Chapter VI · SWEATING SICKNESSES.

Ἔστι γὰρ τὸ πάθος λύσις τῶν δεσμῶν τῆς εἰς ζωὴν δυνάμιος.

Aretæus.

Sect. 1.—The Cardiac Disease of the Ancients.

(Morbus Cardiacus.)

Thus by the autumn of 1551, the Sweating Sickness had vanished from the earth: it has never since appeared as it did then and at earlier periods; and it is not to be supposed, that it will ever again break forth as a great epidemic in the same form, and limited to a four-and-twenty hours’ course; for it is manifest, that the mode of living of the people had a great share in its origin; and this will never again be the same as in those days. Yet nature is not wanting in similar phenomena, which have appeared in ancient and modern times; and if we take into the account the great frequency of cognate rheumatic maladies, it is possible that isolated cases may have sometimes occurred, in which repletion of impure fluids, and violently inflammatory treatment have augmented a rheumatic fever, even to the destruction of nervous vitality, by means of profuse perspiration—only, perhaps, that they ran a longer course, (which does not constitute an essential difference,) and under totally different names, whereby attention is misled. Of all the diseases that have ever appeared which can in any way be compared to the English Sweating Sickness, we have principally three to look back upon—the cardiac disease of the ancients, the Picardy sweat, and the sweating fever of Rötingen. The first was, for reasons which have been already mentioned[465], almost unknown to the learned of the sixteenth century; and it is matter of surprise, that Kaye himself, who had chosen for his favourite the best Roman physician, we mean Celsus, could have so entirely overlooked his by no means unimportant statements respecting this disease. Houlier is the only author who ventures a comparison of the English Sweating Sickness with the ancient cardiac disease; his few, and almost lost words[466], remained however unheeded; nor are the differences between the two diseases small: but to return.

The disease of which we are speaking appeared for a period of 500 years, (from 300 b.c. to 200 after Christ,) and was a common, almost every day occurrence, which is often mentioned even by non-medical writers. It was exceedingly dangerous, and even esteemed fatal; and as it was far above the reach of Greek physiology, there were not wanting extraordinary opinions respecting its nature, and bold and singular modes of treatment, to which those who were attacked were subjected. The name Cardiac disease (morbus cardiacus, νόσος καρδιακὴ and probably also νόσος καρδίτις,) was not bestowed by medical men, but by the people; who, in the fourth century before Christ, for the name is as ancient as that period, could not know that the learned would dispute on that subject. Some affirmed, and among them men of great authority, such as Erasistratus, Asclepiades, and Aretæus, that the people were in the right so to call the disease; that the heart was actually the part affected, and that their knowledge of the heart’s functions was by no means small[467]. Others, on the contrary, would only acknowledge in that name an expression indicative, not of the particular seat of the disease, but only of its importance, inasmuch as the heart is well adapted, as the centre and source of life, to indicate this[468]. Others again, who attempted more refined conjectures, wished to represent the pericardium as the seat of the malady, because darting pains were sometimes felt[469] in the region of the heart, or the diaphragm, or the lungs, or even the liver. The opinions were numerous; the actual knowledge was small[470].

The cardiac disease began with rigors and a numbness in the limbs[471], and sometimes even throughout the whole body. The pulse then took on the worst condition, was small, weak, frequent, empty, and as if dissolving; in a more advanced stage, unequal and fluttering, until it became completely extinct. Patients were affected with hallucinations[472]; they were sleepless, despaired of their recovery, and were usually covered suddenly with an ill-savoured perspiration over the whole body, whence the disorder was likewise called Diaphoresis. Sometimes, however, a washy sweat broke out, first on the face and neck. This then spread itself over the whole body; assumed a very disagreeable odour, became clammy and like water in which flesh had been macerated, and ran through the bed-clothes in streams, so that the patient seemed to be melting away[473]. The breath was short and panting almost to annihilation (insustentabilis). Those affected were in continual fear of suffocation[474]; tossed to and fro in the greatest anguish, and with a very thin and trembling voice uttered forth only broken words. They constantly felt an insufferable oppression in the left side, or even over the whole chest[475]; and in the paroxysms which were ushered in with a fainting fit, or were followed by one, the heart was tumultuous and palpitated, without any alteration in the smallness of the pulse[476]. The countenance was pale as death, the eyes sunk in their sockets, and when the disease took a fatal turn, all was darkness around them. The hands and feet turned blue; and whilst the heart, notwithstanding the universal coldness of the body, still beat violently, they for the most part retained possession of their senses. A few only wandered a short time before death, while others were even seized with convulsions and endowed with the power of prophecy[477]. Finally, the nails became curved on their cold hands, the skin was wrinkled, and thus the sufferers resigned their spirit without any mitigation of their miserable condition[478].

A striking resemblance is plainly perceived, from this description, between the ancient cardiac disease and the English Sweating Sickness in the most exquisite cases of each. In both the same palpitation of the heart, the same alteration of the voice, the same anxiety, the same impediment to respiration, and thence the same affection of the nerves of the chest, the same ill-scented sweat, and, by means of this sweat, the same fatal evacuation; in short, all the essential symptoms arising from the same circle of functions. For in the sweating pestilences of the ancients[479], as well as the moderns, the nerves of the abdomen remained unaffected; the liver, intestines, and kidneys, took no part in the primary affection; the diaphragm, as in the English Sweating Sickness, formed the partition. Hence the acute Aretæus did not hesitate to call the cardiac disease fainting (syncope), with certainly an unusual extension of the notion implied by this term, which in its common acceptation excludes the turbulent commotion of the heart. In the affection of the brain some difference occurs, for though the hallucination afforded an unfavourable prognostic in both diseases, yet the fatal stupor was peculiar to the English Sweating Sickness, no observer having made mention of it in the cardiac disease.

Greater and altogether essential differences between this affection and the English Sweating Sickness appear in another respect. There is every reason to suppose that the cardiac disease first appeared in the time of Alexander the Great, that is to say, at the end of the fourth century before Christ; for the Hippocratic physicians were unacquainted with it, Erasistratus, who was body physician to Seleucus Nicator, and was a universally celebrated professor at Alexandria under the first Ptolemy, being the first to mention it. If that age be compared even superficially with that of Henry the VIIth and Henry the VIIIth; and Africa, Asia Minor, and the South of Europe with England, we shall easily be convinced that the two diseases, notwithstanding the agreement in their main symptoms, could not be the same; moreover, much was comprehended by the ancients under the name of morbus cardiacus, which, on a nearer examination, proves not to be one and the same definite form of morbid action: for sometimes this affection is spoken of as an independent disease; sometimes it is mentioned only as a symptom superadded to others—as a kind of transition from other very various diseases, such as has occurred in modern times. Soranus mentions, as such diseases, continued fevers, accompanied by much heat[480]; and reckons among them the “Causus,” that is, an inflammatory bilious fever, to which Aretæus also saw the cardiac disease superadded. These fevers passed, on the fifth or sixth day, into the cardiac disease, and such a transition occurred chiefly on the critical days[481]. In a similar sense Celsus speaks even of Phrenitis, under which name we are here to understand all inflammatory fevers accompanied by violent delirium, with the exception of actual inflammation of the brain. Thus we see that the cardiac disease arose and increased on a very different soil from other diseases, and was, to furnish an ancient example, as far from being independent under these circumstances as lethargy was in similar cases.

But there was doubtless an independent idiopathic form of the cardiac disease. Whether this was febrile or not, the most celebrated physicians of ancient times were not agreed. Now, how could they ever have differed upon the subject, if the cardiac disease had always appeared only as a sequela on the fifth or sixth day of inflammatory fevers? Apollophanes, a disciple of Erasistratus, and physician to Antiochus the First, considered it, with his master, as constantly febrile, and his opinion prevailed for a long time: perhaps he was in the right, for it is probable that in the first half of the third century, the disorder was much more violent than at a subsequent period. His celebrated contemporary, Demetrius of Apamea, disciple of Herophilus, affirmed, that he had recognised fever only in the beginning of the disease, and that it disappeared in its further progress. Very soon, most physicians decided that it was not febrile, but Asclepiades distinguished a febrile and a non-febrile form of the cardiac disease, and it is certain that this physician was a very accurate observer. Themison and Thessalus also agreed with him. Aretæus described, in a cursory manner, the febrile form only, and perhaps was not acquainted with any other. Soranus followed, in the essential points, Asclepiades, the founder of his school; and later writers generally regarded the inward heat, the hot breath, and the burning thirst—symptoms which were occasionally less marked, as proofs of the febrile nature of the disease. Numerous theoretical views, belonging to particular schools, of which we do not here treat, were intermingled with these, and upon the whole, that form seems to have been esteemed as non-febrile, in which the signs of feverish excitement appeared less marked. In all cases the cardiac disease set in with external coldness, and with a small contracted quick pulse, symptoms which with certainty indicate fever[482].

