Sweating sickness
Encyclopedia
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
, and later continental Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
, in a series of epidemics beginning in 1485. The last outbreak occurred in 1551, after which the disease apparently vanished. The onset of symptoms was dramatic and sudden, with death often occurring within hours. Its cause remains unknown.
1485
Sweating sickness first came to the attention of physicianPhysician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s at the beginning of the reign of Henry VII
Henry VII of England
Henry VII was King of England and Lord of Ireland from his seizing the crown on 22 August 1485 until his death on 21 April 1509, as the first monarch of the House of Tudor....
. It was known a few days after the landing of Henry at Milford Haven
Milford Haven
Milford Haven is a town and community in Pembrokeshire, Wales. It is situated on the north side of the Milford Haven Waterway, a natural harbour used as a port since the Middle Ages. The town was founded in 1790 on the north side of the Waterway, from which it takes its name...
on 7 August 1485, as it was noted before the Battle of Bosworth Field
Battle of Bosworth Field
The Battle of Bosworth Field was the penultimate battle of the Wars of the Roses, the civil war between the House of Lancaster and the House of York that raged across England in the latter half of the 15th century. Fought on 22 August 1485, the battle was won by the Lancastrians...
on 22 August. Soon after the arrival of Henry in London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
on 28 August, it broke out in the capital. There, it killed several thousand people by its conclusion in late October that year. Among those killed were two lord mayor
Lord Mayor of London
The Right Honourable Lord Mayor of London is the legal title for the Mayor of the City of London Corporation. The Lord Mayor of London is to be distinguished from the Mayor of London; the former is an officer only of the City of London, while the Mayor of London is the Mayor of Greater London and...
s, six aldermen, and three sheriff
Sheriff
A sheriff is in principle a legal official with responsibility for a county. In practice, the specific combination of legal, political, and ceremonial duties of a sheriff varies greatly from country to country....
s. This alarming malady soon became known as the sweating sickness. It was regarded as being quite distinct from the plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...
, the pestilential fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
or other epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
s previously known, not only by the special symptom that gave it its name, but also by its extremely rapid and fatal course. The sweating sickness reached Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...
in 1492 when the Annals of Ulster
Annals of Ulster
The Annals of Ulster are annals of medieval Ireland. The entries span the years between AD 431 to AD 1540. The entries up to AD 1489 were compiled in the late 15th century by the scribe Ruaidhrí Ó Luinín, under his patron Cathal Óg Mac Maghnusa on the island of Belle Isle on Lough Erne in the...
(vol.iii, ed. B. MacCarthy, Dublin, 1895, pp 358f.) record the death of James Fleming, Baron of Slane
James Fleming, 7th Baron Slane
James Fleming was a member of the Irish Parliament in 1491 and sheriff of County Meath.James was the son of William Fleming and his wife the former Janet Rochfort. He succeeded to the title of his 1st cousin once removed, Thomas Fleming, 6th Baron Slane in 1471...
from the pláigh allais, newly come to Ireland. The Annals of Connacht
Annals of Connacht
The Annals of Connacht, covering the years 1224 to 1544, are drawn from a manuscript compiled in the 15th and 16th centuries by at least three scribes, all believed to be members of the Clan Ó Duibhgeannáin....
(ed. A. M. Freeman, Dublin, 1944, pp 594f.) also record this obituary, and the Annals of the Four Masters
Annals of the Four Masters
The Annals of the Kingdom of Ireland or the Annals of the Four Masters are a chronicle of medieval Irish history...
(vol.iii, ed. J. O'Donovan, Dublin, 1856, pp 1194f.) record 'an unusual plague in Meath … of 24 hours' duration; and any one who survived it beyond that period recovered. It did not attack infants or little children. However, Freeman in his footnote to the Annals of Connacht denies that this 'plague' was the sweating sickness, in spite of the similarity of the names. He thought it to be 'Relapsing or Famine Fever' -- possibly typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...
