scarcity. But there are few particular illustrations of the type of epidemic sickness. There is, therefore, little left to do but to give the figures, and to add some remarks. _Fever Deaths in the London Bills, 1687-1700._ Spotted Deaths Fever fever from all Year deaths deaths causes 1687 2847 144 21460 1688 3196 139 22921 1689 3313 129 23502 1690 3350 203 21461 1691 3490 193 22691 1692 3205 161 20874 1693 3211 199 20959 1694 5036 423 24109 1695 3019 105 19047 1696 2775 102 18638 1697 3111 137 20292 1698 3343 274 20183 1699 3505 306 20795 1700 3675 189 19443 _Tables from Short’s Abstracts of Parish Registers._ Registers Registers with Deaths Births Year examined excess of death in them in them _Country Parishes._ 1689 144 27 828 692 1690 146 17 532 324 1691 147 16 336 180 1692 147 10 207 146 1693 146 27 650 426 1694 148 18 465 348 1695 149 23 649 492 1696 150 19 503 344 1697 150 21 559 409 1698 152 12 397 289 1699 151 20 433 318 1700 160 29 890 739 _Market Towns._ 1689 25 12 1965 1415 1693 25 5 417 338 1694 25 6 1307 681 1695 25 3 309 246 1696 26 4 1020 708 1697 26 2 109 80 1698 26 4 575 423 1699 26 7 1181 867 1700 27 4 726 587 In the London figures the year 1694 stands out conspicuous by its deaths from all causes, and by its high total of fevers. The fever-deaths began to rise from their steady weekly level a little before Christmas, 1693, and remained high all through the year 1694, with a good many deaths from “spotted fever” in the worst weeks. Among the victims in London in February was Sir William Phipps, Governor of New England: his illness appeared at first to be a cold, which obliged him to keep his chamber; but it proved “a sort of malignant fever, whereof many about this time died in the city[65].” Pepys, writing to Evelyn on 10 August, 1694, calls it “the fever of the season,” three being down with it at his house, but well advanced in their recovery. In that week and in the week following, the deaths in London from all causes touched the highest points of the year, the deaths from fever and spotted fever being a full quarter of them. Fever at its worst in London never made more than a quarter of the annual deaths from all causes; so that, if we take it to have been the successor of the plague, it operated in a very different way--with a greatly lessened fatality of all that were attacked, with only a reminder of the old special incidence upon the summer and autumn seasons, but with a steadiness from year to year, and throughout each year, that made the fever-deaths of a generation little short of one of those enormous totals of plague-deaths that were rapidly piled up during a few months, perhaps once or twice in a generation. The following table from the London weekly Bills shows the progress of the fever from the end of April, 1694, with the number of deaths specially assigned to “spotted fever”:-- _London: Weekly Mortalities from fever and all causes, epidemic of 1694._ Week Spotted All ending Fever fever deaths April 24 90 15 427 May 1 77 10 369 8 89 9 413 15 80 5 395 22 101 3 428 29 72 8 430 June 5 112 12 469 12 113 12 434 19 113 11 430 26 99 14 396 July 3 94 11 423 17 86 10 445 24 115 13 507 31 84 13 484 Aug. 7 99 10 462 14 110 20 530 21 135 19 583 28 111 20 510 Sept. 5 115 16 505 12 112 12 462 18 98 9 504 25 106 4 490 Oct. 2 124 8 533 9 125 10 553 16 114 9 552 23 104 3 511 30 118 3 528 Nov. 6 70 3 439 10 89 7 453 13 106 2 471 20 117 13 538 27 79 6 456 Dec. 4 87 6 475 11 87 3 407 18 78 4 445 25 66 3 394 The year 1694, to which the epidemic of malignant fever (as well as malignant smallpox) belongs, was one of the series of “seven ill years” at the end of the 17th century (1693-99). They were long noted, says Thorold Rogers, “for the distress of the people and for the exalted profits of the farmer.” The price of wheat in the autumn and winter of 1693 was the highest since the famine of 1661. In 1697-8 corn was again dear and much of it was spoilt. At Norwich in 1698 wheat was sold at 44_s._ a comb. Harvests spoiled by wet weather or unseasonable cold appear to have been the most general cause of the high prices of food. In London there was no unusual sickness except in 1694; indeed the other years to the end of the century show a somewhat low mortality, the year 1696, which Macaulay marks as a time of severe distress among the common people owing to the calling in of the debased coinage[66], had the smallest number of deaths from all causes (18,638) since many years before, and for a century after allowing for the increase of population. But the deaths from “fever” were some three thousand every year, and the births, so far as registered, were, as usual, far below the deaths. It was in the country at large that the effects of the “seven ill years” were chiefly felt. According to Short’s abstracts of parish registers, there was unusual mortality at the beginning of the period and at the end of it; in his Chronology he mentions spotted fever, bloody flux and agues in 1693 (besides an