Respecting the course of the cardiac disease, we are not furnished with sufficient information. It was no doubt very rapid, for the frame could not long endure symptoms of so violent a kind, and the disorder must of necessity soon have come to a crisis; yet from the ample directions for treatment, we may conclude that it lasted at least some days. If the perspiration was well surmounted, patients seemed to recover rapidly, and their sufferings appeared to them, according to the expressions of Aretæus, like a dream, out of which they awoke to a consciousness of the increased acumen of their senses[483]. But the termination was not always so fortunate. The disease was very dangerous, and in many, after the occurrence of an incomplete crisis, an insidious fever remained behind, which ended in a consumption[484]. The whole phenomenon was altogether peculiar, and among existing diseases there are none which bear any comparison with it.

There must therefore have been something in the whole state of existence among the ancients which favoured the formation of the cardiac disease. That it arose oftener in summer than in winter, that it attacked men more frequently than women, and especially young people full of life, and hot-blooded plethoric persons, who used much bodily exercise, we learn from credible observers[485]. In this respect, therefore, it bore a resemblance to the English Sweating Sickness. We may also add, that indigestion, repletion, drunkenness, as likewise grief and fear, but especially vomiting and the employment of the bath after dinner, occasioned an attack of the malady[486]. Let us call to mind the habits of the ancients. It was in the time of Alexander that oriental luxury was first introduced. Gluttony became a part of the enjoyment of life, and warm baths a necessary refinement in sensuality, which just at this time were philosophically established by Epicurus; nor was this the last instance in which philosophers encouraged the errors and infirmities of human society.

Here, again, therefore, as in the English Sweating Sickness, we meet with the relaxed state of skin, and the foul repletion engendered by the same indulgence in sensuality which we have found to exist in the sixteenth century. How this corruption of morals increased, and to what a frightful height it was carried among the Romans, it is not necessary here further to elucidate; and we may take it for a fact, that in consequence of it, the general constitution of the ancients underwent a peculiar modification; that this relaxation of skin and gross repletion were propagated from generation to generation; and that, as among chronic diseases, those of a gouty character were its more frequent results, so among the inflammatory, the cardiac disease made its appearance as the general effect of this kind of life.

Where, however, such a system of life existed among whole communities, the original and peculiar occasion was not needed in every individual case to bring the predisposition for a disease which propagated itself by hereditary taint, to an actual eruption. Shocks to the constitution of quite a different kind were often sufficient for the purpose. Thus, among the Romans, it was by no means always the case, that gluttony and relaxation of the skin immediately gave rise to the cardiac disease; while, on the other hand, the usual faintness, induced by too copious blood-letting, passed into this impetuous agitation of the heart, accompanied by colliquative sweats[487]; and all overviolent perspirations in other diseases were apt to take the same dangerous course[488]. We must here also take into account a practice among the Romans, which was very injurious, and yet rendered sacred by the laws; namely, visiting the public baths late in the evening, just after the principal meal, and awaiting the digestion of their food in these places of soft indulgence[489]. How much must the tendency of sweating disorders have been favoured by these means!

Surmises founded on the facts already stated, can alone be offered respecting the nature of the ancient cardiac disease. The ancients give us no certain intelligence upon it; for their mode of observing did not lead to that object at which modern medicine aims. That the cardiac disease was not of a rheumatic character seems deducible from several circumstances—from the quality of the atmosphere in southern climates, which is not so favourable to rheumatic maladies, as to give rise to a distinctly defined form of that complaint throughout a period of five hundred years; from the nature of the so-called inflammatory fever, which exhibited no rheumatic symptoms in its course; and lastly, from the treatment of the cardiac disease, for it was a common practice to cool down the “diaphoretic” patients in the midst of their perspiration, by sponging them with cold water, to expose them to the air, and some physicians went so far as to advise cold baths and affusions[490]. How could they have ventured upon such remedies if the cardiac disease had been of a rheumatic nature?

In the sweating fevers of the sixteenth century, every abrupt refrigeration, every exposure of the skin, was fatal. It is thence to be inferred, that the English Sweating Sickness differed from the ancient cardiac disease in its rheumatic character; even although both diseases were founded in common on an impure gross repletion and relaxation of skin, and the essential phenomena of both went through the same course: not to advert to other differences which are manifest from what has been stated.

The remaining treatment of the cardiac disorder should not be altogether passed over in this place, because it shews very clearly the general style of thinking of the medical profession, as also certain metaphysical excitations which are innate in that profession, and of which there is therefore a repetition in all ages. For whilst some proceeded with commendable care and caution, and Aræteus feared[491] a fatal result from the slightest error, others again, would fain render excited nature obedient to their rough command by means of the most violent remedies. It, therefore, occasionally happened that in their over hasty activity they were unable to distinguish between a salutary perspiration and a dangerous “diaphoresis.” This they suppressed at all hazards, and thus sent their patients to the shades of their fathers. Others forthwith flew to Chrysippic bandaging, the great means of suppressing profuse evacuations, and even violent spasms[492]. Others were for obviating the debility as quickly as possible by means of nourishing diet; and overloaded the stomach, as if the recovery of strength depended entirely upon eating. Others allowed as much wine as possible to be drunk for twenty-four hours together, even to the extent of producing intoxication[493]; and Asclepiades selected for this extraordinary death-bed carousal the Greek salt wine[494], for the sake of bringing on a diarrhœa, whereby the opened pores of the skin might again close, and the too mobile atoms might be carried towards the bowels. With the same object he ordered active clysters[495], for if they succeeded in causing a full evacuation, he maintained that the perspiration must necessarily be arrested! Endemus, of the Methodic sect, recommended even clysters of cold water[496], and whatever else the rashness of medical men had fool-hardily contrived; acting on the ancient notion, that severe diseases always required violent remedies. Aretæus recommended blood-letting, which others pronounced to be nothing short of certain death[497]. He had, however, a notion that the Causus was the foundation of the cardiac disease, and perhaps he was right.

A cautious employment of wine was apparently of great use[498], and what may excite surprise, physicians gave detailed and frivolous precepts on the choice and enjoyment of food. If the irritable stomach rejected this repeatedly, they even went so far, according to the Roman method, as to make the patient vomit both before and after his meals, in order that the organ might thus bear the repeated use of nourishment. It was also asserted that the stomach retained food and wine better if the body were previously rubbed all over with bruised onions[499]. All this affords us an insight into the nature of this remarkable disease, which has now so completely vanished from the world. Finally, when astringent decoctions proved fruitless, particular confidence was placed in the application of various powders[500] to the surface of the body, conjointly with the use of light bed-clothes and the avoidance of feather-beds, which the effeminacy of the ancients had already introduced[501]. As astringents they selected pomegranate bark, the leaves of roses, blackberries, and myrtles, as also fullers’ earth, gypsum, alum, litharge, slaked lime[502], and, when nothing else was at hand, even common road dust[503]! The efficacy of some of these extraordinary remedies cannot be denied. At least it has been proved in modern times with respect to alkalies, which are of a somewhat similar nature, that they are of great service where there is an abundant determination of acid towards the skin, and it is very probable that the perspiration of these diaphoretic patients contained much acid.

Sect. 2.—The Picardy Sweat.

(Suette des Picards—Suette Miliaire.)

The Picardy Sweat is a decided miliary fever, which has often prevailed, not only in Picardy, but also in other provinces of France, for more than a hundred years, and even at the present time exists in some places as an endemic disease[504]. We have pointed out the affinity between the English Sweating Sickness and miliary fever. Both are rheumatic fevers—the former of twenty-four hours’ duration, the latter running a course of at least seven days. In the former there was no eruption, or if in isolated cases an eruption made its appearance, it was doubtless subordinate, not essential. In the miliary fever, on the contrary, the eruption is so essential, that this disease may be considered as a completely exanthematous form of rheumatic fever.

The history of miliary fever is full of important facts, and the sweating fever of Picardy forms but a variety of it. The eruption in itself is of very ancient occurrence, and was most probably, as at present, observed time immemorial in conjunction with petechiæ, occurring as a critical metastasis in the oriental glandular plague, perhaps even in the ancient plague recorded by Thucydides. It also occasionally accompanied petechial fever, as unquestionably it did small-pox and many other diseases, in the same manner as we now see; for the miliary eruption is a very common symptom, which is easily induced, and increases the danger of various other accidental complications. This is different, however, from the idiopathic miliary fever, which did not exist either before, or even at the period of the English Sweating Sickness, but occurred as an epidemic, frequently mentioned in Saxony, a hundred years later[505], (1652.)

We cannot, therefore, consider this eruptive disease as having proceeded from the English Sweating Sickness, in the same manner as the petechial fever had its probable origin in the glandular plague, even supposing a more decided inclination of the Sweating Sickness to the eruptive character could be proved than is possible from the facts afforded. A whole century intervened, and what vast national revolutions!

