Review of Fever in England to 1643.

Of the prevalence of malignant fevers in England in the earlier years of the 17th century we have only occasional glimpses. Thus, in London in November, 1612, there were several deaths of prominent personages. Prince Henry, eldest son of James I., died of a fever in the course of that month, the illness being thus referred to by Chamberlain in one of his letters to Carleton, written on November 12 from London:

Sir Theodore Mayerne, the king’s physician (who had been driven from Paris by the intolerance of the Galenists towards those who used antimony and other Paracelsist remedies), was a good deal blamed because he had purged the patient instead of bleeding him.

Writing again on the 19th November, Chamberlain says: “On Friday Sir Harry Row, our alderman died, and, same morning, Sir George Carey, master of the wards, of this new disease.” Chamberlain’s statement that an epidemic fever, which he calls “the ordinary ague,” had raged all over England from the end of summer, 1612, is supported by Short’s abstracts of the parish registers for that year, while the following year, 1613, stands out as still more unhealthy. The next unwholesome year in Short’s tables is 1616; and of that sickly time we have one great personal illustration. Shakespeare died on April 23 at Stratford-on-Avon, after three days’ illness of a fever (but possibly of a chill) having just completed his 52nd year. So far as is known, he was not in failing health. It is a singular coincidence that he made his will on March 25 preceding, the first day of the year, old style; but the customary phrase, “in perfect health and memory (God be praised!),” would have been perhaps varied a little if illness had been creeping upon him. Now the year 1616 is the most unhealthy in Short’s tables from the beginning of the century; the parish registers do not bear witness again to so much sickness until 1623, which, as we have seen, was a year of typhus. The winter of 1615-16 was altogether exceptional: warm and tempestuous south-westerly and westerly winds prevailed from November until February; on the 8th February, there were East Indiamen lying in the Downs, which had been at anchor there for ten weeks waiting for a change of wind to take them down the Channel. The warm winds brought “perpetual weeping weather, foul ways and great floods,” and brought also an early spring. In the last week of January the archbishop found a nest of young blackbirds in his garden at Lambeth, and had “another sent to him from Croydon about four days after.” That was proverbially the kind of Christmas to make a fat churchyard; but it is impossible to say whether one type of sickness, such as fever, predominated, as in the preceding sickly years, 1612-13, and in the next following 1616, namely 1623-24. The following figures from Short’s tables will prove, at least, that there was excessive mortality.

In the year 1616, twenty-one parish registers out of eighty-eight examined, showed excessive mortality, the burials being 601 and the baptisms 417, the year 1617 showing a somewhat improved state of health. In the market towns for the same two years, the excessive proportion of burials to christenings is equally striking: of sixteen town registers examined, ten showed a bad state of health in 1616 (714 burials to 568 baptisms), and in 1617, nine towns had 786 burials to 652 baptisms. But neither in town nor country do the years 1616-17 stand out so unhealthy as the years 1623-24. Those two biennial periods are the only very conspicuous ones in Short’s list for the first quarter of the 17th century, the year 1613 coming next in unhealthiness.

Let us now seek for any causes such as unwholesome conditions of living upon which these epidemic fevers might have depended. One of the most notorious forms of typhus in the 18th century was the ship-fever. The problem how to destroy its infection in the hulls of transports and ships of war occupied the attention of the men of science, Stephen Hales among the rest. Parliament, eager for any cure of so disastrous a pest, voted some thousands of pounds to a projector whose method, when tried, resulted in nothing but the burning of three ships to the water’s edge. This ship-fever became notorious early in the 17th century, having occurred before in 1588. If the Elizabethan naval annals in Hakluyt’s collection were less engrossed than they are with adventures and doughty deeds, we should probably have had more glimpses of an unwholesome state of things in the ’tween-decks. At all events there is no doubt that fever infested the shipping of England as well as of France about the year 1625. The conditions on board ship are, of course, special; there might have been ship-fever, when there was no gaol-fever, workhouse-fever, or domestic typhus in general. But what happened on board ship was no bad index of what was happening on shore. The nation, both on sea and on land, was expanding far beyond its old medieval limits, with very crude notions of the elbow-room that it needed. The ideas of cubic space, ventilation, and the like, with which we are now so familiar, had then no existence. A few facts about the shipping, gaols and houses will serve to illustrate this statement.

The fleet which sailed from Plymouth to make war on Spain in the autumn of 1625 consisted of 90 sail, and carried 10,000 men. Whether there was overcrowding would depend, of course, on the size of the ships; and it may be safely said that the largest ship of the fleet was not a fourth part the size of a transport that would be allowed to carry five hundred men today. The expedition came back in a few weeks broken by sickness and mutiny, just as the expedition of Mansfeld for the relief of the Palatinate had fared. The wretched state of the thirty ships which arrived at Plymouth in November, 1625, has been mentioned already. At the same date we read of French ships of war also throwing overboard two or three dead men every day. There are some more precise figures for French ships in 1627, to be given in the next chapter, which will enable us to measure the provocation to ship-fever afforded by the conditions of a transport service in those years.

