The Epidemics of the Middle Ages

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THE BLACK DEATH.

THE DANCING MANIA.

THE SWEATING SICKNESS.

The Council of the Sydenham Society having deemed Hecker’s three treatises on different Epidemics occurring in the Middle Ages worthy of being collected into a volume, and laid before its members in an English dress, I have felt much pleasure in presenting them with the copyright of the Black Death; in negociating for them, the purchase of that of the Dancing Mania, whereof I could resign only my share of a joint interest; and, in preparing for the press these productions, together with a translation, now for the first time made public, of the Sweating Sickness. This last work, from its greater length, and from the immediate relation of its chief subject to our own country, may be considered the most interesting and important of the series.

Professor Hecker is generally acknowledged to be the most learned medical historian, and one of the most able medical writers in Germany. His numerous works suffice to show not only with what zeal he has laboured, but also how highly his labours have been appreciated by his countrymen; and when I state that, with one trifling exception, they have all been translated into other languages, I furnish a fair proof of the estimation in which they are held in foreign countries; and, so far at least as regards the originals, a full justification of the Council of the Sydenham Society in their choice on the present occasion.

The “Schwarze Tod,” or “Black Death,” was published in 1832; and I was prompted to undertake its translation, from a belief that it would prove interesting at a moment when another fearful epidemic, the Cholera, with which it admitted of comparison in several particulars, was fresh in the memory of men. The “Tanzwuth,” or “Dancing Mania,” came out shortly afterwards; and, as it appeared to me that, though relating to a less terrific visitation, it possessed an equal share of interest, and, holding a kind of middle place between a physical and a moral pestilence, furnished subject of contemplation for the general as well as the professional reader, I determined on adding it also to our common stock of medical literature. When the “Englische Schweiss,” or “Sweating Sickness,” which contained much collateral matter little known in England, and which completed the history of the principal epidemics of the middle ages, appeared in 1834, I proceeded to finish my task; but failing in the accomplishment of certain arrangements connected with its publication, I laid aside my translation for the time under a hope, which has at length been fulfilled, that at some future more auspicious moment, it might yet see the light.

It must not be supposed that the author, in thus taking up the history of three of the most important epidemics of the middle ages, although he has illustrated them by less detailed notices of several others, considers that he has exhausted his subject; on the contrary, it is his belief, that, in order to come at the secret springs of these general morbific influences, a most minute as well as a most extended survey of them, such as can be made only by the united efforts of many, is required. He would seem to aim at collecting together such a number of facts from the medical history of all countries and of all ages, as may at length enable us to deal with epidemics in the same way as Louis has dealt with individual diseases; and thus by a numerical arrangement of data, together with a just consideration of their relative value, to arrive at the discovery of general laws. The present work, therefore, is but one stone of an edifice, for the construction of which he invites medical men in all parts of the world to furnish materials[1].

Whether the information which could be collected even by the most diligent and extensive research would prove sufficiently copious and accurate to enable us to pursue this method with complete success, may be a matter of doubt; but it is at least probable, that many valuable facts, now buried in oblivion, would thus be brought to light; and the incidental results, as often occurs in the pursuit of science, might prove as serviceable as those which were the direct object of discovery. Of what immense importance, for instance, in the fourteenth century, would a general knowledge have been of the simple but universal circumstance, that in all severe epidemics, from the time of Thucydides[2] to the present day, a false suspicion has been entertained by the vulgar, that the springs or provisions have been poisoned, or the air infected by some supposed enemies to the common weal. How many thousands of innocent lives would thus have been spared, which were barbarously sacrificed under this absurd notion?

Whether Hecker’s call for aid in his undertaking has, in any instance, been answered by the physicians of Germany, I know not; but he will be as much pleased to learn, as I am to inform him, that it was the perusal of the “Black Death” which suggested to Dr. Simpson of Edinburgh the idea of collecting materials for a history of the Leprosy, as it existed in Great Britain during the middle ages; and that this author’s very learned and interesting antiquarian researches on that subject, as published in the Edinburgh Medical and Surgical Journal, have been the valuable, and, I trust, will not prove the solitary result.

As the three treatises, now comprised for the first time under the title of “The Epidemics of the Middle Ages,” came out at different periods, I have thought it best to prefix to each the original preface of the author; and to the two which have already been published in English, that of the translator also; while Hecker’s Address to the Physicians of Germany, although written before the publication of the “Englische Schweiss,” forms an appropriate substitute for an author’s general preface to the whole volume.