influenza or universal slight fever recorded by Molyneux of Dublin), and again in 1697 and 1698 “purples, quinsies, Hungarian and spotted fever, universal pestilential spotted fever,” from famine and bad food. When we look for the evidence of this in England we shall have difficulty in finding it. Short’s own abstracts give almost no colour to it; but there are other figures from the parish registers, scattered through the county histories and statistical works, which prove that the seven ill years must have checked population. Thus at Sheffield in the ten years 1691-1700 there was the greatest excess of burials over baptisms in the whole history of the town from 1561--namely, 2856 burials to 2221 baptisms (688 marriages). At Minehead, Somerset, a parish of some 1200 people occupied in weaving, the deaths and births were as follows in four years of the decennium: Baptised. Buried. 1691 57 75 1694 34 55 1695 47 48 1697 35 65 A glimpse of spotted or pestilential fever in Bristol during the years of distress at the end of the 17th century comes from Dr Dover, a man of no academical repute, but at all events an articulate voice. Passing from an account of the spotted pestilential fever at Guayaquil, “when I took it by storm,” he goes on[67]: “About thirty-seven years since [written in 1732], this fever raged much in Bristol, so that I visited from twenty-five to thirty patients a day for a considerable time, besides their poor children taken into their workhouse, where I engaged myself, for the encouragement of so good and charitable an undertaking, to find them physick and give them advice at my own expense and trouble for the two first years. All these poor children in general had this fever, yet no more than one of them died of it of the whole number, which was near two hundred.” --an experience of typhus in children which was strictly according to rule. This had clearly been the occasion of a memorial addressed to the Mayor and Aldermen of Bristol, in 1696, praying that a capacious workhouse should be erected for children and the aged, which “will prevent children from being smothered or starved by the neglect of the parish officers and poverty of their parents, which is now a great loss to the nation[68].” The year 1698 was the climax of the seven ill years. The spring was the most backward for forty-seven years, the first wheat in the ear being seen near London on 16th June. For four months to the end of August the days were almost all rainy, except from the 18th to the 26th July. Whole fields of corn were spoilt. In Kent there was barley standing uncut on 29th September, and some lay in the swathe until December. Much of the corn in the north of England was not got in until Christmas, and in Scotland they were reaping the green empty corn in January[69]. Fevers of the seven ill years in Scotland. It is from Scotland that we hear most of the effects of the seven ill years in the way of famine and fever. Scotland was then in a backward state compared with England; and its northern climate, making the harvest always a few weeks later than in England, told especially against it in the ill years. Fynes Morryson, in the beginning of the 17th century, contrasts the Scotch manner of life unfavourably with the English, and Sir Robert Sibbald’s account towards the end of that century is little better. Morryson says, “the excesse of drinking was then farre greater in generall among the Scots than the English.” Sibbald remarks[70] on the drinking habits of the Scots common people: their potations of ale or spirits on an empty stomach, especially in the morning, relaxed the fibres and induced “erratic fevers of a bad type, bastard pleurisies, ... dropsies, stupors, lethargies and apoplexies.” Morryson says: “Their bedsteads were then like cubbards in the wall, with doores to be opened and shut at pleasure, so as we climbed up to our beds. They used but one sheete, open at the sides and top, but close at the feete, and so doubled[71].” Sibbald says the peasantry had poor food and hard work, and were subject to many diseases--“heartburn, sleeplessness, ravings, hypochondriac affections, mania, dysentery, scrophula, cancer, and a dire troop of diseases which everywhere now invades the husbandmen that were formerly free from diseases.” _Causa a victu est._ Therefore consumption was common enough. He has much to say of fevers,--of intermittents, especially in spring and autumn, catarrhal fevers, nervous fevers, comatose fevers, with delirium, spasms and the like symptoms, malignant, spotted, pestilential, hectic, &c. The continued fevers ranged in duration from fifteen to thirty-one days, recovery being ushered in with sweats, alvine flux and salivation. Purple fevers had sometimes livid or black spots mixed with the purple (mottling); in a case given, there were suppurations which appear to have been bubonic. There had been no plague in Scotland since 1647-48; but fevers, unless Sibbald has given undue prominence to them, would appear to have filled its place among the adults. Another writer of this period, from whom some information is got as to fevers, was Dr Andrew Brown of Edinburgh. He is mainly a controversialist, and is on the whole of little use save for the history of the treatment of fevers. He came to London on a visit in 1687, attracted by the fame of Sydenham’s method of curing fevers by antimonial emetics and by purgation: “Returning home as much overjoyed as I had gotten a treasure, I presently set myself to that practice”--of which he gave an account in his ‘Vindicatory Schedule concerning the New Cure of Fever[72].’ Continual fever, he says, takes up, with its pendicles, the half of all the diseases that men are afflicted with; and some part of what he calls continual fever must have been spotted: “As concerning the eruption of spots in fevers, these altogether resemble the marks made by stroaks on the skin, and these marks are also made by the stagnation and coagulation of the blood in the small channels [according to the doctrine of obstructions].... They tinge the skin with blewness or redness.” The bitter controversy as to the treatment of fevers led Brown into another writing in 1699[73]. “The fevers that reign at this time [it was towards the end of the seven ill years] are for the most part quick and peracute, and cut off in a few days persons of impure bodies. And as I have used this method by vomiting and purging in many, and most successfully at this time, so I have had lately considerable experience thereof in my own family: wherein four of my children and ten servants had the fever, and blessed be God, are all recovered, by repeated vomiting with antimonial vomits and frequent purgings, except two servants, the one having gotten a great stress at work, who bragging of his strength did contend with his neighbour at the mowing of hay, and presently sickened and died the sixth day, and whom I saw not till the day before he died, and found him in such a condition that I could not give him either vomit or purge: and the other was his neighbour who strove with him, being a man of most impure and emaciate body, who had endured want and stress before he came to my service, and who got not all was necessary because he had not the occasion of due attendance, all my servants being sick at the time[74].” This account of the experience which Dr Andrew Brown had lately had among his children and domestics in or near Edinburgh was written in 1699, and may be taken as relating to part of the wide-spread sickliness of the seven ill years in Scotland. Fletcher of Saltoun gives us a general view of the deplorable state of Scotland at the end of the 17th century, which was intensified by the succession of bad harvests[75]. The rents of cultivated farms were paid, not in money, but in corn, which gave occasion to many inequalities, to the traditional fraudulent practices of millers and to usury. The pasture lands for sheep and black cattle had no shelters from the weather, and no winter provision of hay or straw (roots were unheard of until long after), “so that the beasts are in a dying condition.” The country swarmed with vagrants (a hundred thousand, he estimates, in ordinary times, but doubled in the dear years), who lived and multiplied in incest, rioted in swarms in the nearest hills in times of plenty, and in times of distress fell upon farmhouses in gangs of forty or more, demanding food. Besides these there were a great many poor families very meanly provided for by the Church boxes, who lived wholly upon bad food and fell into various diseases. He had been credibly informed that some families in the years of mere scarcity preceding the climax of 1698-99 had eaten grains, for want of bread. “In the worst time, from unwholesome food diseases are so multiplied among poor people that, if some course be not taken, the famine may very probably be followed by a plague[76].” We owe some details of these calamities in Scotland to Patrick Walker, the Covenanter, who records them to show how the prophecies of Divine vengeance on the land, uttered during the Stuart persecutions by Cargill and Peden, had been in due time fulfilled[77]: “In the year 1694, in the month of August, that crop got such a stroke in one night by east mist or fog standing like mountains (and where it remained longest and thickest the badder were the effects, which all our old men, that had seen frost, blasting and mildewing, had never seen the like) that it got little more good of the ground. In November that winter many were smitten with wasting sore fluxes and strange fevers (which carried many off the stage) of such a nature and manner that all our old physicians had never seen the like and could make no help; for all things that used to be proper remedies proved destructive. And this was not to be imputed to bad unwholesome victual; for severals who had plenty of old victual did send to Glasgow for Irish meal, and yet were smitten