Besides ship-fever, in the great typhus period of the 18th century, there used to be named gaol-fever, and workhouse-fever. Of the gaol-fever one hears little in these years. It was severe in the Queen’s Bench prison in Southwark in March, 1579; a petition of that date complains that the prison held double the usual number, that “the sickness of the house” was rife, and that near a hundred had died of it there during the previous six years, many more having been sick[1059]. “The sickness of the house” is a name suggestive of what was usual. These events of prison life made little stir unless they involved the health of classes far removed from the prison-class, as in the three memorable instances of the Black Assizes at Cambridge, Oxford and Exeter. But it is not certain that even such cases have been all recorded, or that instances of gaol-fever spreading to those outside may not have been more frequent than appears. Whitmore in his book of 1659 on fevers in London and the country, quotes Bacon’s remarks upon the Black Assizes of the Tudor period and adds: “and within this eight or nine years there happened the like at Southwark, as I am credibly informed.” That would have been in the King’s Bench prison some time about 1650, which is not far from the date we have brought the history down to[1060].

The overcrowding of the ships and of the gaols had its counterpart in the dwelling-houses of London and other towns such as Portsmouth. The proclamations against the erection of houses on new sites within three miles of the city gates continued to be issued to the time of Cromwell. The effect of them was merely to call into existence a class of poor tenements in odd corners or to overcrowd the existing houses. Thus, on June 27, 1602: “The council have spied an inconvenient increase of housing in and about London by building in odd corners, in gardens and over stables. They have begun to pull down one here and there, lighting in almost every parish on the unluckiest, which is far from removing the mischief[1061].” Again, on February 24, 1623, certain inhabitants of Chancery Lane were indicted at the Middlesex Sessions for subletting, “to the great danger of infectious disease with plague and other diseases[1062].” Again, in May, 1637, there were found in one house eleven married couples and fifteen single persons; in another the householder had taken in eighteen lodgers[1063]. The monstrous window-tax, which did more than anything else to breed typhus and perpetuate smallpox, was not imposed until after the Revolution; but there was enough in the London of the Stuarts to explain the great increase of those diseases.

We have already had evidence of the wide prevalence of spotted fever in 1624, even in the houses of the rich. In the harvest of 1625, Mead, of Cambridge, heard of much sickness which he calls “ague,” about Royston and Barkway, localities by no means malarious; so many were ill that the people wanted help to gather the harvest out of the fields. The nature of these “agues” is a question of great difficulty. The intermissions or remissions of the country fevers are clearly enough asserted by Willis and others, whatever they were; at the same time the general characters of the disease, or diseases, are not those of intermittent malarial fever; and “influenza” does not help us. Chamberlain calls the fever of 1624 “the spotted fever,” and Sir Theodore Mayerne, physician to James I., in a long opinion upon the king’s state of health and the treatment, dated Aug. 20, 1624, introduces a paragraph “Ad Febrem Purpuream,” which, he says, was prevalent that year, “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 etc. These various accounts for town and country point to a form of typhus; and we find that diagnosis confirmed for the country fevers which were again widely prevalent a few years later, about 1638.

Among other statistics in Graunt’s essay of 1662 we find the figures from the register of “a parish in Hampshire” from 1569 to 1658. There were several years of excessive mortality in that period just as in Short’s tables, but the worst were 1638 and 1639—the years of high mortality (not plague) in London also. Of that mortality in the Hampshire parish Graunt has given a brief account, which he seems to have based on first-hand information. The parish contained about 2700 inhabitants, and enjoyed average good health during the period of 90 years covered by the figures, the births exceeding the deaths by twelve on an average in the year. In the year 1638 the deaths were 156 and the births 66 (about the average); in 1639 the deaths were 114 and the births 55. The cause of this great excess of mortality in a country parish was, says Graunt, not plague, “but a malignant fever raging so fiercely about harvest that there appeared scarce hands enough to take in the corn; which argues, considering there were 2700 parishioners, that 7 might be sick for one that died; whereas of the plague more die than recover. They lay longer sick than is usual in plague,” and there were no plague-tokens.

