Chapter I: Typhus and Other Continued Fevers (2)

A letter of 12 March, 1685, says: “Sir R. Mason died this morning in his lodging at Whitehall. A fever rages that proves very mortal, and gives great apprehensions of a plague[32].” Sydenham also was reminded of the circumstances preceding the Great Plague of London in 1665. In his first account of the epidemic of fever in 1685[33], which began with a thaw in February, he points out that the thaw in March, 1665, had been followed by pestilential fever and thereafter by the plague proper. In a later reference, when the epidemic of fever was in its second year (1686) he says: “How long it may last I shall not guess; nor do I quite know whether it may not be a certain more spirituous, subtle beginning, and as if _primordium_, of the former depuratory fever (1661-64) which was followed by the most terrible plague. There are some phenomena which so far incline me to that belief[34].” However, no plague followed the malignant, if not pestilential, fever of 1685-86. The reign of plague, as the event showed, was over; the fever which had been on former occasions its portent and satellite, came into the place of reigning disease. It is true that Sydenham does not identify the fever of 1685-86 by name as pestilential fever; on the contrary, he entitles his essay “De Novae Febris Ingressu.” But the novelty of type was partly in contrast to the fevers immediately preceding, which admitted treatment by bark, and its principal difference from the pestilential fever of former occasions seems to have been that it was not followed by plague[35]. Its antecedents and circumstances were very much those of plague itself. Its mortality was greatest in the old plague-seasons of summer and autumn, it had slight relation to famine or scarcity, or to other obvious cause of domestic typhus. Sydenham can find no explanation of the new constitution but “some secret and recondite change in the bowels of the earth pervading the whole atmosphere, or some influence of the celestial bodies.” He enlarges, however, on the character of the seasons preceding, which would have affected the surface, if not the bowels, of the earth, and the levels of the ground-water.

The winter of 1683-84 was one of intense frost; an ice-carnival was held on the Thames during the whole of January. The long dry frost of winter was followed by an excessively hot and dry summer, the drought being such as Evelyn did not remember, and as “no man in England had known.” For eight or nine months there had not been above one or two considerable showers, which came in storms. The winter of 1684-85 set in early, and became “a long and cruel frost,” more interrupted, however, than that of the year before. The spring was again dry, and it was not until the end of May 1685 that “we had plentiful rain after two years’ excessive drought and severe winters[36].”

The two years of excessive drought, with severe winters, had their effect upon the public health, as will appear from Short’s abstracts of parish registers in town and country[37]; the years 1683-85 being conspicuous for the excess of burials over baptisms:

_Country Parishes._

Year Registers Registers with Deaths in Births in
examined excess of death them them

1683 140 37 923 685
1684 140 31 900 629
1685 140 19 574 478
1686 140 16 419 301
1687 143 19 522 427
1688 143 11 327 267

_Towns._

1683 25 8 1398 1169
1684 25 8 1243 865
1685 25 4 1191 741
1686 25 2 555 418
1687 25 1 313 269
1688 25 2 191 146

There is no clue to the forms of sickness that caused the excessive mortality in country parishes and provincial towns. But in London it appears from the Bills that the one great cause of the unusual excess of deaths in 1684 was an enormous mortality from infantile diarrhoea, from the end of July to the middle of September, during the weather which Evelyn describes as excessively hot and dry with occasional storms of rain.

It was in the second year of the long drought, February, 1685, that Sydenham dated the beginning of his new febrile constitutions. The mortality of 1685 was just twenty deaths more than in 1684 (23,222); but fever (with spotted fever) and smallpox had each a thousand more out of the total than in the year before. Sydenham says that the fever did not spare children, which might be alleged of typhus at all times; but a fever of the kind, even if it ran through the children of a household, seldom cut off the very young, the mortality being in greatest part of adults and adolescents. Excepting smallpox for the year 1685, infantile and children’s maladies were not prominent during the constitution of the “new fever;” the usual items of high infantile mortality, such as convulsions and “griping in the guts” or infantile diarrhoea, were moderate and even low. Hence, although the weekly fever-deaths in the following Table may not appear sufficient for the professional and other interest that they excited, it is to be kept in mind that they had been mostly of adult lives. It is probable also that a good many of them had been among the well-to-do, and perhaps at first in the West End; for there is nothing in the height of the weekly bills for all London to bear out the remark of the letter of 12 March, already quoted, “A fever rages that proves very mortal and gives apprehensions of a plague.”

_Weekly Mortalities in London._

1685.