This same separation of so long a period makes also against the supposition, that the English Sweating Sickness was an interrupted miliary fever, which exhausted its power by a too luxuriant activity of the skin on the first day, before the eruption made its appearance. Moreover, the similarity and isolation of all the five epidemic sweating fevers, as regards the brevity of the course of the disease, and the absence of all transition forms of any duration, which certainly would have existed had nature intended gradually to form a miliary fever out of the English Sweating Sickness, lead to the same conclusion.

But to return to the miliary fever. Some forms of this disease have been observed, in which a profuse perspiration, in combination with nervous symptoms, has endangered life on the first day of the attack; equally often, too, the eruption has appeared fully formed on the very first day; and if we duly consider, as we ought, the regular course of miliary fever whenever it has assumed an epidemic character, we shall always find, even in that case, a development of symptoms differing fundamentally from those of the English Sweating Sickness. If, occasionally, instances of miliary fever occurred, in which no eruption came out, as was the case recently (in 1821), they were to be considered in the same light as other acute eruptive diseases, as, for example, scarlet fever, in which nature indulges in a like irregularity, without, however, altering the essence of those diseases. And since, finally, it has been observed in many cases[506], that the miliary eruption could be prevented by the application of cold at the commencement, a distinguished modern physician has attached great consequence to this circumstance, as showing that miliary fever and the English Sweating Sickness were the same disease[507]; but a check of this kind is, at all events, impossible in those miliary fevers where the eruption breaks forth on the first or second day; and moreover, experience tells us, that many other diseases also, such as inflammations, rheumatisms, gastric fevers, and even abdominal typhus, may be arrested in their course, and confined within narrower bounds, so as not to manifest all their symptoms.

We are, therefore, completely entitled to consider the appearance of the miliary sweating fevers as altogether a novelty, originating in the middle of the 17th century, and having no discoverable connexion with the English Sweating Sickness. There have been in Germany, since the year 1652, many visitations of miliary fever; but this disease did not increase much in extent until about the year 1715, when it spread into France and the neighbouring countries, particularly Piedmont[508], whilst England remained almost entirely free from it. The French epidemics were, upon the whole, much more severe than the German; and on this account we select one of the most ancient, and also the most recent of them, in order to give a general view of miliary fever, as compared with the English Sweating Sickness.

The miliary fever first appeared in Picardy, in the year 1718, in le Vimeux (Vinnemacus pagus), a district on the north of the Somme and on the south of the Bresle and the department of the Lower Seine. It increased annually in extent; most places in Picardy were visited by it, and it was not long before it was seen in Flanders[509].

We are still in possession of a very distinct account, which we will here detail, of an epidemic at Abbeville in the year 1733, where the miliary fever had existed fifteen years previously. There were scarcely any premonitory symptoms, but the disease commenced at once with pinching pains in the stomach, extreme prostration of strength, dull headache, and difficulty of breathing, interrupted by sighing. Patients complained of violent heat, and were bathed in a pungent sweat of foul odour, while nausea was occasionally felt. Sparks appeared before the eyes, and the countenance became flushed. Patients were tormented with burning thirst; and yet the tongue was as moist as in perfect health. The pulse was frequent and undulating, without hardness; and in the course of a few hours, an insufferable itching came on over the whole body, accompanied by distressing jactitation: upon this, thickly studded, red, round pustules, not bigger than mustard-seeds, broke out, wherefrom patients emitted an extremely disagreeable urinous odour, which was imparted to those who were about their persons. Sometimes they had evacuations, at other times they suffered from constipation, but all complained of want of sleep; and when they felt an inclination to doze, they were again aroused by fresh chilliness. Many bled at the nose till they fainted; and with women, the menstrual discharge often appeared, though not at the proper time. The urine was at times deficient in quantity, at others discharged in abundance, and without any critical signs; if pale and plentiful, it betokened delirium; then the eyelids twitched convulsively, a humming noise commenced in the ears, and the patient tossed about restlessly. The pulse became strong, irregular, and, like the breathing, very quick. The countenance grew redder and redder; and soon after, the sufferers, as though struck by lightning, were seized with lethargy, and expired, generally in the act of coughing and spitting blood.

Such was the nature of the disease when it attacked many at once: there were, however, several varieties. With some the miliary vesicles broke out on the second day, with others not before the third; and if all went on favourably, they lost their redness on the seventh day, and the skin all over the body scaled off like bran. The fever was sometimes extremely violent; at others, without apparent cause, very mild; at least one might be deceived at the commencement of the attack, by the apparently favourable symptoms; for those who in the morning had scarcely any notable degree of fever, who neither suffered from any anxious sensation nor violent heat, in whom no subsultus tendinum was perceptible, no want of perspiration, nor any retrocession of the eruption, were sometimes towards evening seized with phrenzy, and died in a state of lethargy. Evacuations, which alleviate other diseases, made this miliary fever worse. Favourable symptoms could never be depended on. In the midst of profuse perspiration the patient died, either from constipation or diarrhœa. A copious discharge of urine was a bad sign; composure was succeeded by delirium, cheerfulness by lethargy: the disease was throughout treacherous and disguised. It was particularly necessary for those suffering from pleurisy or any inflammatory fevers to be guarded against its approach. Many fell sacrifices to this epidemic who thought themselves in a state of convalescence; and with such it was easier to foretell than to prevent the consequences. In cases of this kind the miliary vesicles were less red and grew pale sooner; but if the disease attacked a healthy person, then they were redder, and continued longer. Of those who recovered, not a few suffered for many months, nay, even for a whole year, from night perspirations, without fever or sleeplessness, but with an eruption of little miliary vesicles, which disappeared[510] again on the slightest exposure to cold. The later miliary epidemic fevers in France, which are distinguished by the name of the Picardy Sweating Sickness, are generally very well described[511]; so much so, that we have few epidemics of modern times whose course and succession we can trace so well. But the epidemic of 1821, which raged in the departments of the Oise, and of the Seine and Oise, from March to October, has been observed by all with the greatest care, including men of distinguished talent[512].

We shall give the description of this disease. There were no constant premonitory symptoms; it often broke out quite suddenly, but many complained some days before of debility, despondency, want of appetite, nausea, headache; sometimes also of giddiness and slight chilliness. Many retired to rest in health, and awoke during the night with the disease, covered with a perspiration, which ceased only with death or recovery. With some the sweating was preceded for some hours, or even only for some moments, by a scarcely perceptible feverish commotion, accompanied with burning heat, or with a sensation of pain which ran through every limb, and nearly always with spasms in the stomach. With others the disease announced itself by lacerating rheumatic pains, which gradually increasing, they became bed-ridden. The mouth was foul, the taste at times bitter, the tongue white, more rarely tinged with yellow, and thus it remained till the patient was restored. The sufferer was shortly covered with a thick, peculiarly fetid sweat, that certainly produced alleviation, but became very intolerable to him from its unpleasant stench, which was even communicated to the clothes of the bystanders. In the mean time it was discovered by the pulse, that the fever had considerably abated; but, on the third day, the patient was seized with convulsive spasms in the stomach, great oppression at the chest, and a sensation of suffocation—symptoms which caused him insupportable anguish. These attacks accompanied by hiccup and eructation, continued for several hours, and returned from time to time, an eruption, partly papular, simultaneously breaking out first on the neck, then on the shoulders down to the hands and breast, less frequently on the thighs and face. The little pimples were of a pale red colour and conical, with glistening heads, and between them appeared innumerable small miliary pustules, filled with transparent serous fluid, which soon thickened and assumed a whiter hue. At the time and previous to the breaking out of the exanthem, the patient experienced a very severe burning and pricking sensation in the skin, which nevertheless sometimes occurred on the second or fourth day, and which increased sometimes in one part, sometimes in another, when the sweating declined.

Towards the fifth day, however, after the sweating had entirely ceased, the complaint grew worse again. The spasms and paroxysms of suffocation returned, and they were succeeded by renewed eruptions of the exanthem; a decided improvement, however, shortly took place; the little pimples lost their redness, the miliary vesicles dried away, and at a period from the seventh to the tenth day recovery commenced under a general exfoliation of the cuticle. Sometimes the eruption did not appear, whether the patients were under medical treatment, or left to their own guidance, but with those few in whom there was an absence of miliary vesicles, that peculiar pricking and itching of the skin did not take place.

Between the fifth and seventh day the patients usually complained of great weakness, and had a desire to eat. A few tablespoonfuls of wine then agreed with them very well; for the rest, neither thirst nor lethargy was observable, but it was particularly remarkable that the urine was clear and abundant. Up to the seventh day a confined state of bowels was usual, and, with the exception of the already mentioned attacks of tightness and oppression, the breathing remained free, though with great sleeplessness, during the whole malady. Nothing morbid was to be observed in the chest, and the patients lay stretched out at full length, so that there was no occasion at any time to raise their heads.