This considerable epidemic of fever, which must have affected some hundreds of people, occurred in a Hampshire parish. In the very same season (autumn and winter of 1638) we hear of what is obviously the same sickness being epidemic all over the county of Monmouth. On April 23, 1639, the sheriff of Monmouthshire thus explained his delay in executing the king’s writ for an assessment: “In January last I sent forth my warrants for the gathering and levying thereof, but there has been such a general sickness over all this country, called ‘the new disease,’ that they could not possibly be expedited.... Besides, the plague was very hot in divers parts of the county, as Caerleon, Abergavenny, Bedwelty, and many other places[1064].” Here the sheriff uses the same name as Greaves put on his title-page five years after, and he distinguishes clearly between the fever and the plague. The mayor and others of Northampton, in a memorial to the Recorder, dated May 1, 1638, touching the exclusion of Northampton tradesmen from fairs in the vicinity owing to suspicions of the plague in their town, had been informed by the physicians that some cases were of the plague, and some of “the spotted fever[1065].” The same distinction had been made at Norwich, in 1636: in October there was a suspicion of the plague, “but the physicians say it is some other contagious disease which die with the spots[1066].” At Northampton, the coexistence of plague and some other sickness is asserted also by the sheriff (Sept. 18, 1638), who had to excuse himself, like so many other sheriffs, for his failure to remit the ship-money: he himself and his servants had had sickness, and the plague was so great and so long in Northampton that the county still allowed £148 a week for relief of the sick. The deaths in that epidemic from March to September were 533[1067]. The sheriff of Montgomery, making a like excuse on October 25, 1638, speaks of the plague only: “It pleased God to visit a great part of the county with the plague, and three of the greatest towns, Machynlleth, Llanidloes and Newton[1068].” The sheriff of Radnorshire, in his excuse to the Privy Council, on November 14, says he could not collect the ship-money at Presteign “by reason of the plague, which continued there for two years together, and did not cease until the latter end of April last[1069].” We may take it, then, that there was a great deal of plague in Wales about 1637 and 1638, that there was also “the new disease,” or spotted fever, all over Monmouth and probably other Welsh counties, that the same two forms coexisted at Norwich and Northampton, just as they coexisted in London, and that Graunt’s parish in Hampshire in 1638 had probably the fever only.

Short’s statistical tables again bear out the concrete history. In 1638, nineteen country parishes, out of ninety-four examined, had 699 burials to 542 baptisms, and in 1639, eighteen parishes had 585 burials to 386 baptisms. In the market towns the unhealthy period (which may have been due to plague in great part) is a year earlier. In 1637, ten towns out of twenty-four whose registers were added up, show 1474 burials to 1008 baptisms, the proportion in 1638 for the same number of unhealthy towns being 1438 to 1025.

It would have been one of the country epidemics of those years that Boghurst brings into his account of the plague of London in 1665: “I was told by an ancient woman that in Somersetshire the spotted fever was very epidemical, so that whole families died; but being told that plantan [plantain] was very good, all of them almost took it, which wrought an admirable change, for very few died that took it, whereas before they died very fast.” He thinks plantain was as likely to have effected a cure as “higher priced medicines.” We shall find a corresponding prevalence of fever described by a competent physician, Whitmore, for rural parts of Cheshire and Shropshire in 1651 and 1658. Thus we have a remarkable epidemiological phenomenon, somewhat new to England unless, indeed, we bring all those spotted fevers and the like under the generic name of influenza. It was in country districts in 1612-13 and from 1623 to 1625, it was extensively prevalent in 1638 in places as far apart as Hampshire, Monmouth and Northampton, it appeared in Berkshire and Oxfordshire in 1643 in connexion with the military movements of the Royalist and Parliamentary armies, it caused a disastrous loss of life in Tiverton within a few weeks of Essex’s army passing through the town in 1644; it is heard of again in Shropshire and Cumberland in 1651-52, and in the same parts in 1658, as well as in Somerset, and in London steadily from year to year.

It was in its steadiness from year to year in the poor quarters of towns, as well as in its more frequent recurrences as a country epidemic, that the spotted fever deserved the name of “new disease” in the reign of Charles I. But more than one epidemic fever had been called a “new disease” in England before; and no fewer than five epidemics were so called from 1643 to 1685, of which only one or two can be classed among the influenzas.