Week Of spotted Of Of griping
ending Dead Of fever fever smallpox in the guts

March 3 376 49 0 11 35
10 458 73 2 30 31
17 367 53 1 25 17
24 441 63 3 33 27
31 366 53 5 24 36
April 7 421 47 10 28 30
14 433 64 8 32 27
21 473 66 6 47 45
28 470 68 3 49 45
May 5 385 50 6 35 39
12 447 75 3 59 41
19 437 79 4 58 43
26 452 61 2 74 39
June 2 469 65 8 65 36
9 521 88 14 62 41
16 499 91 9 66 34
23 478 76 12 71 53
30 526 82 13 84 45
July 7 497 81 8 87 53
14 478 82 11 78 51
21 464 79 11 87 47
28 488 62 6 68 54
Aug. 4 493 82 5 86 51
11 529 109 13 89 47
18 580 74 13 99 71
25 536 91 7 67 85
Sept. 1 556 94 13 53 104
8 539 82 10 81 77
15 485 90 7 63 70
22 459 90 10 37 51
29 502 114 3 58 53
Oct. 6 444 108 11 40 54
13 445 89 13 61 38
20 369 86 5 40 28
27 379 73 7 29 45
Nov. 3 443 96 8 55 43
10 410 84 7 26 35
17 432 103 8 35 39
24 471 107 6 56 31
Dec. 1 384 87 4 36 24
8 452 98 8 49 24
15 403 69 3 29 47
22 438 99 2 34 27
29 432 80 9 28 28

_Weekly Mortalities in London._

1686.

Week Of spotted Of Of griping
ending Dead Of fever fever smallpox in the guts

Jan. 5 394 80 5 28 29
12 400 80 3 27 48
19 396 67 5 36 32
26 366 76 2 21 30
Feb. 2 452 87 8 16 30
9 416 78 5 37 30
16 405 94 9 20 25
23 419 74 7 16 40
March 2 417 84 1 20 37
9 455 95 6 18 30
16 415 71 10 31 21
23 453 78 11 22 46
30 372 58 8 17 35
April 6 392 80 11 13 27
13 393 72 7 21 29
20 420 61 10 26 37
27 471 99 9 27 22
May 4 429 78 21 28 46
11 374 71 6 16 22
18 395 69 5 17 3 (sic)
25 395 66 11 24 36
June 1 383 63 4 15 49
8 404 66 6 26 38
15 523 88 9 43 64
22 503 99 9 25 73
29 473 90 10 31 62
July 6 430 71 6 18 62
13 401 76 2 19 56
20 464 87 14 24 74
27 508 99 3 23 76
Aug. 3 506 86 9 14 90
10 493 74 7 14 104
17 522 99 7 26 101
24 536 115 5 18 104
31 520 90 8 22 93
Sept. 7 531 94 4 21 104
14 498 84 6 18 110
21 540 100 3 17 101
28 443 90 5 13 67
Oct. 5 425 81 4 13 60
12 432 96 2 9 56
19 391 73 1 9 33
26 402 79 3 11 43
Nov. 2 373 64 1 23 39
9 456 85 1 19 31
16 401 73 2 9 23
23 359 61 4 10 54
30 397 68 1 7 34
Dec. 7 359 76 0 9 21
14 438 60 0 8 46
21 354 49 1 8 39
28 356 53 2 9 32

Sydenham says that he regarded the new fever at first as nothing more than the “bastard peripneumony” which he had described for previous seasons; but he had soon cause to see that it wanted the violent cough, the racking pain in the head during coughing, the giddiness caused by the slightest movement, and the excessive dyspnoea of the latter (Huxham likewise distinguished typhus from “bastard peripneumony”). The early symptoms of the “new fever” were alternating chills and flushings, pain in the head and limbs, a cough, which might go off soon, with pain in the neck and throat. The fever was a continued one, with exacerbation towards evening; it was apt to change into a phrensy, with tranquil or muttering delirium; petechiae and livid blotches were brought out in some cases (Sydenham thought they were caused by cordials and a heating regimen), and there were occasional eruptions of miliary vesicles. The tongue might be moist and white at the edges for a time, latterly brown and dry. Clammy sweats were apt to break out, especially from the head. If the brain became the organ most touched, the fever-heat declined, the pulse became irregular, and jerking of the limbs came on before death.

Later writers, for example those who described the great epidemic fever of 1741, have identified the fever of 1685-86 with the contagious malignant fever afterwards called typhus, and Murchison, in his brief retrospect of typhus in Britain, has included it under that name. Sydenham mentions petechiae and livid blotches in some cases, and the Bills give a good many of the deaths in the worst weeks of the epidemic under the head of “spotted fever.” It is not at first easy to understand why Sydenham should have written an essay specially upon it, in September, 1686, to claim it as a new fever[38] and not rather as the old pestilential fever--“populares meos admonens de subingressu novae cujusdam Constitutionis, a qua pendet Febris nova species, a nuper grassantibus multum abludens.” It should be kept in mind that his motive was correct treatment, and that the fashionable treatment of the day by Peruvian bark was, in his judgment, unsuited to this fever, however much it may have suited the epidemical intermittents of 1678-79 and the “depuratory” dregs of them for several years after. Physicians, he says, had learned to drive off by bark the fevers of the former constitution, from 1677 to the beginning of 1685, even when the fever intermitted little and sometimes when it intermitted not at all; and they saw an indication for bark in the nocturnal exacerbations of the new fever. Sydenham found that even large doses of bark did not free the patient from fever, and that restoration to health under treatment with the bark was due “magis fortunato alicui morbi eventu quam corticis viribus.” He seeks to establish the indications for another treatment by setting forth the symptoms minutely; and as the question of bark in fevers was the great medical question of the time, this may well have been Sydenham’s motive for discovering in the epidemic of 1685-6 a “new fever” although he does not say so in as many words. We have a good instance of how the bark-craze was at this time influencing the very highest circles of practice in the case of Lord Keeper Guildford, in July, 1685, as related in another chapter.

