Charles Creighton

“ It is a melancholy picture of society to witness the increase of wealth and luxury on one side, and the greatest want and wretchedness on the other; to meet famine and exhaustion in the great body of the people, in a country that produces as much food as would afford a full supply for once and a half its present population; to see the granaries full of corn and flour, and the great body of the people scarcely existing on a half supply of bad potatoes. ”

“ We are taught to see the figures of lepers in their grey or russet gowns flitting everywhere through the scene; the air of those remote times is as if filled with the dull creaking of St Lazarus’s rattle. Our business here is to apply to the question of leprosy in medieval Britain the same kind of scrutiny which has been applied to the question of famines and famine-fevers, and remains to be applied next in order to the great question of plague—the kind of scrutiny which no historian would be excused from if his business were with politics, or campaigns, or economics, or manners and customs. ”

“ A judicious historical view of the English writings on fevers, such as this 18th century critic desired to see, may now be thought superfluous. The theories, the indications for treatment, the medical terms, have passed away and become the mere objects of a learned curiosity. But the actual history of the old fevers, of their kinds, their epidemic prevalence, their incidence upon rich or poor, upon children or adults, their fatality, their contagiousness, their connexion with the seasons and other vicissitudes of the people—all this is something more than curious. ”

“ Under the year 1143 he writes that there was most dire famine in all England; the people ate the flesh of dogs and horses or the raw garbage of herbs and roots. The people in crowds pined and died, or another part entered on a sorrowful exile with their whole families. One might see houses of great name standing nearly empty, the residents of either sex and of every age being dead. As autumn drew near and the fields whitened for the harvest, there was no one to reap them, for the cultivators were cut off by the pestilent hunger which had come between. ”

“ Asiatic Cholera brings us back, at the end of the history, to the same great problem which the Black Death of the 14th century raised near the beginning of it, namely, the importation of the seeds of pestilence from some remote country, and their dependence for vitality or effectiveness in the new soil upon certain favouring conditions, which sanitary science has now happily in its power to withhold. I have left Influenza to be mentioned last. Its place is indeed unique among epidemic diseases; it is the oldest and most obdurate of all the problems in epidemiology. ”

“ The Devonshire diffusion was like the spreading circles in a still pool. The spread of influenza was like the flying ripples on a broad surface of water. The spread of plague, on the occasions when it was universal, was like the massive rollers of the depths, the onward march of cholera from the East having, in our own times, illustrated afresh the same momentum. ”

“ An ingenious friend of mine has remarked to me in conversation that some light is thrown on this subject by considering that whichever of the epidemic maladies attack children first, it will be the most fatal, inasmuch as all feeble constitutions will fall in its way while the stronger will be left to encounter the attacks of the others; and that the smallpox, owing probably to the greater abundance and rankness of their effluvia, are generally caught in a casual way before measles, hooping cough and scarlet fever, and are therefore reckoned more fatal than any of these. ”

“ The invasion of the Black Death was part of the great human drama, just as if a swarming people or a barbarous conqueror had been visibly present in it. If things were moving in the fourteenth century towards a particular issue, as historians find in their retrospect that they were, then the coming of a great plague was part of that movement, organically bound up with the other forces of it, and no more arbitrary than they. ”

“ With our modern habit of seeking out the matter of fact, of going back to the reality and of reconstructing the theory, it is not easy for us to understand how completely the medieval world of medicine was enslaved to authority and tradition even in matters that were directly under their eyes. It was thought a great thing that Linacre, of Oxford, in the first years of the 16th century, and Caius, of Cambridge, some fifty years later, should have gone back to Galen for their authority, passing over the Arabians who had been the interpreters of classical medicine all through the Middle Ages. ”

“ 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. ”

“ What kind of infection can that be which has befallen men on both sides of the Alps within the same short time in the 12th century as in the 19th? And what kind of infection is it which has outlived so many changes in the great pestilences of mankind, has seen the extinction of plague and the rise of cholera, and all other variations, most of them for the better, in the reigning types of epidemic sickness? ”

“ London must have been unusually full of people in the weeks before the Coronation on the 30th October. But the pestilence that broke out was not the “common infection” or plague, which might intelligibly have been fanned into a flame by a great concourse of people. It was the sweat,—a new disease, a stranger not only to England but to all the world. We shall understand the mysteriousness of the visitation and the inadequacy of all ordinary explanations, by taking Forrestier’s account of the causes of it, drawn up in the year of its first occurrence. ”

“ The contagion that reached England and Scotland from the scene of famine in Ireland was more apt to produce typhus than relapsing fever. That the Irish contagion was the principal source of the great epidemics in England and Scotland in 1847-48, seems to be proved by every fact in their progress, direction and other circumstances. But it is not so clear that England and Scotland would not have had an unusual amount of typhus in the same years even if the Irish had been kept out by an ideally strict quarantine. What touched Ireland most, touched Scotland and England in a measure. ”

“ So sharp was the famine before the harvest of that year, that crowds of the poor went to the fields in the month of July, and plucked the unripe ears of corn, rubbing them in their hands and eating the raw grain. The St Albans monk is full of indignation against the prevailing spirit of avarice which reduced some of the people to that sad necessity: Alms had everywhere gone out of fashion; the rich, abounding in all manner of temporal goods, were so smitten with blind greed that they suffered Christian men, made in the image of God, to die for want of food. ”

“ The increased prevalence of smallpox in the generation before the last great outburst of plague, and the infantile or puerile character of the epidemic fever of 1661, as described by Willis, show that the incidence of infectious mortality had already begun to shift towards the age of childhood. It looks as if the conditions of population, intricate and obscure as they must be confessed to be, were somehow determining what the reigning infectious maladies, with their special age-incidence, should be. ”

“ No one doubts that the birth-rate and the death-rate have had great variations from time to time, depending on the greater or less abundance of the means of subsistence, on overcrowding, or other things; and the variation in the birth-rate and death-rate is only the most obvious and numerically precise of a whole series of variations in vital phenomena, of which the successions, alternations, and novelties in the types of disease are the least simple, and least within the reach of mere notional apprehension or mere statistical management. ”