If it had been possible to keep in mind the history of sicknesses from century to century or even from generation to generation, the “new disease” might have been recognised as not unlike the type that overran England in 1087, that was described by William of Newburgh in 1196, by Matthew Paris in 1258, and by Trokelowe in 1315-16. The conditions producing it or favouring it were not, indeed, the same in all particulars in the medieval period, in the Tudor period, and in the Stuart period. In the medieval period, the extreme want and misery which brought epidemic sickness were due to occasional sharp famines at long intervals, from failure of the crops. In the Tudor period epidemics were still so occasional (so far as is known) that something more special will have to be blamed for them than the swarms of vagrants and criminals all over England, which made the reign of Henry VIII. notorious, and were still a source of trouble until late in the reign of Elizabeth; the four chief periods were in 1540, 1557-8, 1580-82, and 1596-97 so that some special cause would have to be assumed in those years to account for their peculiar “epidemic constitution.” Almost from the beginning of the Stuart period, the seasons of fever (to say nothing of flux and smallpox), seem to come in quicker succession; they are heard of in 1612-13, 1623-25, 1638, 1643-44, 1651, 1658-9, and 1661-65, and heard of in those years over wide tracts of rural England as well as in London and other towns. It was from such experiences that the doctrine arose, so unintelligible to us now, of an “epidemic constitution of the air,” which may be traced, indeed, to much earlier writings than those of the 17th century, but finds its most frequent applications in the latter. The fevers were in part contagious and not contagious; contagion could not explain them all, and yet there was an undoubted infective element in them. The universality or generality of their incidence was accounted for by assuming, on the one hand, something common in the state of the air and, on the other hand, some common predisposition in the bodies of men, which might itself have had seasonal causes. We have now only one name for such common infection of the air, namely influenza; and it is significant that the catarrhal influenzas of 1658 and 1659 were regarded by some at the time as only the appropriate vernal form of the fever which in the hot weather of 1657 and 1658 had prevailed almost in the same general way as influenza, but with the symptoms of typhus. One thing which should not be overlooked, is that plague was still in the country, not always at the same time as the fever, and perhaps not usually coincident with it. Another thing, which will come out in its due order at a later part of the history, is that after the extinction of plague, fever became far more steady in the towns from year to year, and in certain years was not less prevalent in influenza-like epidemics all over the country. One might offer some suggestions as to the meaning of these epidemiological phenomena; but it will perhaps be more convenient that critics who have a speculative turn or a craving for generalities should exercise the one or gratify the other at their own risk.

Along with the prevalence of plague in 1637-38 in many towns of Wales, we may associate the outbreak of 1638 in Gloucester on the one side and in the small Salopian town of Clun on the other. From a letter of the Privy Council to the justices of Gloucestershire, it appears that a rate in aid of the plague-stricken in the city had been imposed upon the county in December, 1637, and that the infection still continued in Gloucester in September, 1638. Contributions made in Bridgenorth for the relief of the visited in Clun appear to belong to the same year. At Reading a tax for the “visited” had been collected once or oftener between 1638 and 1641. In 1641 the town of Leicester was put to some expense (£46. 8s. 7d.) in watching to keep out the sickness which prevailed in Thurmaston, Birstal, Whetstone and Oakham. The very severe plague in Stamford the same year would have been the most intense part of the epidemic in that corner of England; “Camden,” quoting from bishop Sanderson’s manuscript, says that it began at St James’s tide, 1641, and ended in March following, whereof are said to have died between 500 and 600 persons[1070].

Another centre of plague in 1641 was Congleton, in Cheshire, if we may trust the accuracy of the date given in a manuscript written some time after and seemingly based upon tradition[1071]. The infection was traced to a box of clothes which had belonged to one dead of the plague in London and were sent to the dead man’s relations at North Rede Hall. The family who received the box “caught the infection and died.” It spread “all over the country,” and came to Congleton, where it made dreadful ravages. The traditions which the anonymous narrator has put on record are, indeed, those of a plague of the greater degree—stories of corpses that no one would bury, of the sick left to their fate, of money dropped into water before it changed hands. This somewhat doubtful narrative ends with the statement that “the greatest part of the inhabitants died.”

The period from 1643 to 1650 contains all the outbreaks of plague that remain, whether in London or the provinces, until we come to the final explosion of 1665. In London the plague continued at a low endemic level from the outburst of 1636 until 1648, the deaths in 1647 reaching the considerable figure of 3597. This series of plague-years has no other interest than as showing how regularly every season the infection increased from a few cases in May or June to a maximum in September or October. One incident, out of many, may find a place. In August, 1647, Sir Philip Stapleton, one of the Eleven Members, leaders of the Presbyterian party, who were accused of treason by the Army, went over to Calais with five more of the accused, and died of the plague almost as soon as he landed. The people of the house where he died made the rest of the party pay them £80 before they would let them come forth, for bringing the sickness into their house[1072].

The plagues in provincial towns were in those years much more serious relatively than those in London. All of them occurred in towns that were besieged, or had been besieged, or had been occupied by bodies of troops or by garrisons. At the same time most of them were towns which had suffered plagues before. But the first effects of the war in the way of epidemic sickness were not of the type of plague.

War-typhus in Oxfordshire and Berkshire.

It was in the spring and summer of 1643 that England had a first experience of the war-typhus which had been familiar to the continent of Europe for a century and a half, having reached perhaps its greatest prevalence in the Thirty Years’ War. It is only in the sense of war-typhus that Shakespeare’s boast, put into the mouth of John of Gaunt, holds good:

“This fortress, built by nature for herself,
Against infection and the hand of war.”