It will be seen from the table of weekly deaths that the second of the two hard winters was over before the fever began to attract notice. Sydenham compares its beginning after the thaw in February, 1685, to the beginning of the plague when the frost broke in March, 1665.

If it had been merely the typhus of a hard winter, of overcrowding indoors, of work and wages stopped by the frost, and of want of fuel (which things Evelyn mentions as matters of fact), it would have come sooner than the spring of 1685. The Bills for years before have regularly a good many deaths from fever, and always some from spotted fever; but these may have come from parishes wholly beyond the range of Sydenham’s practice. The fever began definitely for him in February, 1685, and was at its worst in the old plague-seasons of summer and autumn. If the seasons had any relation at all to it, the epidemic was a late effect of the long drought, an effect which was manifested most when the rain came, in the summer of 1685 and throughout the mild winter and normal summer of 1685-86. It must have been for that reason that Sydenham traced the source of it to “some secret and recondite change in the bowels of the earth,” rather than to a change in the sensible qualities of the air. One must ever bear in mind that the physicians of the Restoration gave no thought to insanitary conditions of living; in that respect the later Stuart period seems to have been behind the Elizabethan or even the medieval; we cannot err in assuming, behind all Sydenham’s speculative causes, a great deal of unwholesomeness indoors. Sydenham’s fullest reference to the subterranean sources of poisonous miasmata occurs in his tractate on Gout:

“Whether it be that the bowels of the earth, if one may so speak,
undergo various changes, so that by the accession of vapours exhaled
therefrom the air is disturbed, or that the whole atmosphere is
infected by a change which some peculiar conjunction of certain of the
heavenly bodies induces in it;--the matter so falls out that at this
or that time the air is furnished with particles that are adverse to
the economy of the human body, just as at another time it is
impregnated with particles of a like kind that agree ill with the
bodies of some species of brute animals. At these times, as often as
by inspiration we draw into the naked blood miasmata of this kind,
noxious and inimical to nature, and we fall into those epidemical
diseases which they are apt to produce, Nature raises a fever,--her
accustomed means of vindicating the blood from some hostile matter.
And such diseases are commonly called _epidemical_; and they are short
and sharp because they have thus a quick and violent movement[39].”

It was Sydenham’s intimate friend Robert Boyle who worked out the hypothesis of subterraneous miasmata as a cause of epidemic (and endemic) diseases. An account of his theory will be found in the chapter on Influenzas and Epidemic Agues. It may be said here that it needs only a few changes, especially the substitution of organic for inorganic matters in the soil, to bring it into line with the modern doctrine of miasmatic infective disease as expounded by the Munich school.

It has not been usual to think of spotted fever, (or of influenzas), in that connexion; but a telluric source of the epidemic constitution of 1685-86 was clearly Sydenham’s view; and as the fever came in circumstances like those of the last great plague, and was thought at the time to be the forerunner of another great plague, its connexion with recondite decompositions in the soil, dependent on the phenomenal drought of two whole years before, cannot be set aside as a possibility, the less so that the fever, although of the type of typhus, was not a fever of cold, hunger, and domestic distress, but mainly of the warm, or mild, or soft weather following the long drought, and of many well-to-do-people, as in the great Netherlands fever of 1669. My view of it is that it was the modified successor of plague, the _pestis mitior_, which used to precede and accompany the plague, now become the dominant constitution. The authentic figures of its mortality come from London; but Sydenham says that its “effects were felt far more in other places”; although Short’s abstracts of parish registers, given above, do not indicate excessive mortality throughout England.

Retrospect of the great Fever of 1623-25.

The most instructive instance of _pestis mitior_ in Britain is not the pestilential fever which led up to the last plague (1665-6), but the great epidemic of fever all over England and Scotland which reigned for two or three years before the great outburst of plague in 1625. I go back to this because it was not wholly or even mainly a famine fever (although it was as general as one of the medieval famine-fevers), and because in that respect it furnishes a close parallel to the fever of 1685-86, which I regard as the successor of the plague. After this interlude in the history, we shall proceed to consider the question of the final extinction of plague.

In Scotland the fever of 1622-23 was directly connected with famine,
but in England it was not obviously so according to the records that
remain. The dearth in Scotland began as early as the autumn of 1621:
“Great skarsitie of cornes throw all the kingdome,” the harvest having
been spoiled by wet weather and unheard of river floods; however,
abundance of foreign victual came in, and the scarcity was got
over[40]. In England the same harvest of oats was abundant, and
probably yielded the “foreign victual” which relieved the Scots; but
the price of wheat rose greatly[41]. It was the year following, 1622,
that really brought famine and famine-sickness to Scotland, as the
second of two bad harvests had always done. On 21 July, 1622, a fast
was proclaimed at Aberdeen for “the present plague of dearth and
famine, and the continuance thereof threatened by tempests,
inundations and weets likely to rot the fruit on the ground[42].”