At the end of the “Black Death,” I had originally given, as No. III. of the Appendix, some copious extracts from Caius’ “Boke or Counseill against the Disease commonly called the Sweate or Sweatyng Sicknesse;” but this little treatise is so characteristic of the times in which it was written, so curious, so short, and so very scarce[3], that I have thought it worth while, with the permission of the council of our Society, to reprint it entire, and to add it in its more appropriate place, as an Appendix to the Sweating Sickness.


It has long been my earnest desire to address my honoured colleagues, especially those with whom I feel myself connected by congeniality of sentiment, in order to impress on them a subject in which science is deeply interested, and which, according to the direct evidence of Nature herself, is one of the most exalted and important that can be submitted to the researches of the learned. I allude to the investigation of Epidemic Diseases, on a scale commensurate with the extent of our exertions in other departments, and worthy of the age in which we live. It is, with justice, required of medical men, since their sole business is with life, that they should regard it in a right point of view. They are expected to have a perception of life, as it exists individually and collectively: in the former, to bear in mind the general system of creation; in the latter, to demonstrate the connexion and signification of the individual phenomena,—to discern the one by the aid of the other, and thus to penetrate, with becoming reverence, into the sanctuary of cosmical and microcosmical science. This expectation is not extravagant, and the truth of the principles which the medical explorer of nature deduces from it, is so obvious, that it seems scarcely possible that any doubts should be entertained on the subject.

Yet we may ask, Has medical science as it exists in our days, with all the splendour which surrounds it, with all the perfection of which it boasts, satisfied this demand? This question we are obliged to answer in the negative.

Let us consider only the doctrine of diseases, which has been cultivated since the commencement of scientific study. It has grown up amid the illumination of knowledge and the gloom of ignorance; it has been nurtured by the storms of centuries; its monuments of ancient and modern times cannot be numbered, and it speaks clearly to the initiated, in the languages of all civilized nations. Yet, hitherto, it has given an account only of individual diseases, so far as the human mind can discern their nature. In this it has succeeded admirably, and its success becomes every year greater and more extensive.

But if we extend our inquiries to the diseases of nations, and of the whole human race, science is mute; as if it were not her province to take cognizance of them, and shows us only an immeasurable and unexplored country, which many suppose to be merely a barren desert, because no one to whose voice they are wont to listen, gives any information respecting it. Small is the number of those who have traversed it; often have they arrested their steps, filled with admiration at striking phenomena; have beheld inexhaustible mines waiting only for the hand of the labourer, and, from contemplating the development of collective organic life, which science nowhere else displays to them on so magnificent a scale, have experienced all the sacred joy of the naturalist to whom a higher source of knowledge has been opened. Yet could they not make themselves heard in the noisy tumult of the markets, and still less answer the innumerable questions directed to them by many, as from one mouth, not indeed to inquire after the truth, but to obtain a confirmation of an anciently received opinion, which originated in the fifth century before our era.

Hence it is, that the doctrine of epidemics, surrounded by the other flourishing branches of medicine, remains alone unfruitful—we might almost say stunted in its growth. For, to the weighty opinions of Hippocrates, to the doctrines of Fracastoro which contain the experience of the much-tried Middle Ages, and lastly to the observations of Sydenham, only trifling and isolated facts have been added. Beyond these facts there exist, even up to the present times, only assumptions, which might, long since, have been reduced to their original nothingness, had that serious spirit of inquiry prevailed which comprehends space and penetrates ages.

No epidemic ever prevailed during which the need of more accurate information was not felt, and during which the wish of the learned was not loudly expressed, to become acquainted with the secret springs of such stupendous engines of destruction. Was the disease of a new character?—the spirit of inquiry was roused among physicians; nor were the most eminent of them ever deficient either in courage or in zeal for investigation. When the glandular plague first made its appearance as an universal epidemic, whilst the more pusillanimous, haunted by visionary fears, shut themselves up in their closets, some physicians at Constantinople, astonished at the phenomenon, opened the boils of the deceased. The like has occurred both in ancient and modern times, not without favourable results for science; nay, more matured views excited an eager desire to become acquainted with similar or still greater visitations among the ancients; but as later ages have always been fond of referring to Grecian antiquity, the learned of those times, from a partial and meagre predilection, were contented with the descriptions of Thucydides, even where nature had revealed, in infinite diversity, the workings of her powers.