The medieval civil wars in England do not seem to have bred infection among the people, unless, perhaps, during the anarchy of Stephen’s reign: there is reason to think that the faction-fights of York and Lancaster had no such result. But the wars of the Parliament against the Royalists produced war-sickness in its most characteristic form, and that too, at the very beginning of the struggle.

The existence of sickness in 1643 among the troops of the Parliament in Berkshire and Oxfordshire, under the earl of Essex, is briefly stated by Rushworth. But, for the first time in the history, we find a medical account of the type of sickness, of its circumstances, and of the extent of its prevalence, which is not without interest even for the military history. It happened that the afterwards celebrated Dr Thomas Willis, chemist, anatomist, physiologist and physician, was at Christ Church, Oxford, in 1643, being then aged twenty-one, and intending to enter the Church. In 1659 he published at the Hague his first medical essays, one on Fermentation and the other on Fevers[1073]; and in the latter he recalls many particulars of what he had seen in his earlier years in and around Oxford. The sickness of 1643 was also the subject of a tract published that year in Oxford, by his majesty’s command, by Sir Edward Greaves, physician to the king, which appears to have been in sufficient request in the town to be reprinted within the year[1074].

The preceding events may be briefly summarized[1075]. In November, 1642, the king moved from Oxford with his army towards London and seized Brentford. The forces of the Parliament, under Essex, concentrated round the capital, where they were joined by the trainbands of the City, so that the king recrossed the Thames at Kingston and retired upon Reading and Oxford. All through the months from January to April 1643, tedious negociations went on for a treaty, the details largely relating to the places to be occupied by the Parliamentary troops on the one hand (around Windsor) and by the Royalist troops on the other (in Oxfordshire and Bucks). In April the negociations fell through, and Essex came before Reading on the 15th, with an army of 15,000 foot and 3000 horse. The king and prince Rupert attempted to raise the siege by a march from Oxford, but were stopped at Caversham bridge, and on the 26th April, Reading was surrendered to the Lord General, the garrison marching out the day after.

The siege had lasted only eleven days; the Royalist commandant was sentenced to death at Oxford for betraying the town, but was pardoned. When Essex entered Reading he found the place “infected,” and a great mortality ensued among his men, who were discontented at the want of plunder and of pay. In June he moved his troops across the chalk downs to Thame, on the borders of Bucks; but the weather being wet and unseasonable in the early summer, and afterwards hot, the sickness so increased among them that “he judged the design upon Oxford impracticable” (Rushworth), and on July 9, wrote to the Parliament advising a peace. In his letter, Essex explained that it was impossible to keep the counties from being plundered, “so that they must suffer much wrong, and the cries of the people are infinite.” Eventually he brought what remained of his army to the neighbourhood of London, and having received 2000 recruits from the City, he held a muster on Hounslow Heath, when his whole force amounted to 10,000 men. With his recruited army he marched to the relief of Gloucester[1076], raised the siege, and on September 20 won the (first) battle of Newbury.

The realities of that inactive summer at Reading and Thame may be conceived from what Willis tells us of the state of things within the Royalist lines in Oxfordshire. These things, he says, “fell under our own observation,” he being then at Christ Church and not yet entered on the physic line.

In the spring of 1643, Reading being held for the king,

Willis recalls how this epidemic disease changed its type as the season wore on. At first it was a “putrid synochus,” which seemed to be helped by a sweat or a looseness; a relapse or renewal followed the crisis. Later, it became a continual fever of six or seven days, with no crisis; when the fever ceased the sick kept their beds, sometimes raging, more often in a stupor, great weakness continuing, and sometimes convulsions ensuing. About midsummer “the disease betrayed its malignancy by the eruption of whelks and spots.” It would often begin with an insidious languishing, the strength being totally withdrawn. At length buboes appeared in many, as in the plague. At this time, during the dog-days, the disease began to be handled, not as a fever, but as a lesser plague—by vomits, purges, and sudorifics. The autumn coming on, the disease by degrees remitted its wonted fierceness, so that fewer grew sick of it, and of them many grew well. At the approach of winter the fever almost wholly vanished, and health was fully restored to Oxford and the country round about. Among the victims are mentioned “some belonging to the king’s and queen’s Court, with a few scholars[1078].”

Of the causes, Willis says that, so far as concerned the army, the evident causes were “errors in the six non-naturals.” The spring was very moist and “flabbery,” with almost continual showers, to which a hot summer succeeded. The tract upon the Oxford fever by Greaves, a short piece of some 25 pages, which was written for use in the city during the epidemic, bears out the account by Willis, without developing the doctrine of increasing malignancy. He is concerned to prove that it was not the plague “as the relations and hopes of your enemies, and the fears of others, have suggested.” One of his proofs is the insidious mode of invasion, which Willis ascribes to the sickness in its later type—great weakness without any manifest cause appearing, such as sweating or looseness, so that even strong men were prostrated, with a quick, weak and creeping pulse, sometimes intermittent, with pains in the head, vertigo &c. The most distinctive thing was the spots; “But what need we any farther signs than the spots, which appear upon half the number, at least, of those that fall sick?” Greaves seems to claim that Oxford had some immunity for a time: “God hath been most merciful to this city in sparing us heretofore, when our neighbours round about us were visited.”