In an entry of the Chronicle of Perth, subsequent to July, 1622, it is
said: “In this yeir about the harvest and efter, thair wes suche ane
universall seikness in all the countrie as the ellyke hes not bene
hard of. But speciallie in this burgh, that no familie in all the
citie was frie of this visitation. Thair was also great mortalitie
amonge the poore.” From which it appears that the autumnal fever of
1622 was among all classes in Scotland. The famine in Scotland became
more acute in the spring and summer of 1623; the country swarmed with
beggars, and in July, says Calderwood, the famine increased daily
until “many, both in burgh and land, died of hunger.” At Perth ten or
twelve died every day from Midsummer to Michaelmas; the disease was
not the plague, but a fever[43]. At Dumfries 492 died during the first
ten months of 1623, perhaps a ninth part of the inhabitants, about one
hundred of the deaths being specially marked as of “poor[44].” The
“malignant spotted fever” which caused numerous deaths in 1623 in
Wigton, Penrith and Kendal is clearly part of the famine-fever of
Scotland extending to the Borders and crossing them. This is a
famine-fever of the old medieval type, like that of 1196 which,
according to William of Newburgh “crept about everywhere,” always the
same acute fever, putting an end to the miseries of the starving, but
attacking also those who had food.

The same spotted fever was all over England in 1623, but it did not,
as in Scotland, come in the wake of famine. It is true that the
English harvest of 1622 was a good deal spoiled; a letter of 25
September says[45]: “Though the latter part of this summer proved so
far seasonable, yet the harvest is scant, and corn at a great price by
reason of the mildews and blasting generally over the whole realm,”
rye being quoted a few weeks later at 7/- the bushel and wheat at
10/-, although the average of wheat for the year, in Rogers’s tables,
is not more than 51/1_d._ per quarter, while the average of next year
falls to 37/8_d._ These were not famine-prices in England, and there
is no evidence of general sickness directly after the harvest of 1622,
when corn was dearest. Also, although the autumn of 1623 was a time of
“continual wet” in England[46], the price of wheat remained moderate,
and even low as compared with the rather stiff price of the winter of
1622-23. But it was not until the summer and autumn of 1623 that the
spotted fever became epidemic in England. Short’s abstracts of the
registers of market towns show how sickly that year was:

Year. No. of No. with Buried Baptised
registers excess of in the in the
examined. burials. same. same.

1622 25 4 442 345
1623 25 16 2254 439 (sic)
1624 25 9 978 714
1625 25 9 666 563

In September, 1623, the corporation of Stamford made a collection “in
this dangerous time of visitation,” and sent £10 of it to Grantham,
the rest to go “to London or some other town, as occasion offered.” A
London letter of 6 December, 1623, from Chamberlain to Carleton
says[47]:--

“Here is a contagious spotted or purple fever that reigns much, which,
together with the smallpox, hath taken away many of good sort, as well
as meaner people.” He then gives the names of notables dead of it, and
adds: “Yet many escape, as the dean of St Paul’s [Dr Donne, who used
the occasion to compile a manual of devotion] is like to do, though he
were in great danger.” One of the Coke family writes early in January,
1624, from London[48]: “Having two sons at Cambridge, we sent for them
to keep Christmas with us, and not many days after their coming my
eldest son Joseph fell suddenly into the sickness of the time which
they call the spotted fever, and which after two days’ extremity took
away his life.” From another letter it appears that one of his
symptoms was “not being able to sleep,” the unmistakable vigil of
typhus. Although there is no word of the epidemic continuing in
Scotland in 1624, it was undoubtedly as prevalent in England in that
year as the year before, and prevalent in country houses as well as
in towns and cities. Thus, on 7 August, 1624, Chamberlain writes: “The
[king’s] progress is now so far off that we hear little thence, but
only that there be many sick of the spotted ague, which took away the
Duke of Lennox in a few days. He died at Kirby,” a country house in
Northamptonshire[49]. On 21 August he writes again: “This spotted
fever is cousin-german to it [the plague] at least, and makes as quick
riddance almost. The Lady Hatton hath two or three of her children
sick of it at her brother Fanshaw’s in Essex, and hath lost her
younger daughter, that was buried at Westminster on Wednesday night by
her father; a pretty gentlewoman, much lamented.” A letter of 4
September says there was excessive mortality in London, in great part
among children (doubtless from the usual infantile trouble of a hot
autumn, diarrhoea), while “most of the rest are carried away by this
spotted fever, which reigns almost everywhere, in the country as ill
as here.” Sir Theodore Mayerne, the king’s physician, confirms this,
under date 20 August, 1624: the purple fever, he says, was “not so
much contagious as common through a universal disposing cause,”
seizing upon many in the same house, and destroying numbers, being
most full of malignity[50]. It was clearly an inexplicable visitation.
The summer was hot and dry, from which character of the season, says
Chamberlain, “some have found out a far-fetched speculation, which yet
runs current, and would ascribe it [the spotted fever] to the
extraordinary quantity of cucumbers this year, which the gardeners, to
hasten and bring forward, used to water out of the next ditches, which
this dry time growing low, noisome and stinking, poisoned the fruit.
But,” adds Chamberlain, “that reason will reach no farther than this
[London] town, whereas the mortality is spread far and near, and takes
hold of whole households in many places.” He then gives the names of
several eminent persons dead of it, and speaks of others who were
“still in the balance[51].” On 9 October, “the town continues sickly
still,” and Parliament had been put off, “in consideration of the
danger,” from 2 November, 1624, to 15 February, 1625. On Ash
Wednesday, 1625, the Marquis of Hamilton died of the pestilent fever
at Moor Park, Rickmansworth. Thus far there had been no plague; and if
the spotted fever were cousin-german to the plague, as Chamberlain
said, it was remarkable in this that it prevailed in the mansions of
the rich in town and country and took off more victims among the upper
classes than the plague itself even in its most terrific outbursts.
However, a plague of the first rank followed in London and elsewhere
in the summer and autumn of 1625.