Such was the regular course of this miliary fever, but its progress was often accelerated by very dangerous symptoms, and occasionally it proved fatal within a very few hours. If at the time of the attack the patients were very restless and talkative, the eyes glistening, the pulse, without being hard, tumultuous, and the edges of the tongue reddened, delirium soon succeeded and then convulsions and death. Great depression of the spirits was a very bad symptom; bleeding was never of any avail, yet the menstrual discharge did not interrupt the course of the disease. There was in general a great degree of malignancy perceptible in the malady, as was also rendered apparent by the course of the epidemic. If the miliary Sweating Fever broke out in a fresh place, two or three persons only were thereupon attacked, and that favourably, which led to a supposition that the evil had all passed away, for during the next fifteen or twenty days, not any fresh attacks were heard of. Suddenly, however, the epidemic reappeared with increased virulence. The great number of the sufferers spread consternation and terror amongst the inhabitants, and the cases of death became frequent. After this first burst of fury, the epidemic grew more mild again, so that many patients were not confined to their beds at all. This mitigation of the miliary fever was likewise manifested[513] by the prolongation of its course beyond the seventh day.

If we compare this epidemic with the one observed at Abbeville in 1773, we shall find between them but very trifling differences, which would appear still more clearly in some of the intermediate visitations, thus conforming to what has been observed in other eruptive maladies. It is consequently evident that the miliary fevers[514] which have appeared in France in recent times, do not differ in any essential point from those of more ancient date. The surest proof of their identity is, their persistence for nearly two centuries; and from the manner in which they have presented themselves to observation, they are to be considered as distinct from the English Sweating Sickness, though certainly allied to it. It would exceed our limits to pursue this inquiry further, but it may be as well to give the following short catalogue[515] of the most important miliary epidemics.

1652. Leipzig.

1660. Augsburg.

1666. Bavaria.

1672. Hungary.

1675. Hamburgh.

1680. Germany to a great extent.

1689. Philippsburg.

1690. Stuttgard. Düsseldorf. Erfurt. Jena.

1694. Berlin.

1700. Breslau.

1709. Dantzic, Marienburg.

1712. Mümpelgart.

1713. Saint Valery. (Somme.)

1714, 15. Laybach.

1715. Breslau. Turin.

1718. Tübingen. Abbeville. (Somme.)

1720. Canton de Bray. (Lower Seine.)

1723. Francfort on the Maine.

1724. Turin. Vercelli.

1726. Acqui. Guise. (Aisne.)

1728. Chambéry, Annecy, St. Jean de Maurienne. (Savoy.) Carmagnola. Vercelli. Ivrea. Biella.

1729. Vienna. (Austria.)

1730. Pignerol.

1731. Fossano.

1732. Nizza. Rivoli.

1733. Fossano. Asti. Lanti. Acqui. Basle. Silesia.

1734. Strasburg. (Lower Rhine.) Acqui. Lanti.

1735. Trino. Lanti. Fresneuse. (Lower Seine.) Vimeux. (Seine et Oise.) Orleans. (Loiret.) Pluviers. (Loiret.) Meaux. Villeneuve. Saint George. (Seine et Marne.) Bohemia. Denmark. Sweden. Russia.

1738. Luzarches, Royaumont. (Seine et Oise.) Susa. Crescentino.

1740. Caen. (Calvados.) Provins. (Seine et Marne.) Vire. (Calvados.) Berthonville. (Eure.) Falaise. (Calvados.)

1741. Rouen. (Lower Seine.) Tartana. Valencia. Alexandria. London.

1742. Caudebec. (Lower Seine.) Ceva. Turin. Sorillano. Alba. Ivrea. Cherasco. Fossano.

1743. Villafranca.

1744. Acqui.

1746. Zurich.

1747. Paris. (Seine.) Beaumont. (Seine et Oise.) Chambly. (Oise.) Modena. Lodi. Mantua. Piacenza.

1750. Schaffhausen. Bern. Geneva. Beauvais. (Oise.)

1751. Villafranca.

1752. Fernaise. (Seine et Oise.)

1753. Susa.

1754. Valepuiseux. (Seine et Oise.)

1755. Novara.

1756. Cusset. (Allier.) Boulogne. (Pas de Calais.)

1757. Montaigu les Combrailles. (Puy de Dôme.)

1758. Amiens, environs. (Somme.)

1759. Paris. (Seine.) Guise. (Aisne.) Caudebec. (Lower Seine.)

1760. Alençon. (Orne.)

1763. Vire. (Calvados.)

1763, 64. Bayeux. (Calvados.)

1765. Balleroy, Basoques. (Calvados.) Saint-George, Saint-Quentin. (Calvados.)

1766. Campagny. (Calvados.)

1767. Thinchebray, Truttemer. (Orne.)

1768, 69. St. Quentin. (Aisne.)

1770. Louviers. (Eure.)

1771. Montargis. (Loiret.)

1772. Hardivilliers, environs.

1773. Hardivilliers. (Oise.)

1776. Laigle. (Orne.)

1777. Jouy. (Seine et Oise.)

1782. Castelnaudary. (Aude.) Boissy Saint-Léger. (Seine et Oise.)

1783. Beaumont. (Seine et Oise.)

1791. Méru. (Oise.)

1810. Nourare, Villotran. (Oise.)

1812. Rosheim, and many other places. (Lower Rhine.)

1821. La Chapelle, Saint-Pierre and sixty places around. (Oise; Seine et Oise.)

Sect. 3.—The Roettingen Sweating Sickness.

We now come to a phenomenon which, notwithstanding its short duration and very limited extension, is one of the most memorable of this century. Up to the present time, its real importance has not been recognised, because the clouds of self-sufficient ignorance have prevented our taking a survey of the formation of diseases, throughout long periods of time. It has been sunk for an age in the sea of oblivion, from whence we will now draw it forth to the light of day.

In November, 1802, a very hot and dry summer had been succeeded by incessant rain. Thick fogs spread over the country, and enveloped such places in central Germany as were inaccessible to ventilation. Amongst others, the small Franconian town of Roettingen, situated on the river Tauber, and surrounded by mountains[516]. Scarcely had a few weeks elapsed, when unexpectedly, towards the 25th of November, an extremely fatal disease broke out in the town, which was without example in the memory of its inhabitants, and totally unknown to the physicians of the country.

Strong vigorous young men were suddenly seized with unspeakable dread; the heart became agitated and beat violently against the ribs, a profuse, sour, ill-smelling perspiration broke out over the whole body, and at the same time, they experienced a lacerating pain in the nape of the neck, as if a violent rheumatic fever had taken possession of the tendinous tissues. This pain ceased sometimes very quickly, and if it then shifted to the chest, the distressing palpitation of the heart recommenced; a spasmodic trembling of the whole body ensued; the sufferers fainted, their limbs became rigid, and thus they breathed their last. In most cases, all this occurred within four and twenty hours. They did not all, however, succumb under the first attack, but as soon as the accelerated pulse had sunk to the lowest ebb of smallness and feebleness, a corresponding effect being observable in the respiration, the violent pain would in some cases return to the outward parts. The patient then felt a benumbing pressure and stiffness in the nape of the neck; and the pulse and respiration became restored again as in health, but the perspiration continued to pour incessantly down the skin.

This apparent safety was, however, very deceptive, for a renewed palpitation of the heart unexpectedly commenced, accompanied by a feeble pulse; and then death was often inevitable. It was remarkable, that the patients, though bathed in perspiration, had very little thirst, and the tongue was not dry, nor ever even foul, but retained its natural moisture. With most, however, the urine was scanty; as the skin, under the increasing debility, permitted too much fluid to stream forth through its pores. If the disease passed off without heating sudorifics, then in general no eruption made its appearance. The malady then continued till the sixth day, but on the first only, did it display its malignant symptoms, for by the second, the sweating diminished and lost every unfavourable quality, so that increased transpiration of the skin, without any other symptoms of importance, alone remained, and on the sixth day the patient was perfectly restored.

Had there been in Roettingen a physician at hand from the commencement, well skilled in medical history, and who would have adopted the old English treatment of the Sweating Sickness, this new fever would have appeared but as a perfectly mild disease, and would certainly have carried off but few of the inhabitants of this peaceful little town. As it was, however, the scenes of Lübeck and Zwickau were renewed, and it seemed as if the innumerable victims to the hot treatment, and to Kegeler’s truculent medical work, had descended to the grave in vain. The sufferers were, as in the sixteenth century, literally stewed to death! for the moment the people imagined that they knew how nature meant to escape, they ordered feather-beds to be heaped on the perspiring patient, so that the mouth and nose alone remained uncovered. Doors and windows were tightly closed, and the stove emitted a glowing heat, whilst a most intolerable odour of perspiration streamed forth from beneath the broad and lofty beds; added to which, that two and even more patients were often lying in the same room; nay, even stowed together under the same mountain of feathers, and in order that inward heat might not be wanting, pots of theriaca were swallowed, and the patient was incessantly plied with elder electuary. Thus the bad humours were expelled together with the perspiration; and whether the sufferers were suffocated, or surmounted, as by a miracle, this mal-treatment of nature, a conviction was felt, that the most salutary remedies had been employed, and when at last, eruptions of various colours broke out, it was considered as certain, that the poison had been carried off in them. The citizens of Roettingen, therefore, fell into the same erroneous opinion, which, upheld by medical schools, had, time immemorial, increased inflammatory diseases, particularly the exanthematous, and caused them to become malignant. The above-mentioned eruptions were of various sorts; miliary vesicles of every form and colour, filled with an acrid fluid; actual blistery eruptions, (pemphigus,) and even petechiæ; and it is to be observed, that the patients, during the first days of the sweating fever, never suffered from that peculiar pricking sensation over the whole body, which precedes the eruption of miliaria, but complained only, and that not always, of a local itching, where the eruption had broken out. It was equally rare to observe a regular desquamation of the skin, and it is therefore to be assumed, that the eruptions were only symptomatic, and not by any means necessarily connected with the disease, as in the decidedly miliary fevers.