.
1502, 1507, 1517
From 1492 to 1502, nothing was heard of the ailment. In 1502, it was believed to have caused the death of young Arthur, Prince of WalesArthur, Prince of Wales
Arthur Tudor, Prince of Wales was the first son of King Henry VII of England and Elizabeth of York, and therefore, heir to the throne of England. As he predeceased his father, Arthur never became king...
, elder brother of Henry VIII of England
Henry VIII of England
Henry VIII was King of England from 21 April 1509 until his death. He was Lord, and later King, of Ireland, as well as continuing the nominal claim by the English monarchs to the Kingdom of France...
. He died in his home at Ludlow Castle
Ludlow Castle
Ludlow Castle is a large, partly ruined, non-inhabited castle which dominates the town of Ludlow in Shropshire, England. It stands on a high point overlooking the River Teme...
in 1502, leaving his young wife, Catherine of Aragon
Catherine of Aragon
Catherine of Aragon , also known as Katherine or Katharine, was Queen consort of England as the first wife of King Henry VIII of England and Princess of Wales as the wife to Arthur, Prince of Wales...
, a widow.
In 1507 a second, less widespread outbreak occurred, followed in 1517 by a third and much more severe epidemic. In Oxford
Oxford
The city of Oxford is the county town of Oxfordshire, England. The city, made prominent by its medieval university, has a population of just under 165,000, with 153,900 living within the district boundary. It lies about 50 miles north-west of London. The rivers Cherwell and Thames run through...
and Cambridge
Cambridge
The city of Cambridge is a university town and the administrative centre of the county of Cambridgeshire, England. It lies in East Anglia about north of London. Cambridge is at the heart of the high-technology centre known as Silicon Fen – a play on Silicon Valley and the fens surrounding the...
it was frequently fatal, as well as in other towns, where in some cases half the population are said to have perished. There is evidence of this outbreak spreading to Calais
Calais
Calais is a town in Northern France in the department of Pas-de-Calais, of which it is a sub-prefecture. Although Calais is by far the largest city in Pas-de-Calais, the department's capital is its third-largest city of Arras....
and Antwerp, but nowhere else outside of England.
1528
In 1528 the disease recurred for the fourth time and with great severity. It first broke out in London at the end of May and speedily spread over the whole of England, save for the far north, not spreading to ScotlandScotland
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
, though it did reach Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...
, where the Lord Chancellor
Lord Chancellor of Ireland
The office of Lord Chancellor of Ireland was the highest judicial office in Ireland until the establishment of the Irish Free State in 1922. From 1721 to 1801 it was also the highest political office of the Irish Parliament.-13th century:...
, Hugh Inge
Hugh Inge
Hugh Inge or Ynge was an English born judge and prelate in sixteenth century Ireland who held the offices of Bishop of Meath, Archbishop of Dublin and Lord Chancellor of Ireland....
, was the most prominent victim. In London the mortality was very great; the court was broken up, and Henry VIII
Henry VIII of England
Henry VIII was King of England from 21 April 1509 until his death. He was Lord, and later King, of Ireland, as well as continuing the nominal claim by the English monarchs to the Kingdom of France...
left London, frequently changing his residence. The most remarkable fact about this epidemic is that it spread to Europe, suddenly appearing at Hamburg
Hamburg
-History:The first historic name for the city was, according to Claudius Ptolemy's reports, Treva.But the city takes its modern name, Hamburg, from the first permanent building on the site, a castle whose construction was ordered by the Emperor Charlemagne in AD 808...
and spreading so rapidly that in a few weeks, more than a thousand people died. The sweating sickness swept through eastern Europe as an epidemic causing high mortality rates. It appeared to be infectious similar to cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...