The cucumber-theory, above mentioned, shows how puzzled people must
have been to account for the spotted fever, or “spotted ague” as it
was also called, in 1624. Sir Theodore Mayerne did not think contagion
from person to person could explain it, but referred it to “some
universal disposing cause.” It is conceivable that the famine-fever of
1622 and 1623 in Scotland and the Marches may have spread by contagion
into England in the latter year; but in 1624 there is nothing said of
fever in Scotland or of scarcity as a primary cause in England.

Besides the famine-fever of Scotland in 1622-23, there was another
associated thing which should not be left out of account. Before the
famine and fever had begun in that country, the notorious Hungarian
fever was raging in the Palatinate, and continued to rage for four
years. “Hungarian fever” had become the dreaded name for war-typhus of
a peculiar malignity and diffusive power. It had been so often
engendered since the 16th century in campaigns upon Hungarian soil as
to have become known everywhere under the name of that country. Its
infection spread, also, everywhere through Europe; thus it is said to
have even reached England in 1566, and again in 1589, although it is
not easy to find English evidence of it for either year. It was this
type of fever which broke out in the Upper Palatinate, occupied by
troops of the Catholic powers, in 1620, and continued through the
years 1621, 1622 and 1623; as the title of one of the essays upon this
outbreak somewhat fantastically declares, it spread “ex castris ad
rastra, ex rastris ad rostra, ab his ad aras et focos[52].” Was the
epidemic constitution of “spotted ague” in England in 1623 and 1624
derived from the centre of famine-fever in Scotland, or from the
centre of camp-fever in the Palatinate? In the last years of James I.
communications were frequent with the latter country, and there was of
course much intercourse with Scotland.

The spotted fever or spotted ague of 1623-24, the plague of 1625, and the country agues of the same autumn make really a more instructive series of epidemic constitutions than any that fell under Sydenham’s observation, so instructive, indeed, that it has seemed worth while to revert to it for the sake of illustrating the doctrine of epidemics then in vogue. That doctrine made little of contagion from person to person; yet the idea of contagion was familiar, and had been so since medieval times. If we might assume contagion to explain such cases as those that occurred in the houses of squires and nobles, we might find a source of it either in the famine-fever of Scotland or in the war-fever of the Palatinate. But the teaching of the time was that it was in the air; and if the infective principle had been generated either in Scotland or on the upper Rhine it had diffused itself in some inscrutable way. The doctrine of epidemic constitutions seems strange to us; but some of the facts that it was meant to embrace are also strange to us. Were it not for an occasional reminder from influenza, we should hardly believe that any fevers could have travelled as the Hungarian fevers, the spotted fevers or “spotted agues” of former times are said to have done.

On the other hand, we have now a scientific doctrine of the effects of great fluctuations of the ground-water upon the production of telluric miasmata, which may be used to rationalize the theory of emanations adopted by Sydenham and Boyle. From this modern point of view the remarkable droughts preceding the pestilential fevers and plagues of 1624-25 and 1665, and preceding the fever of 1685-86, which is the one that immediately concerns us, may be not without significance.

The London fever of 1685-86 having been suspected at the time to be the forerunner of a plague, as other such fevers in the earlier part of the century had been, and no plague having ensued, the question arises most naturally at this stage, why the plague should have never come back in London or elsewhere in Britain after the great outbreak of 1665-66.

The extinction of Plague in Britain.

Plague had been the grand infective disease of Britain from the year of the Black Death, 1348-9, for more than three centuries, down to 1666. The last of plague in Scotland was in 1647-8, in the west and north-west of England about 1650 (in Wales probably in 1636-8), in Ireland in 1650, and in all other parts of the kingdom including London in 1666, the absolute last of its provincial prevalence having been at Peterborough in the first months of 1667[53], while two or three occasional deaths continued to occur annually in London down to 1679. False reports of plague, contradicted by public advertisement, were circulated for Bath in 1675[54], and for Newcastle in 1710[55]; while in London as late as 1799, during a bad time of typhus fever, the occurrence of plague was alleged[56].