The disease excited, from its very commencement, the greatest consternation; and as it was increased, even from the first days of its appearance, by the sudorific system of treatment, deaths were multiplied; the continual peal of funeral bells struck mortal terror, as of old at Shrewsbury, into the hearts of both sick and healthy; and this oppressed little town was shunned as a pesthole by the inhabitants of the surrounding neighbourhood. At the commencement of the disease, they were entirely without medical advice, till a skilful physician arrived from the vicinity[517], and as most of the inhabitants were already attacked with the sweating fever, he immediately prescribed the proper treatment. But the powers of one man are not sufficient, amid such confusion, to contend with the deeply rooted prejudices of the people, and so they continued in most houses to expel by heat and theriaca both perspiration and life together; till at last, on the third of December, Dr. Sinner of Würzburg arrived, without whom the remembrance of this remarkable disease would have been obliterated, and conjointly with his gallant colleague, like the anonymous physician formerly in Zwickau, subdued the destructive prejudices of the people. He found eighty-four patients[518] under piles of feather-beds, who, when pure air was admitted, breathed once more freely, and by a prudent cooling system, all recovered easily, and without danger, one only excepted. His method reminds us of the old English treatment[519]. The disease was confined entirely to Roettingen, it did not make its appearance anywhere beyond the gates of this little town. On the fifth of December, however, clear, frosty weather set in; from that time no new cases occurred, and all traces of this Roettingen sweating fever, which was never either preceded or followed by miliary fever in any part of Franconia, have from that time disappeared.

The resemblance of this fever to the English Sweating Sickness is manifest, and is proved even by the short (only ten days’) duration of the visitation, which, as we have stated, is a most essential characteristic of the English sweating epidemic, at least as it appeared in Germany, the miliary epidemics always having lasted a much longer period. But if we confine ourselves merely to the symptoms of the disease, we shall find, that in the Roettingen sweating fever, there are, throughout, none that can be considered essential, except the palpitation of the heart, accompanied with anguish, the profuse perspiration, and the rheumatic pains in the nape of the neck, which never were wanting in any case; and the very same symptoms are clearly and perceptibly to be discerned in like proportion as compared with others, in the representation of the English Sweating Sickness; whereas, the eruptions were altogether as unessential as in the epidemic of the sixteenth century. The irritability of the skin, and tendency to dangerous metastases, were less marked in the Roettingen fever than in the English Sweating Sickness; for the patients could, without injury, change their linen in the midst of the perspiration, which, in the English Sweating Sickness, could not have been done without fatal consequences; but this difference can easily be accounted for, from the greater degree of suffering in the latter disease than in the former. It only now remains to examine the duration of the disease, and here we plainly perceive that the principal paroxysm was over in the Roettingen epidemic within the first four and twenty hours, at least when it was undisturbed by treatment; and the sole symptom which continued until the sixth day—the increased perspiration, (we speak here only of perfectly pure cases,) could only reasonably be regarded as a sequela. The crisis did not occur all on a sudden, as in the English Sweating Sickness, but this cannot constitute any essential difference.

We do not hesitate, therefore, to pronounce the Roettingen fever to have been the same disease as the English Sweating Sickness. To give, however, this phenomenon its proper interpretation—to have a clear conception of the causes which again drew down from the clouds, into the midst of Germany, this mist-born spectre of 1529, and allowed it to expend its brief fury upon a single place, is beyond the power of human wisdom. Science is not comprehensive enough to discover, in the crossings of these unknown comet-paths, the moving causes of this visitation of disease. But as all insight into the works of nature must be preceded by a strict investigation and search after phenomena in all countries, at all times, and under all circumstances of development, so an improved knowledge of diseases and of the whole human system, will not fail to follow, when the investigations of epidemics throughout extensive periods have increased in number and success.

The present age demands such a knowledge of medical men, whose vocation it is to investigate life minutely in all its bearings. It demands of them an historical pathology, and to this branch of the study of nature is the present work intended to contribute.

CHRONOLOGICAL SURVEY.

Political Events.

1461–1483. Louis XI.

1485–1509. Henry VII.

1493–1519. Maximilian I. Mercenary troops are introduced.

1483–1498. Charles VIII.

1483–1485. Richard III.

1483, October. First abortive attempt of the Earl of Richmond, (who had fled to France in 1471,) against Richard III. The Duke of Buckingham executed.

1485. Richmond obtains support from Charles VIII.

1485, 25th July. Richmond’s departure from Havre.

1485, 1st August. Landing at Milford Haven.

1485. From the 1st to the 22d of August, march from Milford Haven to Lichfield and Bosworth.

1485, 22d August. The battle of Bosworth. Richard III.falls. The Earl of Richmond becomes king, under the name of Henry VII.

1485, 28th August. Henry’s entry into London.

1485, 30th October. Henry’s coronation.

1481–1492. The wars of Ferdinand the Catholic, against the Saracens.

1495. Useless war for the succession of Charles VIII. against Alfonso II., (who died in 1495,) and Ferdinand II. of Naples. The conquest of the kingdom was again immediately relinquished.

First Visitation of the Sweating Sickness.

1472–1482. Swarms of locusts in the south of Europe.

1480–1485. Wet years.

1483. Overflow of the Severn, (the great water of the Duke of Buckingham.)

1480 and 1481. Famine in Germany and France.

1477–1485. Glandular plague in Italy.

1480, 1481. Encephalitis in Germany.

1482. Febrile cerebritis in France, and epidemic pleuritis in Italy.

1483. Glandular plague in Spain.

1484 and 1485. Malignant fever in Germany and Switzerland. Plague in Spain.

1485. In the beginning of August: eruption of the English Sweating Sickness, probably amongst Richmond’s mercenary troops. It spread from west to east, and then in a contrary direction.

1485. The end of August, in Oxford.

1485. 21st September till the early part of October, in London.

1485. The middle of November, in Croyland.

1486. 1st January. Termination of the first epidemic Sweating Sickness.

1486. Epidemic scurvy in Germany. Plague in Spain.

1488–1490. Plague in Spain.

1490. First eruption of petechial fever in Granada, in the army of Ferdinand the Catholic.

1495. Eruption of the syphilitic pestilence at Naples, among the mercenary army of Charles VIII.

1499. Great plague in London.

Political Events.

1485–1509. Henry VII.

1501. His eldest son, Arthur, marries Catherine of Arragon, daughter of Ferdinand the Catholic.

1502. Prince Arthur dies. Prince Henry (VIII.), second son of Henry VII., is affianced to Catherine of Arragon.

The internal condition of England is altered by Henry VII.The towns begin to rise importance, and the sciences to become diffused. A rigorous and unjust financial system.

1498–1515. Louis XII.

1501. conquers Naples in conjunction with the Spaniards, and is by the

1504. expelled thence. He establishes his power in Upper Italy.

1511. Pope Julius II. (1503–1513) forms the sacred league against France, into which enters likewise, in 1512, Henry VIII. The French lose their power in Italy.

1504. Isabella of Castile dies. Philip I. of Austria, her daughter Johanna’s husband, succeeds her, his son, Charles V., having been born in 1500.

1506. Philip I. dies.

1516. Ferdinand the Catholic dies.

Second Visitation.

1500–1503. Mould-spots (signacula) in Germany and France.

1500. Comet.

1500. Mortality among cattle in Germany.

1502. Very extensive destruction of cultivation in Germany by blights of caterpillars.

1503. Glandular plague, and destructive epidemics in Germany and France.

1504. Plague in Spain.

1504 and 1505. Encephalitis, putrid fever, and malignant pneumonia in Germany.

1505. Plague in Portugal.

1505. First epidemic petechial fever in Italy. The morbid activity of the organism shewed a decided determination towards the skin during all this period.

1505. Moist summer. Lamentable moral state of England.

1506. The summer: the Sweating Sickness breaks out in London, and continues to a moderate extent, being confined to England, until the autumn. This second visitation is the mildest of all, and the old English method of treatment proves effectual everywhere.

1506–1508. Pestilential epidemics in Spain.

1508. Swarms of locusts in Spain.

Political Events.

1509–1547. Henry VIII.