These researches, if indeed they deserved that name, were never scientific or comprehensive. They never seized but upon a part, and no sooner had the mortality ceased, than the scarcely awakened zeal relapsed into its former indifference to the interesting phenomena of nature, in the same way as abstemiousness, which had ever been practised during epidemics, only as a constrained virtue, gave place, as soon as the danger was over, to unbridled indulgence. This inconstancy might almost bring to our mind the pious Byzantines who, on the shock of an earthquake, in 529, which appeared as the prognostic of the great epidemic, prostrated themselves before their altars by thousands, and sought to excel each other in Christian self-denial and benevolence; but no sooner did they feel the ground firm beneath their feet, than they again abandoned themselves, without remorse, to all the vices of the metropolis. May I be pardoned for this comparison of scientific zeal with other human excitements? Alas! even this is a virtue which few practise for its own sake, and which, with the multitude, stands quite as much in need as any other, of the incentives of fear and reward.

But we are constrained to acknowledge that among our medical predecessors, these incentives were scarcely ever sufficiently powerful to induce them to leave us circumstantial and scientific accounts of contemporary epidemics, which, nevertheless, have, even in historical times, afflicted, in almost numberless visitations, the whole human race. Still less did it occur to them to take a more exalted stand, whence they could comprehend at one view, these stupendous phenomena of organic collective life, wherein the whole spirit of humanity powerfully and wonderfully moves, and thus regard them as one whole, in which higher laws of nature, uniting together the utmost diversity of individual parts, might be anticipated or perceived.

Here a wide, and almost unfathomable chasm occurs in the science of medicine, which, in this age of mature judgment and multifarious learning, cannot, as formerly, be overlooked. History alone can fill it up; she alone can give to the doctrine of diseases that importance without which its application is limited to occurrences of the moment; whereas the development of the phenomena of life, during extensive periods, is no less a problem of research for the philosopher, who makes the boundless science of nature his study, than the revolutions of the planet on which we move. In this region of inquiry the very stones have a language, and the inscriptions are yet legible which, before the creation of man, were engraved by organic life, in wondrous forms on eternal tablets. Exalted ideas of the monuments of primÆval antiquity are here excited, and the forms of the antemundane ways and creations of nature are conjured up from the inmost bosom of the earth, in order to throw their bright beaming light upon the surface of the present.

Medicine extends not so far. The remains of animals make us indeed acquainted, even now, with diseases to which the brute creation was subject long ere the waters overflowed, and the mountains sunk; but the investigation which is our more immediate object, scarcely reaches to the beginning of human culture. Records of remote and of proximate eras, lie before us in rich abundance. They speak of the deviations and destructions of human life, of exterminated and newly-formed nations; they lay before us stupendous facts, which we are called upon to recognise and expound in order to solve this exalted problem. If physicians cannot boast of having unrolled these records with the avidity of true explorers of Nature, they may find some excuse in the nature of the inquiry—for the characters are dead, and the spirits of which they are the magic symbols, manifest themselves only to him who knows how to adjure them. Epidemics leave no corporeal traces; whence their history is perhaps more intellectual than the science of the Geologist, who, on his side, possesses the advantage of treating on subjects which strike the senses, and are therefore more attractive,—such as the impressions of plants no longer extant, and the skeletons of lost races of animals. This, however, does not entirely exculpate us from the charge of neglecting our science, in a quarter where the most important facts are to be unveiled. It is high time to make up for what has been left unaccomplished, if we would not remain idle and mean-spirited in the rear of other naturalists.

I was animated by these and similar reflections, and excited too by passing events, when I undertook to write the history of the “Black Death.” With some anxiety, I sent this book into the world, for it was scarcely to be expected that it would be everywhere received with indulgence, since it belonged to an hitherto unknown department of historical research, the utility of which might not be obvious in our practical times. Yet I soon received encouragement, not only from learned friends, but also from other men of distinguished merit, on whose judgment I placed great reliance; and thus I was led to hope that it was not in vain, and without some advantage to science, that I had unveiled the dismal picture of a long departed age.