It is not easy to say why the plague should have died out. It had been continuous in England from 1348, at first in general epidemics, all over the country in certain years, thereafter mostly in the towns, either in great explosions at long intervals or at a moderate level for years together. The final outburst in 1665, which was one of the most severe in its whole history, had followed an unusually long period of freedom from plague in London, and was followed, as it were, by a still longer period of freedom until at last it could be said that the plague was extinct. In some large towns it had been extinct, as the event showed, at a much earlier date; thus at York the last known epidemic was in 1604, and it can hardly be doubted that many other towns in England, Scotland and Ireland would have closed their records of plague earlier than they did had not the sieges and military occupations of the Civil Wars given especial occasion for the seeds of the infection to spring into life. Plague seemed to be dying out all over England and Scotland (in Ireland it is little heard of except in connexion with the Elizabethan and Cromwellian conquests) for some time before its final grand explosion in London in 1665.

In seeking for the causes of its decline and extinction we must keep prominently in view the fact that the virus was brought into the country from abroad as the Black Death of 1348-9. But for that importation it is conceivable that there would have been no signal history of plague in Britain. Its original prevalence was on a great scale, and there were several other widespread epidemics throughout the rest of the 14th century. In the first volume of this history I have collected evidence that plague was endemic or steady for long periods of the 15th and 16th centuries in London, with greater outbursts at intervals, and that in the 17th century it came chiefly in great explosions. Something must have served to keep the virus in the country, and more especially in the towns, until at length it was exhausted. An exotic infection, or one that had not arisen from indigenous conditions, and would probably never have so arisen, does not remain indefinitely in the country to which it is imported. Thus Asiatic cholera, imported into Europe on six, or perhaps five, occasions in the 19th century, has never become domesticated; and yellow fever had a career in the southern provinces of Spain during some twenty years only. Plague did become domesticated for about three centuries in England, and for longer in some other countries of Europe; but it died out at length, and it would almost certainly have died out sooner had it not found in all European countries some conditions not altogether unsuited to it. What were the favouring conditions?

If, as I believe, the virus of plague had its habitat in the soil, from which it rose in emanations, and if it depended therein, both remotely for its origin in some distant country, as well as immediately for its continuance in all countries, upon the decomposition of human bodies, then it is easy to understand that the immense mortalities caused by each epidemic would preserve the seeds of the disease, or the crude matters of the disease, in the soil. Buried plague-bodies would be the most obvious sources of future plagues. But if the theory given of the Black Death be correct, bodies dead of famine or famine-fever would also favour in an especial way the continuance of the plague-virus in certain spots of ground, although they would probably never have originated it in this country. Moreover, the products of ordinary cadaveric decomposition would be so much pabulum or nutriment for the continuance of the virus. But all those things being constant, the continuance of plague would largely depend upon the manner in which the dead, after plague, or after famine and fever, or in general, were disposed of. The soil of all England in 1348-9 was filled with multitudes of the dead laid in trenches, and there were several general revivals of plague in the fifty or sixty years following. In London there were plague-pits opened in the suburbs in many great epidemics during three centuries. Even when there was no epidemic the dead were laid in the ground in such a manner that their resolution was speedy, and the diffusion of the products unchecked. But it is undoubted that greater care in the disposal of the dead did at length come into vogue. Thus, in the Black Book of the Corporation of Tewkesbury there is an entry under the year 1603, that all those dead of plague, “to avoid the perill, were buried in coffins of bourde,” the disease having carried off no fewer than 560 the year before (1602) and being then in its second season.[57]. The reason given is “to avoid the peril,” and it is beyond question that burial in a coffin did in fact delay decomposition (unless in peculiar circumstances which need not be particularized), and kept the cadaveric products from passing quickly and freely into the pores of the ground. Again, if the burial were in such coffins as the Chinese commonly use, the decomposition would proceed almost as slowly as if the body had been embalmed, and with as little risk of befouling the soil. For a long time in England such burials were the privilege only of the rich; but as wealth increased by commerce they became the privilege of all classes; and in the last great plague of London, as I said in my former volume, “even at the worst time coffins would seem to have been got for most.” Defoe’s account of the burials in heaps in plague-pits is so exactly like that of Dekker for the plague of 1603, and of other contemporaries for the plague of 1625, that one may reasonably suspect him to have used these earlier accounts as his authority for the practice in 1665, which he had no direct knowledge of. However, I do not contend that there were no such burials in 1665; just as one learns from Dekker that the coffin-makers in 1603 were busily employed and grew rich, although he also describes how a husband “saw his wife and his deadly enemy whom he hated” launched into the pit “within a pair of sheets.” In ordinary times, as we learn from the tables of burial-dues, there were poorer interments without coffins as late as 1628, according to a document printed by Spelman, the name of the parish being withheld, and even as late as 1672 in the parish of St Giles’s, Cripplegate. Spelman’s object in writing in 1641 was to protest against the mercenary practices of the clergy in the matter of burial, recalling the numerous canons of the medieval Church directed against all such forms of simony; and incidentally he mentions that it was testified before the Commissioners that a certain parson “had made forty pound of one grave in ten yeeres, by ten pounds at a time”[58]--a “tenancy of the soil” short enough to satisfy even the so-called Church of England Burial Reform Association. The use of coffins in the burial of the very poorest is now so universal that we hardly realize how gradually it was introduced. I am unable to say when burial in a sheet or cerecloth ceased; but it became less and less the rule for the poorer classes throughout the 17th century. In 1666 was passed the Act for burial in woollen, which was re-enacted more strictly in 1678[59]. The motive of it was to encourage the native woollen manufactures, or to prevent the money of the country from being expended on foreign-made linen; and its clauses ordained that woollen should be substituted for linen in the lining of the coffin and in the shrouding of the corpse, but that no penalty should be exacted for burying in linen any that shall die of the plague. Whether it prohibited in effect the use of linen cerecloths to enshroud corpses where no coffin was used does not appear clearly from the terms of the Act; but, as the intention was to discourage the use of linen, and to bring in the use of woollen, for all purposes of burial, it is probable that it served to put an end to coffinless burials altogether, wherever it was enforced, inasmuch as the prescribed material was wholly unsuited for the purpose of a cerecloth.