1515–1547. Francis I. immediately attacks Milan again, and conquers.

1515. the Swiss, in the battle of Marignano. Keeps possession of Milan, and establishes the French dominion in Italy until the year 1522.

1516. Cardinal Wolsey changes the policy of England in favour of Francis I.,

1520. then of Charles V.

1513–1522. Leo X., against France. Promotes, by a new bull of indulgences, the outbreak of the Reformation.

1517. 31st of October, Luther commences the Reformation.

1519. 12th January, the Emperor Maximilian I. dies.

1519–1556. Charles V.

1521. Imperial diet at Worms.

1517. May: Insurrections of the operatives in London.

1517. In the autumn and winter, Henry VIII. frequently changes the residence of his Court in consequence of the Sweating Sickness and the Plague.

1518. 11th February, Queen Mary is born.

1518. The College of Physicians in London is founded by Linacre.

1521. Henry VIII. opposes Luther, and obtains the title of “Defender of the Faith.” (Thomas More.)

Third Visitation.

1515. Pestilential epidemics in Spain.

1516. Comet.

1517. Unproductive, but not moist summer.

1510. Great influenza (Coqueluche) throughout France, and probably to a still further extent. Plague in the north of Europe.

1517. In the early months epidemic trachæitis and œsophagitis (diphtheritis) in Holland, lasting only eleven days. This epidemic extends towards the south, and appears in the same summer at Bâsle.

1517. On the 16th June, earthquake in Swabia (and Spain).

1517. Encephalitis and other inflammatory fevers in Germany.

1517 In July, outbreak in London of the third visitation of epidemic sweating sickness; it spreads with great malignity all over England, and among the English at Calais; in the sixth week it attains its greatest violence, and terminates in December. Ammonius, of Lucca, and many distinguished and learned persons in Oxford and Cambridge are carriedoff by it.

1517. In December, immediately after the Sweating Sickness, a plague occurs in England and lasts all the winter.

1517. Small-pox breaks out in Hispaniola.

Political Events.

1524. October, Francis I. passes Mont Cenis, and is

1525. beaten at Pavia and captured.

1526. 14th January. Peace of Madrid.

1526. Clement VII. (1523–1534) becomes the head of the Holy League against the Emperor.

1527. 6th May. Rome is vanquished by the imperial army and sacked.

1528. A French army, under Lautrec, conquers the greatest part of Italy, and commences

1528. 1st May, the siege of Naples. Lautrec dies in August.

1528. 29th August, the siege of Naples is raised. The remains of the French army are made prisoners.

1528. Charles V. challenges Francis I. to single combat.

1529. 5th August, Francis I. concludes the unfavourable peace of Cambray. Termination of the French dominion in Italy. The Reformation in England is retarded.

1527. Scruples of Henry VIII. respecting his marriage with Catherine of Arragon. Various negotiations on the subject in the following years. Cardinal Wolsey falls into disgrace. Thomas More becomes chancellor.

1528. Henry VIII. retires to Tytynhangar in consequence of the Sweating Sickness.

1532. Separation of the king from Catherine. Mary is excluded from the government.

1533. January, Anna Boleyn becomes queen. The Reformation is introduced.

1535. Thomas More and Fisher are executed.

1536. Anna Boleyn is executed. Jane Seymour becomes queen. Dies 1537.

1537. Anne of Cleves becomes queen. Separation after six months.

1541. Catherine Howard, queen, and executed one year and six months afterwards.

1544. Catherine, queen.

1547. 13th December, Henry VIII. dies.

1521. Plots of the Iconoclasts in Zwickau and Wittenberg.

1523–1525. Peasant war. On the 15th May, battle ofFrankenhausen.

1529. Imperial Diet at Spires.

1529. 22d September-16th October, the Turks before Vienna.

1529. 2d October, assemblage of the Reformers in Marburg.

1530. 25th June, surrender of the Augsburg confession. Severe decrees against the Protestants.

1531. League of the Protestant princes at Schmalkalden. Continued danger from the Turks.

1532. Imperial Diet at Nuremberg. The Protestants obtain security.

1333–1535. Excesses of the Anabaptists at Münster.

1536. The Schmalkaldic league is strengthened.

1538. The Catholic States establish the sacred league at Nuremberg

1540. Paul III. (1534–1550) confirms the order of the Jesuits, founded in 1534 by Ignatius Loyola.

1519–1541. Conquest of Mexico, Peru, Chili, &c.

Fourth Visitation.

1524. Great plague at Milan,

1527. Inundations in Upper Italy.

1527. 11th August, a comet.

1527. Plague in the imperial army in Italy, after the sacking of Rome; and in Wittenberg.

1528–1534. Years of famine, with a prevalence of moisture and heat.

1528. Repeated inundations. Continual south winds and summer fogs in Italy. Second great epidemic petechial fever there.

1528. Destruction of the French army before Naples by a pestilential Spotted Fever.

1528. Cold spring and moist summer in France.

1528–1532. Warm winters, moist summers. Repeated failures of harvest, and great famines in that country.

1528. The Trousse-galant carries off a fourth part of the inhabitants of France in this and the following years.

1528. Wet and mild winter. Moist summer with fogs. Failure in crops, and famine in England.

1528. At the end of May: outbreak in London of the Fourth epidemic Sweating Sickness. It spreads with great malignity, and with much disturbance of social life, all over England; carries off many distinguished persons, and terminates in the winter. This year it remains confined to England, and does not return in the following year.

1528. Continual south-east winds. Great drought. Swarms of locusts and fiery meteors in the north of Germany.

1529. Earthquake in Upper Italy. Sanguineous rain at Cremona. A comet in July and August.

1529. Mild winter in Germany. The spring begins in February. Great moisture throughout the summer. General dearth in March. Disease among the porpoises in the Baltic. Unwholesomeness of the river fish in the north of Germany. Disease among birds. Languor resembling syncope in Pomerania. Frequent suicides in the March. In the middle of June a flood of rain lasting four days (torrent of St. Vitus) in the south of Germany. On the 10th of August, a universal tempest. 24th of August, and the following days great heat.

1529. 25th July, outbreak of the epidemic Sweating Sickness in Hamburgh. Termination on the 5th August. On the 29th July in Lübeck. On the 14th August in Zwickau. About the 1st September the English Sweating Sickness appears to spread universally all over Germany. On the 31st August in Stettin; termination on the 8th September. On the 1st September in Dantzic; termination on the 6th September. On the 24th August in Strasburg. On the 5th, 6th and 7th September in Cologne, Augsburg and Francfort on the Maine. About the 20th September in Vienna and among the besieging Turks. On the 27th September in Amsterdam. Termination on the 1st October in Antwerp and the rest of the Netherlands; simultaneously, at the end of September, in Denmark, Sweden and Noway. At the commencement of November a universal cessation of the epidemic Sweating Sickness.

1530. In October, overflow of the Tiber. Bursting of the dykes, and sudden inundations in Holland, which were repeated in 1532.

1531. 1st of August to 3d September, the comet of Halley.

1532. From 2d October to 8th November, and

1533. From the middle of June to August, comets.

1534. Termination of the years of scarcity, during which malignant fevers prevailed in circumscribed localitiesthroughout Europe.

Political Events.

1542. Maurice Duke of Saxony renounces the league of Schmalkalden.

1542. The imperial army which opposes the Turks in Hungary, under Joachim II. of Brandenburg, is destroyed by sickness.

1546. The 18th of February, Luther dies.

1546. Charles V. takes the field against the Protestants, proclaimsthe Elector, John Frederick, and Landgrave Philip of Hesse, outlaws. Gains

1547. 24th April, the battle of Muhlberg. Raises

1548. Duke Maurice to the electorate of Saxony, and prescribes the interim, which is not accepted by Magdeburg.

1551. Magdeburg declared to be under the imperial ban, and besieged in vain by the Saxons.

1552. Henry II. of France (1547–1559), in alliance with the Protestant princes, takes Metz, Toul, and Verdun.

1552. The treaty of Passau secures to the Protestants equal rights with the Catholics.

1547–1553. Edward VI. nine years old. The Duke of Somerset governs the kingdom as Protector. The Reformation is favoured, and makes progress.

1553. Mary persecutes the Protestants, and in 1558 loses Calais.

1556. Charles V. abdicates, and dies on the 11th of September, 1558, in Spain.

Fifth Visitation.

1538. Epidemic dysentery in France.

1540. The hot summer. The forests take fire spontaneously.

1541. Plague in Constantinople.

1542. Swarms of locusts in the south of Europe, and plague in Hungary during the war of the Turks in that kingdom.

1543. Plague and petechial fever in Germany. Metz.

1545 and 1546. Trousse-galant in France, of which 10,000 English die at Boulogne.

1546. Plague in the Netherlands and France.

1547. Petechial fever in the imperial army.

1547–1551. Mould spots and red water in the north of Germany.

1549. Caterpillars destroy the herbage, and a mortality occurs among cattle in Germany. The 21st of September an aurora borealis.