This work I have followed up by a treatise on a nervous disorder, which, for the first time, appeared in the same century, as an epidemic, with symptoms that can be accounted for only by the spirit of the Middle Ages—symptoms which, in the manner of the diffusion of the disease among thousands of people, and of its propagation for more than two centuries, exercised a demoniacal influence over the human race, yet in close, though uncongenial alliance, with kindlier feelings. I have prepared materials for various other subjects, so far as the resources at my disposal extend, and I may hope, if circumstances prove favourable, to complete by degrees, the history of a more extensive series of Epidemics on the same plan as the “Black Death,” and the “Dancing Mania.”

Amid the accumulated materials which past ages afford, the powers and the life of one individual, even with the aid of previous study, are insufficient to complete a comprehensive history of Epidemics. The zealous activity of many must be exerted if we would speedily possess a work which is so much wanted in order that we may not encounter new epidemics with culpable ignorance of analogous phenomena. How often has it appeared on the breaking out of epidemics, as if the experience of so many centuries had been accumulated in vain. Men gazed at the phenomena with astonishment, and even before they had a just perception of their nature, pronounced their opinions, which, as they were divided into strongly opposed parties, they defended with all the ardour of zealots, wholly unconscious of the majesty of all-governing nature. In the descriptive branches of natural history, a person would infallibly expose himself to the severest censure, who should attempt to describe some hitherto unknown natural production, whether animal or vegetable, if he were ignorant of the allied genera and species, and perhaps neither a botanist nor zoologist; yet an analogous ignorance of epidemics, in those who nevertheless discussed their nature, but too frequently occurred, and men were insensible to the justest reproof. Thus it has ever been, and for this reason we cannot apply to ourselves in this department, the significant words of Bacon, that we are the ancients, and our forefathers the moderns, for we are equally remote, with them, from a scientific and comprehensive knowledge of epidemics. This might, and ought to be otherwise, in an age which, in other respects, may, with justice, boast of a rich diversity of knowledge, and of a rapid progress in the natural sciences.

If in the form of an address to the physicians of Germany, I express the wish to see such a melancholy state of things remedied, the nature of the subject requires that, with the exception of the still prevailing Cholera, remarkable universal epidemics should be selected for investigation. They form the grand epochs, according to which those epidemics which are less extensive, but not, on that account, less worthy of observation, naturally range themselves. Far be it from me to recommend any fixed series, or even the plan and method to be pursued in treating the subject. It would, perhaps, be, on the whole, most advantageous, if my honoured Colleagues, who attend to this request, were to commence with those epidemics for which they possess complete materials, and that entirely according to their own plan, without adopting any model for imitation, for in this manner simple historical truth will be best elicited. Should it, however, be found impracticable to furnish historical descriptions of entire epidemics, a task often attended with difficulties, interesting fragments of all kinds, for which there are rich treasures in MSS. and scarce works in various places, would be no less welcome and useful towards the great object of preparing a collective history of epidemics.

Up to the present moment, it might almost seem that the most essential preliminaries are wanting for the accomplishment of such an undertaking. The study of medical history is everywhere at a low ebb;—in France and England scarcely a trace remains, to the most serious detriment of the whole domain of medicine; in Germany too, there are but few who suspect what inexhaustible stores of instructive truth are lying dormant within their power; they may, perhaps, class them among theoretical doctrines, and commend the laborious investigation of them without being willing to recognise their spirit. None of the Universities of Germany, whose business it ought to be to provide, in this respect, for the prosperity of the inheritance committed to their charge, can boast a Professor’s chair for the History of Medicine; nay, in many, it is so entirely unknown, that it is not even regarded as an object of secondary importance, so that it is to be apprehended that the fame of German erudition, may, at least in medicine, gradually vanish, and our medical knowledge become, as practical indeed, but at the same time as assuming, as mechanical, and as defective, as that of France and England. Even those noble institutions, the Academies, in which the spirit of the eighteenth century still lingers, and whose more peculiar province it is to explore the rich pages of science, have not entered upon the history of Epidemics, and by their silence have encouraged the unfounded and injurious supposition, that this field is desolate and unfruitful.

All these obstacles are indeed great, but to determined and persevering exertion they are not insuperable; and, though we cannot conceal them from ourselves, we should not allow them to daunt our spirit. There is, in Germany, a sufficiency of intellectual power to overcome them; let this power be combined, and exert itself in active co-operation. Sooner or later a new road must be opened for Medical Science. Should the time not yet have arrived, I have at least endeavoured to discharge my duty, by attempting to point out its future direction.


                                                                                                                                                                                                                                                                                                           

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