The history of the London plague-pit between Soho and the present Regent Street shows that, after the last great plague of 1665-66, more caution was used against infection from the buried plague-bodies. Macaulay says it was popularly believed that the earth was deeply tainted with infection, and could not be disturbed without imminent risk to human life; and he asserts that no foundations were laid in the pest-field till two generations had passed and till the spot had long been surrounded with buildings, the space being left blank in maps of London as late as the end of George I.’s reign[60].

After 1666 the old churchyards were not less crowded than before, but more crowded, perhaps because coffined corpses occupied more space and decayed more slowly. On 17 October, 1672, Evelyn paid a visit to Norwich: “I observed that most of the churchyards (tho’ some of them large enough) were filled up with earth, or rather the congestion of dead bodys one upon another, for want of earth, even to the very top of the walls, and some above the walls, so as the churches seemed to be built in pitts.” The same day he had visited Sir Thomas Browne, the author of the famous essay on urn burial or cremation, (suggested to him by the digging up of forty or fifty funeral urns in a field at Old Walsingham). The essay is full of curious learning and equally curious moralizing. But Sir Thomas, though a physician, has not a word to say on so proximate a topic as the state of the Norwich churchyards, which came under his eyes and perhaps under his nose every day of his life[61].

The practice of burying in coffins, which came at length within the means of all classes, may seem too paltry a cause to assign, even in part, for so remarkable an effect as the absolute disappearance of plague after a duration of more than three centuries. My view of the matter is that the virus would have died out of itself had it not been continually augmented, or fed by its appropriate pabulum, and that the gradual change in the mode of interment helped to check such augmentation or feeding.

But the more elaborate interment of the dead was itself an index of the greater spending power of the community, and it may be said that it was the better condition of the people, and not this one particular thing in it, which put an end to the periodical recurrences of plague. In all but its earliest outbursts in the fourteenth, and perhaps the fifteenth century, plague had been peculiarly an infection of the poor, being known as “the poor’s plague.” Perhaps the chief reason why the richer classes usually escaped it was that they fled from the plague-tainted place, leaving the poorer classes unable to stir from their homes, exposed to the infectious air, and all the more exposed that their habitual employments and wages would cease, their sustenance become precarious, their condition lowered, and their manners reckless. Again, it was not unusual for the plague to break out in a season of famine or scarcity, during which the ordinary risks of the labouring class would be aggravated. Famines ceased (except in Ireland, where there had been comparatively little plague), and scarcities became less common. The sieges and occupations of the Civil Wars in the middle of the 17th century, which undoubtedly were the occasion of the last outbursts of plague in many of the towns, were a brief experience, followed by unbroken tranquillity. Whatever things were tending to the removal of plague in all its old seats had free course thereafter.

On the other hand, one may make too much of the increase of well-being among the labouring class which coincided with the cessation of plague. As a check upon population plague worked in a very remarkable way. In London, as well as in towns like Newcastle and Chester, plague towards the end of its reign arose perhaps once in a generation and made a clean sweep of a fifth or a fourth part of the inhabitants, including hardly any of the well-to-do. It destroyed, of course, many bread-winners and many that were not absolutely sunk in poverty; but its broad effect was to cut off the margin of poverty as if by a periodical process of pruning. The Lord Mayor of London wrote to the Privy Council at the end of the great plague of 1625: “The great mortality, although it had taken many poor people away, yet had made more poverty by decay of tradesmen”--a decay of trade which they might reasonably expect to recover from before long. No such ruthless shears was ever applied at intervals to the growing fringe of poverty in after times. The poor were a more permanent residue, pressing more upon each other; but they did not press more upon the rich, except through the poor rate; on the contrary, the separation of classes became more marked.

Perhaps I ought to give an illustration of this, so as not to leave so radical a change in the vague and disputable form of a generality. I shall take the instance of Chester; its circuit of walls, remaining from the Roman conquest, is something fixed for the imagination to rest upon amidst changes within and without them.