1549 and 1550. Malignant fever (petechial fever?) in the north of Germany.

1551. Dry and cold spring; hot and wet summer. Inundations, earthquakes, meteors, mock suns, great tempests, summer fogs.

1551. Malignant fever in Swabia: plague in Spain. Influenza.

1551. In the spring, stinking mists on the banks of the Severn.

1551. On the 15th of April outbreak of the fifth epidemic Sweating Fever in Shrewsbury on the Severn. It gradually spreads with stinking mists all over England, and on the 9th of July reaches London. The mortality is very considerable. Foreigners are unaffected, but Englishmen in foreign countries sicken with the English Sweating Sickness. The epidemic terminates on the 30th of September.

1552 and 1553. Malignant fever in Germany and Switzerland.

CATALOGUE OF WORKS[520]

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Annales Berolino Marchici, ab anno 965 ad annum 1740. Deutsche Handschrift. Berliner Königl. Bibl. MS. boruss. fol. 29.

Antwerpsch Chronykje, sedert den jare 1500 tot het jaar 1574, door F. G. V. Te Leyden, 1743, 4to.

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APPENDIX.

A BOKE, OR COUNSEILL

AGAINST

THE DISEASE

COMMONLY CALLED

THE SWEATE,

OR

SWEATYNG SICKNESSE.

MADE BY JHON CAIUS DOCTOUR IN PHISICKE.

UERY NECESSARY FOR EUERYE PERSONNE, AND MUCHE REQUISITE TO BE HAD IN THE HANDES OF AL SORTES, FOR THEIR BETTER INSTRUCTION, PREPARACION AND DEFENCE, AGAINST THE SOUBDEIN COMYNG, AND FEARFUL ASSAULTING OF THE SAME DISEASE.

1552.

TO THE RIGHTE HONOURABLE WILLIAM EARLE OF PENBROKE, LORDE HARBERT OF CARDIFE, KNIGHT OF THE HONOURABLE ORDRE OF THE GARTER, AND PRESIDENT OF THE KYNGES HIGHNES COUNSEILL IN THE MARCHES OF WALES: JHON CAIUS WISHETH HELTH AND HONOUR.

In the fereful tyme of the sweate (ryghte honourable) many resorted vnto me for counseil, among whōe some beinge my frendes & aquaintance, desired me to write vnto them some litle counseil howe to gouerne themselues therin: saiyng also that I should do a greate pleasure to all my frendes and contrimen, if I would deuise at my laisure some thīg, whiche from tyme to tyme might remaine, wherto men might in such cases haue a recourse & present refuge at all nedes, as thē they had none. At whose requeste, at that tyme I wrate diuerse counseiles so shortly as I could for the present necessite, whiche they bothe vsed and dyd geue abrode to many others, & further appoynted in my self to fulfill (for so much as laye in me) the other parte of their honest request for the time to come. The whiche the better to execute and brynge to passe, I spared not to go to all those that sente for me, bothe poore, and riche, day and night. And that not only to do thē that ease that I could, & to instructe thē for their recouery: but to note also throughly, the cases and circumstaunces of the disease in diuerse persons, and to vnderstande the nature and causes of the same fully, for so much as might be. Therefore as I noted, so I wrate as laisure then serued, and finished one boke in Englishe, onely for Englishe mē not lerned, one other in latine for men of lerninge more at large, and generally for the help of thē which hereafter should haue nede, either in this or other coūtreis, that they may lerne by our harmes. This I had thoughte to haue set furth before christmas, & to haue geuē to your lordshippe at new-yeres tide, but that diuerse other businesses letted me. Neuertheles that which then coulde not be done cometh not now out of season, although it be neuer so simple, so it may do ease hereafter, which as I trust this shal, so for good wil I geue and dedicate it vnto your good Lordshippe, trustyng the same will take this with as good a mind, as I geue it to your honour, whiche our Lorde preserue and graunt long to continue.

At London the first of Aprill. 1552.

THE BOKE OF JHON CAIUS AGAINST THE SWEATYNG SICKNES.

Man beyng borne not for his owne vse and cōmoditie alone, but also for the commō benefite of many, (as reason wil and al good authoures write) he whiche in this world is worthy to lyue, ought al wayes to haue his hole minde and intente geuen to profite others. Whiche thynge to shewe in effecte in my selfe, although by fortune some waies I haue ben letted, yet by that whiche fortune cannot debarre some waies again I haue declared. For after certein yeres beyng at cambrige, I of the age of xx. yeres, partly for mine exercise and profe what I coulde do, but chefely for certein of my very frēdes, dyd translate out of Latine into Englishe certein workes, hauyng nothynge els so good to gratifie theim w^t. Wherof one of S. Chrysostome de modo orandi deum, that is, of y^e manner to praye to god, I sent to one my frende then beyng in the courte. One other, a woorke of Erasmus de vera theologia, the true and redy waye to reade the scripture, I dyd geue to Maister Augustine Stiwarde Alderman of Norwiche, not in the ful as the authore made it, but abbreuiate for his only purpose to whome I sent it, Leuyng out many subtile thinges, made rather for great & learned diuines, thē for others. The thirde was the paraphrase of the same Erasmus vpon the Epistle of S. Jude, whiche I translated at the requeste of one other my deare frende.

These I did in Englishe the rather because at that tyme men ware not so geuen all to Englishe, but that they dyd fauoure & maȳteine good learning conteined in tongues & sciences, and did also study and apply diligently the same thē selues. Therfore I thought no hurte done. Sence y^t tyme diuerse other thynges I haue written, but with entente neuer more to write in the Englishe tongue, partly because the cōmoditie of that which is so written, passeth not the compasse of Englande, but remaineth enclosed within the seas, and partly because I thought that labours so taken should be halfe loste among them whiche sette not by learnyng. Thirdly for that I thought it beste to auoide the iudgement of the multitude, from whome in maters of learnyng a man shalbe forced to dissente, in disprouyng that whiche they most approue, & approuyng that whiche they moste disalowe. Fourthly for that the common settyng furthe and printīg of euery foolishe thyng in englishe, both of phisicke vnperfectly, and other matters vndiscretly diminishe the grace of thynges learned set furth in thesame. But chiefely, because I wolde geue none example or comforte to my countrie men, (whō I wolde to be now, as here tofore they haue bene, comparable in learnyng to men of other countries) to stonde onely in the Englishe tongue, but to leaue the simplicite of thesame, and to procede further in many and diuerse knoweleges bothe in tongues and sciences at home and in vniuersities, to the adournyng of the cōmon welthe, better seruice of their kyng, & great pleasure and commodite of their owne selues, to what kinde of life so euer they shold applie them. Therfore whatsoeuer sence that tyme I minded to write, I wrate y^e same either in greke or latine. As firste of all certein commentaries vpon certein bokes of William framinghā, maister of art in Cambrige, a man of great witte, memorie, diligence and learnyng, brought vp in thesame scholes in Englande that I was, euer frō his beginnyng vntil his death. Of the which bokes, ij. of cōtinētia (or cōtinence) wer in prose, y^e reste in metre or verse of diuerse kindes. One a comforte for a blinde mā, entitled ad Aemilianum cæcum consolatio, one other Ecpyrosis, seu incendiū sodomorū, the burnyng of Sodome. The thirde Laurentius, expressyng the tormentes of Saincte Laurence. The fourthe, Idololatria, Idolatrie, not after the trade and veine of scripture (wherein he was also very well exercised) but conformable to scripture and after the ciuile and humane learnyng, declaryng them to worshippe Mars, that warre, or fight: Venus, that lyue incontinently: Pluto, that folowe riches couetousely; and so forth through all vices vsed in his time. The fineth boke Arete, vertue: the sixth, Epigrāmes, conteined in two bokes, whiche by an epistle of his owne hand before y^e boke yet remainyng, he dedicated vnto me, purposyng to haue done many more prety thynges, but that cruell death preuēted, and toke him away wher he and I was borne at Norwiche, in the yere of our Lord M.d.xxxvij. the xxix. daie of September, beynge then of the age of xxv. yeres, vij. Monethes, and vj. daies, a greate losse of so notable a yonge man. These workes at his death he willed to comme to my handes, by which occasion after I had viewed thē, and perceiued them ful of al kyndes of learnyng, thinkyng thē no workes for all mē to vnderstande with out helpe, but such as were wel sene in all sortes of authours: I endeuoured my selfe partely for the helpe of others, & partly for mine owne exercise, to declare vpon theim the profite of my studie in ciuile and humane learnynge, and to haue before mine eyes as in a worke (which was alwaies my delyght) how muche I had profited in the same. Thys so done, I ioyned euery of my commentaries to euery of hys saied bokes, faier written by Nicolas Pergate puple to the saied Maister Framyngham, myndyng after the iudgement of learned men had in thesame, to haue set theim furthe in prynte, if it had ben so thought good to theim. For whyche cause, at my departynge into Italie, I put an Epistle before theym dedicatorye to the right Reuerend father in God Thomas Thirlbye, now Bishoppe of Norwiche, because thesame maister Framyngham loued hym aboue others. He after my departure deliuered the bokes to the reuerende father in god Jhō Skippe, late bishop of Hereforde, then to D. Thirtle, tutor to the sayd maister framynhā, frō him to syr Richard Morisine, now ambassadoure for y^e kinges maiestie with thēperour, then to D. Tailour Deane of Lincolne, and syr Thomas Smithe, secretarie after to y^e kynges Maiestie, all great learned men. Frō these to others they wente, among whome the bokes died, (as I suppose,) or els be closely kept, that after my death they may be setfurthe in the names of them which now haue thē, as their workes. Howe soeuer it be, wel I knowe that at my returne out of Italie (after vj. yeres continuance ther) into Englād, I coulde neuer vnderstand wher they wer, although I bothe diligently and desirousely sought thē. After these I translated out of Greke into Latine a litle boke of Nicephorus, declarynge howe a man maye in praiynge confesse hym selfe, which after I dyd geue vnto Jhō Grome bacheler in arte, a yong man in yeres, but in witte & learnyng for his tyme, of great expectatiō. That done I beganne a chronicle of the citie of Norwiche, of the beginninge therof & thinges done ther frō time to time. The matere wherof yet rude and vndigested lyeth by me, which at laisure I minde to polishe, and to make an end of that I haue begunne. And to be shorte, in phisicke diuerse thynges I haue made & settefurth in print bothe in Greke and Latine, not mindyng to do other wise, as I haue before said, al my life: For which cause al these thinges I haue rehersed, els superfluous in this place. Yet see, meaning now to counseill a litle agaynst the sweatyng sickenes for helpe also of others, notwithstandyng my former purpose, two thynges compell me, in writynge therof, to returne agayne to Englishe, Necessite of the matter, & good wyl to my countrie, frendes, & acquaintance, whiche here to haue required me, to whome I thinke my selfe borne.