, perhaps spread as a result of poor sanitation and contaminated water supplies. It arrived in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
in December, then was carried northwards to Denmark
Denmark
Denmark is a Scandinavian country in Northern Europe. The countries of Denmark and Greenland, as well as the Faroe Islands, constitute the Kingdom of Denmark . It is the southernmost of the Nordic countries, southwest of Sweden and south of Norway, and bordered to the south by Germany. Denmark...
, Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
and Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
, and eastwards to Lithuania
Lithuania
Lithuania , officially the Republic of Lithuania is a country in Northern Europe, the biggest of the three Baltic states. It is situated along the southeastern shore of the Baltic Sea, whereby to the west lie Sweden and Denmark...
, Poland
Poland
Poland , officially the Republic of Poland , is a country in Central Europe bordered by Germany to the west; the Czech Republic and Slovakia to the south; Ukraine, Belarus and Lithuania to the east; and the Baltic Sea and Kaliningrad Oblast, a Russian exclave, to the north...
and Russia
Grand Duchy of Moscow
The Grand Duchy of Moscow or Grand Principality of Moscow, also known in English simply as Muscovy , was a late medieval Rus' principality centered on Moscow, and the predecessor state of the early modern Tsardom of Russia....
. Cases of the disease were not known to occur in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
or Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
. It also emerged in Belgium
Belgium
Belgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...
and the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
, probably transmitted directly from England by travellers, as it appeared simultaneously in the cities of Antwerp and Amsterdam
Amsterdam
Amsterdam is the largest city and the capital of the Netherlands. The current position of Amsterdam as capital city of the Kingdom of the Netherlands is governed by the constitution of August 24, 1815 and its successors. Amsterdam has a population of 783,364 within city limits, an urban population...
on the morning of 27 September. In each place it infected, it prevailed for a short time, generally not more than a fortnight. By the end of the year, it had entirely disappeared, except in eastern Switzerland, where it lingered into the next year. After this, the disease did not recur on mainland Europe.
The final outbreak
The last major outbreak of the disease occurred in England in 1551. An eminent physician, John CaiusJohn Caius
John Caius , also known as Johannes Caius, was an English physician, and second founder of the present Gonville and Caius College, Cambridge.-Early years:...
, wrote an eyewitness account of the disease at this time called A Boke or Counseill Against the Disease Commonly Called the Sweate, or Sweatyng Sicknesse.
Characteristics
The symptoms and signs as described by Caius and others were as follows: The disease began very suddenly with a sense of apprehension, followed by cold shivers (sometimes very violent), giddiness, headache and severe pains in the neck, shoulders and limbs, with great exhaustion. After the cold stage, which might last from half an hour to three hours, the hot and sweatingSweating
Perspiration is the production of a fluid consisting primarily of water as well as various dissolved solids , that is excreted by the sweat glands in the skin of mammals...
stage followed. The characteristic sweat broke out suddenly without any obvious cause. Accompanying the sweat, or after that was poured out, was a sense of heat, headache, delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...
, rapid pulse, and intense thirst. Palpitation
Palpitation
A palpitation is an abnormality of heartbeat that causes a conscious awareness of its beating, whether it is too slow, too fast, irregular, or at its normal frequency. The word may also refer to this sensation itself...
and pain in the heart were frequent symptoms. No skin eruptions were noted by observers including Caius. In the final stages, there was either general exhaustion and collapse, or an irresistible urge to sleep, which Caius thought to be fatal if the patient was permitted to give way to it. One attack did not offer immunity
Immunity (medical)
Immunity is a biological term that describes a state of having sufficient biological defenses to avoid infection, disease, or other unwanted biological invasion. Immunity involves both specific and non-specific components. The non-specific components act either as barriers or as eliminators of wide...
, and some people suffered several bouts before succumbing.
The malady was never seen again in England after 1578. A similar illness, known as the Picardy sweat
Picardy sweat
The Picardy sweat was an infectious disease of unknown etiology. It appeared in the northern French province of Picardy in 1718.All together, 194 epidemics of the Picardy sweat were recorded. The last occurrence took place in 1874. It was named Suette des Picards in France, and Picard'scher Schweiß...