with fluxes and fevers in a more violent and infectious nature and manner than the poorest in the land, whose names and places where they dwelt I could instance. “These unheard-of manifold judgments continued seven years, not always alike, but the seasons, summer and winter, so cold and barren, and the wonted heat of the sun so much withholden, that it was discernible upon the cattle, flying fowls and insects decaying, that seldom a fly or gleg was to be seen. Our harvests not in the ordinary months, many shearing in November and December, yea some in January and February; the names of the places I can instruct. Many contracting their deaths, and losing the use of their feet and hands, shearing and working amongst it in frost and snow; and after all some of it standing still, and rotting upon the ground, and much of it for little use either to man or beast, and which had no taste or colour of meal. Meal became so scarce that it was at two shillings a peck, and many could not get it. “Through the long continuance of these manifold judgments deaths and burials were so many and common that the living were wearied with burying of the dead. I have seen corpses drawn in sleds. Many got neither coffins nor winding-sheet. “I was one of four who carried the corpse of a young woman a mile of way; and when we came to the grave, an honest poor man came and said, ‘You must go and help me to bury my son, he is lien dead this two days; otherwise I will be obliged to bury him in my own yard.’ We went, and there were eight of us had two miles to carry the corpse of that young man, many neighbours looking on us, but none to help us. I was credibly informed, that in the North, two sisters on a Monday’s morning were found carrying the corpse of their brother on a barrow with bearing-ropes, resting themselves many times, and none offering to help them. “I have seen some walking about at sunsetting, and next day at six o’clock in the summer morning found dead in their houses, without making any stir at their death, their head lying upon their hand, with as great a smell as if they had been four days dead; the mice or rats having eaten a great part of their hands and arms. “The nearer and sorer these plagues seized, the sadder were their effects, that took away all natural and relative affections, so that husbands had no sympathy with their wives, nor wives with their husbands, parents with their children, nor children with their parents. These and other things have made me to doubt if ever any of Adam’s race were in a more deplorable condition, their bodies and spirits more low, than many were in these years.” In the parish of West Calder, 300 out of 900 “examinable” persons wasted away. Some facts and traditions of the Seven Ill Years were recorded nearly a century after in the Statistical Account of Scotland. From the Kirk Session records of the parish of Fordyce, Banffshire, it did not appear “that any public measures were pursued for the supply of the poor, nor anything uncommon done by the Session except towards the end. The common distribution of the collections of the church amounted only to about 1_s._ 2_d._ or 1_s._ 4_d._ weekly.” The Kirk Session records bore witness to the numerous cases of immorality in the years before the famine that had been dealt with ecclesiastically, and to the entire and speedy cessation of such cases thereafter[78]. The account for the parish of Keithhall and Kinkell, Aberdeenshire, says that “many died of want, in particular ten Highlanders in a neighbouring parish, that of Kemnay; so that the Session got a bier made to carry them to the grave, not being able to afford coffins for such a number[79].” In the upland parish of Montquhitter, in the same county, the dear years reduced the population by one half or more. Until 1709 many farms were waste. Of sixteen families that resided on the estate of Lettertie, thirteen were extinguished. The account of this parish contains several stories of the distress, with the names of individuals[80]. It is clear, however, that all the parishes of Scotland were not equally distressed. The county of Moray and “some of the best land along the east coast of Buchan and Formartine [Aberdeenshire] abounded with seed and bread;” but transport to the upland parishes was difficult[81]. We may take it that these experiences in the reign of William III. were peculiar to Scotland; even Ireland, which had troubles enough of the same kind in the 18th and 19th centuries, was at that time resorted to as a place of refuge by the distressed Scots. Among the special and temporary causes in Scotland were antiquated agricultural usage, an almost incredible proportion of the people in a state of lawless vagrancy, such as Henry VIII. and Elizabeth had to deal with a century and a half before, a low state of morals, both commercial and private, a tyrannical disposition of the employers, a sullen attitude of the labourers, and a total decay of the spirit of charity. An