Necessite, for that this disease is almoste peculiar vnto vs Englishe men, and not common to all men, folowyng vs, as the shadowe the body, in all countries, albeit not at al times. Therfore compelled I am to vse this our Englishe tongue as best to be vnderstande, and moste nedeful to whome it most foloweth, most behoueth to haue spedy remedie, and often tymes leaste nyghe to places of succource and comforte at lerned mennes handes: and leaste nedefull to be setfurthe in other tongues to be vnderstand generally of all persons, whome it either haunteth not at all, or els very seldome, as ones in an age. Thinkynge it also better to write this in Englishe after mine own meanyng, then to haue it translated out of my Latine by other after their misunderstandyng.

Good wyll to my countrie frendes and acquaintance, seynge them wyth out defence yelde vnto it, and it ferefully to inuade thē, furiousely handle them, spedily oppresse them, vnmercyfully choke them, and that in no small numbers, and such persons so notably noble in birthe, goodly conditions, graue sobrietie, singular wisedōe, and great learnynge, as Henry Duke of Suffolke, and the lorde Charles his brother, as fewe hath bene sene lyke of their age: an heuy & pitifull thyng to here or see. So that if by onely learned men in phisicke & not this waye also it should be holpen, it were nedeful almost halfe so many learned men to be redy in euery toune and citie, as their should be sweatynge sicke folkes. Yet this notwithstandynge, I wyll euery man not to refuse the counseill of the present or nighe physicen learned, who maie, accordyng to the place, persone, cause, & other circūstances, geue more particular counseil at nede, but in any wise exhorte him to seke it with all diligence. To this enterprise also amonge so many learned men, not a litle stirreth me the gentilnes and good willes of al sortes of men, which I haue well proued heretofore by my other former bokes. Mindynge therefore with as good a will to geue my counseil in this, and trusting for no lesse gentlenes in the same, I wyll plainly and in English for their better vnderstandynge to whome I write, firste declare the beginnynge, name, nature, and signes of the sweatynge sickenes. Next, the causes of the same. And thirdly, how to preserue men frō it, and remedy them whē they haue it.

The beginnyng of the disease.—In the yere of our Lorde God M.CCCC.lxxxv. shortly after the vij. daye of august, at whiche tyme kynge Henry the seuenth arriued at Milford in walles, out of Fraunce, and in the firste yere of his reigne, ther chaunced a disease among the people, lastyng the reste of that monethe & all september, which for the soubdeine sharpenes and vnwont cruelnes passed the pestilence. For this commonly geueth iij. or iiij. often vij. sumtyme ix. as that firste at Athenes whiche Thucidides describeth in his seconde boke, sumtyme xj. and sumtyme xiiij. dayes respecte, to whome it vexeth. But that immediatly killed some in opening theire windowes, some in plaieng with children in their strete dores, some in one hour, many in two it destroyed, & at the longest, to thē that merilye dined, it gaue a sorowful Supper. As it founde them so it toke them, some in sleape some in wake, some in mirthe some in care, some fasting & some ful, some busy and some idle, and in one house sometyme three sometime fiue, sometyme seuen sometyme eyght, sometyme more some tyme all, of the whyche, if the haulfe in euerye Towne escaped, it was thoughte great fauour. How, or wyth what maner it toke them, with what grieffe, and accidentes it helde theym, herafter thē I wil declare, whē I shal come to shewe the signes therof. In the mene space, know that this disease (because it most did stand in sweating from the beginning vntil the endyng) was called here, the Sweating sickenesse: and because it firste beganne in Englande, it was named in other countries, the englishe sweate. Yet some coniecture that it, or the like, hath bene before seene among the Grekes in the siege of Troie. In thēperor Octauius warres at Cantabria, called nowe Biscaie, in Hispaine: and in the Turkes, at the Rhodes. How true that is, let the aucthours loke: how true thys is, the best of our Chronicles shewith, & of the late begonne disease the freshe memorie yet confirmeth. But if the name wer now to be geuen, and at my libertie to make the same: I would of the maner and space of the disease (by cause the same is no sweat only, as herafter I will declare, & in the spirites) make the name Ephemera, which is to sai, a feuer of one natural dai. A feuer, for the feruor or burning, drieth & sweating feure like. Of one naturall day, for that it lasteth but the time of xxiiij. houres. And for a distinction from the commune Ephemera, that Galene writeth of, comming both of other causes, and wyth vnlike paines, I wold putte to it either Englishe, for that it followeth somoche English menne, to whō it is almoste proper, and also began here: or els pestilent, for that it cōmeth by infection & putrefaction, otherwise then doth the other Ephemera. Whiche thing I suppose may the better be done, because I se straunge and no english names both in Latine and Greke by commune vsage taken for Englishe. As in Latin, Feure, Quotidiā, Tertian, Quartane, Aier, Infection, Pestilence, Uomite, Person, Reines, Ueines, Peines, Chamere, Numbre, &c. a litle altered by the commune pronunciation. In Greke, Pleuresie, Ischiada, Hydrops, Apostema, Phlegma, and Chole: called by the vulgare pronunciatiō, Schiatica, Dropsie, Impostume, Phleume, & Choler: Gyne also, and Boutyre, Sciourel, Mouse, Rophe, Phrase, Paraphrase, & cephe, wherof cometh Chaucers couercephe, in the romant of the Rose, writtē and pronoūced comōly, kerchief in y^e south, & courchief in the north. Thereof euery head or principall thing, is comonlye called cephe, pronoūced & writtē, chief. Uery many other there be in our commune tongue, whiche here to rehearse were to long. These for an example shortelye I haue here noted. But for the name of this disease it maketh now no matter, the name of Sweat beyng cōmōly vsed. Let vs therfore returne to the thing, which as occasiō & cause serued, came againe in the M.D.vi. the xxii. yeare of the said Kyng Henry the seuenth. Aftre that, in the yeare M.D.xvii. the ix. yeare of Kyng Henry the viii, and endured from July, vnto y^e middest of Decēbre. The iiii tyme, in the yeare M.D.xxviii. the xx. yeare of thesaied Kyng, beginning in thende of May, & continuing June and July. The fifth tyme of this fearful Ephemera of Englande, and pestilent sweat, is this in the yeare M.D.LI. of oure Lorde GOD, and the fifth yeare of oure Souereigne Lorde king Edwarde the sixth, beginning at Shrewesbury in the middest of April, proceadinge with greate mortalitie to Ludlowe, Prestene, and other places in Wales, then to Westchestre, Couentre, Drenfoorde, and other tounes in the Southe, and suche as were in and aboute the way to London, whether it came notablie the seuenth of July, and there continuing sore, with the losse of vii. C. lxi. from the ix. day vntil the xvi. daye, besides those that died in the vii. and viii. dayes, of whō no registre was kept, frō that it abated vntil the xxx. day of the same, with the losse of C. xlii. more. Then ceassing there, it wente from thence throughe al the east partes of England into the Northe vntill the ende of Auguste, at whiche tyme it diminished, and in the ende of Septembre fully ceassed.