Among the causes, he mentions putrid exhalations from stinking matters, dung, carcasses of dead horses and other carrion; “and were there care taken for the removing of these noisome inconveniences, and keeping the streets sweet and clean, it would doubtless tend much to the abatement of the disease.” The diet, also, may have had something to do with it; more particularly the brewers should dry their malt better, boil their beer longer, and put in a sufficiency of hops. But the great cause was the presence of the army.

There appears to have been the almost inevitable doubt in some minds, whether the disease were contagious: “But if anyone be yet obstinate, and will not believe it contagious, let him go near and try.” Among the remedies, he mentions a favourite one of the empiric sort, “Lady Kent’s powder,” which Willis also refers to; but Greaves, as became an academical physician, would not admit that it had any advantage over medicines of known ingredients.

This widespread epidemic of typhus, perhaps not without some relapsing fever, and, according to what Willis says in one of his general chapters, complicated, in its diffusive form in the villages around, “with squinancy [sore throat], dysentery, or deadly sweat,” is the only one medically recorded of the Civil Wars. But there was certainly a renewal of it, in the same circumstances, next year at Tiverton; and it seems probable, from the heavy mortality which the parish registers witness to in that year (1644) that some kind of epidemic sickness had spread far and near. Thus, in Short’s abstracts of the burials and christenings in country parishes and market towns, the years 1643 and 1644, and especially the latter, stand out as the most unhealthy for a long time before and after, the next sickly period, as we shall see, being the years 1657-1659. In the year 1643, out of eighty-eight country registers examined, twenty-nine showed a sickly death-rate, although the disproportion of births to deaths does not appear great (821 to 847). That was the year of the epidemic fever in Berkshire, Oxfordshire and Bucks. Next year, which was the year of the Tiverton epidemic, there are again twenty-nine country registers indicating unusual sickness (715 baptisms to 938 burials). In nineteen out of twenty-four market towns, the same two years come out still more unhealthy (844 births to 1193 deaths in 1643 and 1008 births to 1647 deaths in 1644). The registers examined by Short were mostly from Northern and Midland parishes; but they included two or three from Devonshire, and among his market towns was Tiverton. We shall now see what these bald figures mean in that concrete instance.

War-typhus at Tiverton in 1644.

Tiverton was then a town of some 8000 inhabitants, mostly occupied in the weaving industry. On July 5, 1644, Essex arrived with his army on his way to Cornwall to subdue prince Maurice, and lay there till the 18th. The diary of one farmer Roberts has an entry that Mr Thomas Lawrence, who came from Tiverton, reported to him that the earl had 350 and odd carriages, and of horse belonging thereto for draught 2000[1079]. This would have been his large artillery train, baggage and ammunition waggons, etc. His infantry would be some 6000, and his cavalry perhaps 1000. The king’s force meanwhile advanced after Essex, and on July 25 lay in the great meadow at Crediton. They had advanced by Yeovil and may or may not have passed through Tiverton. The two armies came to blows in Cornwall, a prolonged series of encounters in the country around Lostwithiel in wet August weather ending in the escape of Essex to the coast, the retreat of his cavalry through the Royalist lines, and the surrender of the infantry on 1st September. The disarmed foot-soldiers were convoyed back to Poole and Wareham, and did not trouble Tiverton again. The retreating cavalry passed that way, but did not enter the town, which was now held by the Royalists. But the king’s army came back by the way of Tiverton, which they reached on Saturday, the 21st September. They had got no farther than Chard on the 30th, and may have halted in Tiverton some days. A Royalist garrison of 200 men was left in it, and held the place until October 1645, when it was taken by Fairfax after a short siege[1080].