ancient elder of the parish of Fordyce, who kept some traditions of the dear years, remarked to the minister: “If the same precautions had been taken at that time which he had seen taken more lately in times of scarcity, the famine would not have done so much hurt, nor would so many have perished.” The evil of vagrancy, for which Fletcher of Saltoun saw no remedy but a state of slavery not unlike that which Protector Somerset had actually made the law of England for a couple of years, 1547-49, in somewhat similar circumstances, gradually cured itself without a resort to the practices of antiquity or of barbarism. The union with England in 1707, by removing the customs duties and opening the Colonial trade to Scots shipping (they had a share in the East India trade already) gave a remarkable impulse to the manufacture of linen and to commerce. Such was the demand for Scots linen that, it seemed to De Foe, “the poor could want no employment”; and it may certainly be taken as a fact that the establishment on a free basis of industries and foreign markets gave Scotland relief from the pauperism and vagrancy, like those of Ireland in the 18th and 19th centuries, that threatened for a time, and especially in the Seven Ill Years, to retard the developement of the nation. * * * * * For several years after the period of scarcity or famine from 1693 to 1699, the history of fever in Britain presents little for special remark. A book of the time was Dr George Cheyne’s _New Theory of Continual Fever_, London, 1701. His theory is that of Bellini and Borelli, which accounted for everything in fevers on mechanical principles, and ignored the infective element in them. Cheyne does not even describe what the fevers were; but in showing how the theory applies, he mentions incidentally the symptoms--quick pulse, pain in the head, burning heat, want of sleep, raving, clear or flame-coloured urine, and morbid strength. Equally theoretical is the handling of the subject by Pitcairn. Freind, in his essays on fevers[82], is mainly occupied with controversial matters of treatment, except in connexion with Lord Peterborough’s expedition to Spain in 1705, as we shall see in a section on sickness of camps and fleets. In the absence of clinical details from the medical profession, the following from letters of the time will serve a purpose: On 18 September, 1700, Thomas Bennett writes to Thomas Coke from Paris giving an account of the fever of Coke’s brother: His fever is very violent upon him, and he has a hickup and twitchings in his face; he is especially ill in the night, and has now and then violent sweats. He raved for eight days together and in all that time did not get an hour’s sleep. He was attended by Dr Helvetius and other physicians. Lady Eastes, her son, and most of her servants are sick, but they are all on the mending hand; her steward is dead of a high fever, having been sick but five days[83]. These are Paris fevers, the symptoms suggesting typhus, especially the prolonged vigil in one of the cases. It is to be remarked that they occurred among the upper classes; and it appears that the universal fevers “of a bad type” in France in 1712 did not spare noble houses nor even the palace of Louis the Great[84]. The following from the London Bills will show the prevalence of fever from year to year[85]. Dead of Dead of Dead of Year Fever Spotted Fever all diseases 1701 2902 68 20,471 1702 2682 53 19,481 1703 3162 74 20,720 1704 3243 61 22,684 1705 3290 41 22,097 1706 2662 54 19,847 1707 2947 42 21,600 1708 2738 62 21,291 1709 3140 118 21,800 1710 4397 343 24,620 1711 3461 142 19,833 1712 3131 96 21,198 1713 3039 102 21,057 1714 4631 150 26,569 1715 3588 161 22,232 1716 3078 100 24,436 1717 2940 137 23,446 1718 3475 132 26,523 1719 3803 124 28,347 1720 3910 66 25,454 The London fever of 1709-10. The “seven ill years” were followed by the fine summer and abundant harvest (although hardly more than half the breadth was sown) of 1699. Scarcity was not a cause of excessive sickness again until 1709-10; although the harvest of 1703 was unfavourable. The price of wheat in 1702 was 25_s._ 6_d._ per quarter, and continued low for a number of years, notwithstanding the war with France. In Marlborough’s wars there were no war-prices for farmers, as in the corresponding circumstances a century after; on the contrary, corn and produce of all kinds were so cheap that farmers had difficulty in paying their rents. The bounty of five shillings per quarter on exported wheat had given a great impulse to corn-growing, so that the acreage of wheat sown was much more than the country in an ordinary year required, partly, no doubt, because the bread of the poorer classes was largely made from the coarser cereals. The period of abundance was broken by the excessively severe winter of 1708-9, one of three memorable winters in the 18th century. The frost lasted all over Europe from October to March, and was followed by a greatly deficient crop in