, occurred in France between 1718 and 1861, but was less likely to be fatal. It was accompanied by a rash, which was not a feature of the earlier outbreaks.
Cause
The cause is the most mysterious aspect of the disease. Commentators then and now put much blame on the generally poor sanitation, sewage and contaminated water supplies of the time, which may have harboured the source of infection. The first outbreak at the end of the Wars of the RosesWars of the Roses
The Wars of the Roses were a series of dynastic civil wars for the throne of England fought between supporters of two rival branches of the royal House of Plantagenet: the houses of Lancaster and York...
means that it may have been brought over from France by the French mercenaries whom Henry VII used to gain the English throne, particularly as they seem to have been immune. However, the Croyland Chronicle
Croyland Chronicle
The Croyland Chronicle is an important, if not always reliable, primary source for English medieval history, in particular the late fifteenth century. It was written at the Benedictine Abbey of Croyland, in Lincolnshire, England, off and on from 655 to 1486, and its first author claimed to be...
mentions that Thomas Stanley, 1st Earl of Derby
Thomas Stanley, 1st Earl of Derby
Thomas Stanley, 1st Earl of Derby, KG was titular King of Mann, an English nobleman and stepfather to King Henry VII of England...
used the "sweating sickness" as an excuse not to join with Richard III's army prior to the Battle of Bosworth Field.
Relapsing fever
Relapsing fever
Relapsing fever is an infection caused by certain bacteria in the genus Borrelia. It is a vector-borne disease that is transmitted through the bites of lice or soft-bodied ticks.-Louse-borne relapsing fever:...
has been proposed as a possible cause. This disease, which is spread by ticks and lice, occurs most often during the summer months, as did the original sweating sickness. But, relapsing fever is marked by a prominent black scab at the site of the tick bite and a subsequent skin rash. No contemporaries noted these relatively obvious signs, so the identification is far from certain.
Chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...
has been suggested by Chaudhuria and Behan, based on a 1934 article of epidemic myalgia outbreaks that share clinical similarities with Bornholm disease
Bornholm disease
Bornholm disease or epidemic pleurodynia or epidemic myalgia is a disease caused by the Coxsackie B virus or other viruses.It is named after the Danish island Bornholm where early cases occurred.-Signs and symptoms:...
.
Noting symptom overlap with hantavirus pulmonary syndrome
Hantavirus
Hantaviruses are negative sense RNA viruses in the Bunyaviridae family. Humans may be infected with hantaviruses through rodent bites, urine, saliva or contact with rodent waste products...
, several scientists proposed an unknown hantavirus
Hantavirus
Hantaviruses are negative sense RNA viruses in the Bunyaviridae family. Humans may be infected with hantaviruses through rodent bites, urine, saliva or contact with rodent waste products...
as the cause. A critique of this hypothesis included the argument that, whereas sweating sickness was thought to be transmitted from human to human, hantaviruses are not known to spread in this way. Human to human contact has been proven in Hantavirus outbreaks in Argentina.
External links
- E. Bridson - "The English 'sweate' (Sudor Anglicus) and Hantavirus pulmonary syndrome" in Br J Biomed Sci. 2001;58(1):1-6.
- Sweating Fever Dr Jim Leavesley commemorates the 500th anniversary of the first outbreak - transcript of talk on Ockham's Razor ABC Radio NationalRadio NationalABC Radio National is an Australia-wide non-commercial radio network run by the Australian Broadcasting Corporation.Radio National broadcasts national programming in areas that include news and current affairs, the arts, social issues, science, drama and comedy...
- The Curious Case of the English Sweating Sickness, contains a map of the disease dispersion created and mapped by Kirstyn Pittman from California State University, ChicoCalifornia State University, ChicoCalifornia State University, Chico is the second-oldest campus in the twenty-three-campus California State University system. It is located in Chico, California, about ninety miles north of Sacramento...
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)