Tiverton was thus occupied by both armies in the summer and autumn of 1644, that of Essex having been quartered in and around the town for a fortnight in July. A serious epidemic followed, especially in the suburb on the western side of the Exe. The particulars of it are in the parish register, from which it would appear that the sickness began in August and lasted until November. The greatest mortality was in October, when 105 were buried, the whole mortality of the year having been 443. The ordinary monthly burials would hardly have exceeded a dozen or fifteen; and as the 105 burials in October would have meant some eight or ten times as many sick, it is not surprising to read that the town was desolate, and that grass grew in the streets[1081]. Of this epidemic there are no medical particulars; but it appears from the parish register that it was known as “the sweating sickness.” It would hardly have been so called if sweating had not been a prominent symptom. Besides the English sweat proper, with its five epidemics from 1485 to 1551, we have had occasion to notice a sweating type in several epidemics of fever. That symptom was so marked in the epidemic of 1558 at Southampton, Portsmouth, and Isle of Wight when they were full of troops, that Dr John Jones, who had personal experience of it, compares it to the sweat proper. It was a sufficiently prominent symptom in the Oxford gaol-fever of 1577 for the sudor Anglicus to be called to mind. In the English fevers and influenzas of 1580-82, a sweat or a lask is mentioned by Cogan as a least occasional; but the fevers of the same years on the Continent had so often the sweating character that it was sometimes said the English sweat had come back. Lastly for the war-fevers of 1643 around Reading and Oxford, Willis asserts in more than one place the occurrence of sweats, critical or giving relief for a time in the milder form, “deadly sweats” in fevers of an aggravated type. To anticipate somewhat, it may be mentioned also that a sweating character is recorded of some cases of the perennial London typhus at its worst period in the middle of the 18th century.

Admitting all these facts, we must still hold to the opinion expressed in the chapter on the Sweating Sickness, that sweating was never again the signum pathognomicum of a whole epidemic, as it had been of the sudor Anglicus in its five outbursts. But if there be gradations of type, or approximations of typhus to sweating sickness (as well as to influenza), then we may perhaps take the Tiverton epidemic as coming nearer than any other to the sweating sickness, on the strength of the name given to it in the parish register.

Nothing is known of sickness in the army of Essex, which lay at Tiverton from 5th to 18th July, 1644. It suffered much in the fighting in Cornwall, and the Parliament on 7 September sent to Portsmouth arms for 6000 foot and 6000 suits of clothes and shirts for the infantry who had surrendered and been convoyed back along the coast. The king’s troops which occupied Tiverton on 21 September on their way back, had doubtless suffered also, from the campaigning in wet fields and miry ways, and are known to have been discontented for want of pay. Probably the epidemic at Tiverton was due to aggravation of the usual circumstances of war. It must be classed as a form of typhus; while its distinctive character of sweating might find an explanation, on the analogy of the sweat of 1485 in London after the arrival of Henry VII. from Bosworth Field, if we had sufficient reason to suppose that the soldiers who successively occupied Tiverton were not themselves suffering from fever. Contact alone, especially the contact en masse of men reduced by hardships and disorderly in their habits, will sometimes serve to breed contagion among a population unlike them in these respects. The converse of that principle, namely that contagion need not follow from the introduction of developed sickness en masse, finds an illustration in the case of Tiverton itself within little more than a year after the epidemic of 1644. In November, 1645, Fairfax lay at Ottery St Mary with his army, pending the investment of Exeter. On account of much sickness and heavy mortality among his infantry (not medically described) he removed them on December 2, to Crediton and ultimately to Tiverton, which was supposed to be a healthier situation and became his head-quarters until January 8, 1646[1082]. But no outbreak in the town is mentioned, and almost certainly none occurred; the health of the place continued to be good every year of the time that it was under the rule of the Parliament, as the parish register proves. On the other hand Totness, which was occupied by the same convalescent force after it left Tiverton, had a severe epidemic of plague in the end of the year, 1646.

Plague in the Provinces during the Civil Wars.

The type of sickness, after the first two years of the war, does not appear to have been typhus-fever, but always the old bubo-plague of the towns. So far as the history is known, the experience of war-sicknesses upon English soil began in 1643 and ended in 1644, except in the instance of Fairfax’s troops at Ottery St Mary in November, 1645.

Perhaps the “new model” of the Parliamentary forces, after the pattern of Cromwell’s Ironsides, may have had something to do with the immunity of England from war-typhus in all the marchings and counter-marchings, battles, occupations and sieges, from 1645 to the end of the Civil Wars. Cromwell pointed out to Hampden that the army of Essex was composed of “a set of poor tapsters and town-apprentices,” and gave it as his opinion that these were not the men to win with. When the original commanders, Essex, Manchester, Sir W. Waller, and others, had retired in 1645, terms of the self-denying ordinance, the army of the Parliament acquired a new character under Fairfax and Cromwell: it contained a large proportion of “men of religion,” especially among the officers; and there is sufficient evidence that the war was in future carried on so as to produce as few as possible of those effects of campaigning among the people at large which had marked the Thirty Years’ War in Germany and had attended the operations of Essex and the Royalists in 1643 and 1644.

What remains to be said of the epidemics of the Civil Wars relates almost exclusively to plague, with an occasional reference to the spotted fever which was widely prevalent in the autumn of 1644. These epidemics of plague in the English provinces, during the political troubles, more numerous than usual from 1644 to 1650, are the last on English soil until we come to the final grand explosion of 1665-66.