Passing over its medieval and its not infrequent Tudor experiences of
epidemic sickness, let us come to the beginning of the 17th century.
In two or three successive seasons from 1602 to 1605 it lost 1,313
persons by plague, as well as about 250 from other causes. The
population was then mostly within the walls, and probably did not
exceed 5000. There was a shipping quarter on the west side, with
egress by the Water-gate to the landing-places on the Dee; a millers’
quarter, with corn-market and hostelries, on the south, connecting by
the South gate and bridge with a hamlet across the river along the
road to Wales; a Liberty or Freedom of the city outside the walls on
the east, along the road to Warrington and Manchester, with a Bar, a
short distance out, as in London, to mark the limit of the mayor’s
jurisdiction; and on the north side, within the walls, the
cattle-market and shambles, with the market for country produce, and a
few straggling houses without the gate on the road leading to
Liverpool. Chester was a characteristic county town, with its
cathedral clergy, its garrison, its resident nobility and gentry, its
professional classes, its tradesmen, market people and populace, with
the addition of a shipping trade to Ireland and afterwards to foreign
and colonial ports. Plague continuing from 1602 to 1605 cut off a
fourth or a fifth of its population, and these the poorest. The gaps
in the population would gradually have filled up, and the fringe of
poverty grown again[62].

The plague came again in 1647, and cut off 2053 in the short space of
twenty-three weeks from 22 June to 30 November. The bills of it are
extant[63], and show on what parishes the plague fell most. All the
parishes were originally within the walls but one, St John’s, the
ancient collegiate church of Mercia, built upon a rocky knoll in the
south-east angle made by the walls with the river. The other nine
parish churches and their graveyards were within the walls; but the
parishes of three of them extended beyond the gates, just as the three
parishes dedicated to St Botolph at the gates of London did. These
three were St Oswald’s, which included the Liberty on the east side,
Trinity, which included the shipping quarter on the west as well as
the houses along the Liverpool road on the north, and St Mary’s, which
included the millers’ suburb across the Dee on the south. Hollar’s
map, made a few years after the plague of 1647, shows very few houses
beyond the walls, except in the ancient Liberty on the east. But it
will appear from the following table that the parishes which had
extended beyond the walls must either have been very crowded close up
to the walls (as the Gate parishes were always apt to be), or there
must have actually been a greater population outside the gates than
the contemporary map shows:

_Burials from Plague in the several Parishes of Chester in 23 weeks,
June 22-Nov. 30, 1647._

_5 parishes wholly within the walls._

Total. First Worst (7th)
week. week.

St Peter 75 0 14
St Bridget 85 7 9
St Martin 173 9 23
St Michael 133 26 9
St Olave 59 3 5

_3 parishes extending beyond the walls._

St Oswald 396 11 37
St Mary 314 5 20
Trinity 232 1 32

_1 parish wholly without the walls._

St John 358 2 26
Pesthouse 228 0 34
---- -- ---
2053 64 209

This was the last plague of Chester, but for a small outbreak in 1654.
The next vital statistics that we get for the city are more than a
century after, in 1774[64]. The population of 14,713 was then divided
into two almost distinct parts, separated by the wall. The old city
was being rebuilt, all but some ancient blocks of buildings held in
the dead hand of the cathedral chapter; it was becoming a model 18th
century place of residence for a wealthy and refined class, who were
remarkably healthy and not very prolific, the parishes wholly within
the walls having 3502 inhabitants. The poorer class had gone to live
mostly outside the walls in new and mean suburbs, the three parishes
at the Gates and extending now far beyond the walls, together with the
original extramural parish of St John’s, having a population of
11,211. There was no town in Britain where the separation of the rich
from the poor was more complete; there was hardly another town of the
size where the health of the rich was better; and although the health
of the populace was not so bad as in the manufacturing towns of
Lancashire and Cumberland, close at hand, yet it is hardly possible to
find so great a contrast as that between the clean and wholesome
residential quarter within the walls and the mean fever-stricken
suburbs as described by Haygarth in 1774:

“The inhabitants of the suburbs,” he says, “are generally of the
lowest rank; they want most of the conveniences and comforts of life;
their houses are small, close, crowded and dirty; their diet affords
very bad nourishment, and their cloaths are seldom changed or
washed.... These miserable wretches, even when they go abroad, carry a
poisonous atmosphere round their bodies that is distinguished by a
noisome and offensive smell, which is peculiarly disgustful even to
the healthy and vigorous, exciting sickness and a sense of general
debility. It cannot therefore be wondered that diseases should be
produced where such poison is inspired with every breath.”

The case of Chester shows by broader contrasts than anywhere else the change from the public health of plague-times to that of more modern times. But it can hardly be said to show the populace better off than before; it shows them changed into a proletariat, and separated from the richer classes by walls several feet thick. Such, at least, was the result after four generations of immunity from plague, a result which indicates, as I have said, that we may easily make too much of the improved well-being of the poorer classes as a cause of the cessation of plague.