In 1644 there were two principal centres of plague (besides London), namely Banbury, and the valley of the Tyne. Banbury was near enough to the Royalist head-quarters to have shared in the fever-epidemic of 1643; in that year the burials of 58 soldiers are entered in the parish register, besides a large excess of burials among the civil population (total of 225 deaths in the year as against an annual mortality in former years ranging from 30 to 98). The siege by the Parliamentary forces did not begin until July 19, 1644, and ended in the surrender of the castle in October. The epidemic of plague may have begun as early as January, a soldier having “died in the street” on the 16th; but it is not until March 1644, that plague-deaths appear in the register. In that month there were 10 deaths from plague, in April 34, and so until November, when there were 2, the total mortality from plague having been 161. After the plague ceased, the town remained otherwise unhealthy until 1647[1083].

The information as to Newcastle and Tyneside comes from the observant Scotsman, William Lithgow, who was with the Presbyterian army when Newcastle was stormed on October 20, 1644[1084]. The town had suffered heavily from plague, as we have seen, in 1636, and there had been a slighter outbreak in 1642. Although the state of things during the siege in 1644 was wretched in the extreme, there does not appear to have been plague until after the surrender. The infection was already at work, however, in places near. Thus Tynemouth Castle was surrendered by the Royalist commander, Sir Thomas Riddell on October 27: “The pestilence having been five weeks amongst them, with a great mortality, they were glad to yield, and to scatter themselves abroad; but to the great undoing and infecting of the country about, as it hath contagiously begun” (Lithgow). Among the places infected were Gateshead, Sandgate, Sunderland, and many country villages, the plague being reported in Newcastle itself in 1645 as well as in Darlington[1085].

The year 1645 was one of severe plague in several towns at the same time, some of them in a state of siege and all of them occupied by troops. The largest mortality was at Bristol, being proportionate to its size. The town was taken by prince Rupert on July 22, 1643, and was held by a strong garrison for two years and some weeks. It was towards the end of the Royalist occupation that the plague broke out, probably in the spring of 1645[1086]. On the 16th May, Sir John Culpepper wrote to Lord Digby: “The sickness increases fearfully in this city. There died this week according to the proportion of 1500 in London[1087].” When it had been stormed by Fairfax and Cromwell in September 1645, it was found that prince Rupert’s garrison consisted of 2500 foot, and about 1000 horse. The auxiliaries and the trained bands of the town were reduced in June to about 800, and of the 2500 families then remaining in the town, 1500 were in a state of indigence and want[1088]. In Cromwell’s despatch of September 14 to Mr Speaker Lenthall he says: “I hear but of one man that hath died of the plague in all our army, although we have quartered amongst and in the midst of infected persons and places[1089].” The deaths from plague in the whole epidemic approached 3000, according to the MS. calendars[1090].

While this was going on within the walls of Bristol, an epidemic of plague more severe for the size of the town was progressing at Leeds. The town had been taken by Fairfax on January 23, 1643, and had remained in the quiet possession of the Parliament, under a military governor. In August, 1644, there were buried 131 persons, “before the plague was perceived,” says the parish register; which means that the excessive mortality was not from plague, but probably from the spotted fever which reigned that autumn in other places in the North. The plague proper began with a death in Vicar-lane on March 11, 1645. The weekly bills of mortality which were ordered by the military governor showed a total mortality, from March 11 to December 25, of 1325. It raged most in Vicar-lane and the close yards adjoining; it was also very prevalent in March-lane, the Calls, Call-lane, Lower Briggate, and Mill-hill. The largest number of burials in a week (126) was from July 24 to 31; the mortality kept high all through August and September (60 to 80 weekly), and declined gradually to 3 in the week ending Christmas-day. Whitaker estimates that probably the fifth part of the population died, and he cannot discover any person of name among the victims. The air was so warm and infectious that dogs, cats, mice and rats are said to have died (of rats and mice it can well be believed), and that several birds dropped down dead in their flight over the town[1091]. This appears to have been the only visitation of plague in Leeds, at least since the medieval period.

The plague of Lichfield in 1645-46, like that of Bristol, went on during a constant state of military turmoil. On April 21, 1643, the Close was taken by prince Rupert and was held as a Royalist stronghold until July 26, 1646, the king having repaired thither after his defeat at Naseby in June, 1645, and again in September. The plague is said to have been active both in 1645 and 1646; in twelve streets there occurred 821 deaths, the largest share (121) falling to Green Hill[1092]. In what way the state of siege may have contributed to the plague is uncertain. The fosse was drained dry at one stage, and was choked with rubbish at another. Many of the inhabitants of the town would appear, from the 4th article of the capitulation, to have taken refuge with their effects within the fortified Cathedral Close, which was almost enclosed by water. This was one of several outbreaks of plague that Lichfield had suffered since early Tudor times.

Minor plague outbreaks of 1645 were at Derby and Oxford. Of the latter we have a glimpse from Willis of Christ Church.