Sweating sickness, also known as the
"English sweate" , was a mysterious and highly virulent disease which struck
EnglandEngland 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 and the North Sea to the east, with the English Channel to the south separating it from continental...
and later
EuropeEurope 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 water divide of the Ural Mountains, the Ural River, the Caspian Sea, the Caucasus Mountains , and the Black Sea to the southeast...
in a series of epidemics, the first beginning in 1485 and the last in 1551, afterwards apparently vanishing. The onset of symptoms was dramatic and sudden, with death often occurring within hours. Its cause remains unknown. One suspect is a
hantavirusHantaviruses belong to the Bunyaviridae family of viruses. The Bunyaviridae family is divided into 5 genera: Orthobunyavirus, Nairovirus, Phlebovirus, Tospovirus, and Hantavirus. Like all members of this family, hantaviruses have genomes comprised of three negative-sense, single-stranded RNA...
.
1485
Sweating sickness first came to the attention of
physicianA physician — also known as medical practitioner, doctor of medicine, medical doctor, or simply doctor — practices the ancient profession of medicine, which is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease or injury...
s at the very beginning of the reign of
Henry VIIHenry VII was the 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 Tudor dynasty.Henry was successful in restoring the power and stability of the English monarchy after the political upheavals of the Wars...
. It was known, indeed, a few days after the landing of Henry at
Milford HavenMilford Haven is a town in Pembrokeshire, Wales on the north side of the inlet of the same name...
on 7 August 1485, as there is clear evidence of it being spoken of before the
Battle of Bosworth FieldThe Battle of Bosworth Field was the penultimate battle of the Wars of the Roses, a 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 is the capital of England and the United Kingdom. It has been a major settlement for two millennia, and the history of London goes back to its founding by the Romans, when it was named Londinium. London's core, the ancient City of London, the 'square mile', retains its medieval boundaries...
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 mayorThe 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
sheriffA 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
plaguePlague is a deadly infectious disease caused by the enterobacteria Yersinia pestis . Plague is a zoonotic, primarily carried by rodents and spread to humans via fleas. Plague is notorious throughout history, due to the unrivaled scale of death and devastation it brought...
, the pestilential
feverFever is a frequent medical sign that describes an increase in internal body temperature to levels above normal...
or other
epidemicDefining an epidemic can be subjective, depending in part on what is "expected". An epidemic may be restricted to one locale , more general or even global...
s previously known, not only by the special symptom which gave it its name, but also by its extremely rapid and fatal course. The sweating sickness reached
IrelandIreland is the third-largest island in Europe and the twentieth-largest island in the world. It lies to the north-west of continental Europe and is surrounded by hundreds of islands and islets. To the east of Ireland, separated by the Irish Sea, is the island of Great Britain...
in 1492 when the
Annals of UlsterThe Annals of Ulster are a chronicle of medieval Ireland. The entries span the years between AD 431 and 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...
(vol.iii, ed. B. MacCarthy, Dublin, 185, pp 358f.) record the death of
James Fleming, Baron of SlaneJames 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. He was one of the 11 Irish barons...
from the
pláigh allais, newly come to Ireland. The
Annals of ConnachtThe 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 MastersThe Annals of the Kingdom of Ireland or the Annals of the Four Masters are a chronicle of medieval Irish history. The entries span from the deluge, dated as 2,242 years after creation to AD 1616.-Text:...
(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. Note, however, that 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, but 'Relapsing or Famine Fever', possibly
TyphusEpidemic 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 Wales, an elder brother of Henry VIII of England. He died in his home at
Ludlow CastleLudlow Castle is a large, now 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 AragonCatherine of Aragon was Princess of Wales as the wife of Arthur, Prince of Wales, and Queen of England as the first wife of King Henry VIII of England....
, a widow.
In 1507, another second, less widespread outbreak occurred, followed in 1517 by a third and much more severe epidemic. In
OxfordOxford is a city, and the county town of Oxfordshire, in South East England. The city has a population of just under 165,000, with 151,000 living within the district boundary. The rivers Cherwell and Thames run through Oxford and meet south of the city centre...
and
CambridgeThe 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. It is also at the heart of the high-technology centre known as Silicon Fen....
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
CalaisCalais is a town in northern France in the department of Pas-de-Calais, of which it is a sub-prefecture...
and
Antwerp||-||-||-||}Antwerp is a city and municipality in Belgium and the capital of the Antwerp province in Flanders, one of Belgium's three regions. Antwerp's total population is 472,071 and its total area is , giving a population density of 2,308 inhabitants per km²...
, but nowhere else outside of England.
1528
In 1528 the disease recurred for the fourth time and with great severity. It first showed itself in London at the end of May and speedily spread over the whole of England, save for the far north, sparing
ScotlandScotland 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...
and
IrelandIreland is the third-largest island in Europe and the twentieth-largest island in the world. It lies to the north-west of continental Europe and is surrounded by hundreds of islands and islets. To the east of Ireland, separated by the Irish Sea, is the island of Great Britain...
. In London the mortality was very great; the court was broken up, and
Henry VIIIHenry VIII was King of England from 21 April 1509 until his death. He was also Lord of Ireland and claimant to the Kingdom of France. Henry was the second monarch of the House of Tudor, succeeding his father, Henry VII.Henry VIII was a significant figure in the history of the English monarchy...
left London, frequently changing his residence. The most remarkable fact about this epidemic is that it spread over Europe, suddenly appearing at
HamburgHamburg is the second-largest city in Germany and the sixth-largest city in the European Union...
and spreading so rapidly that in a few weeks more than a thousand people died. Thus was the terrible sweating sickness started on a destructive course, during which it caused fearful mortality throughout Eastern Europe. It spread much in the same way as
choleraCholera, sometimes known as Asiatic or epidemic cholera, is an infectious gastroenteritis caused by enterotoxin-producing strains of the bacterium Vibrio cholerae. Transmission to humans occurs through eating food or drinking water contaminated with Vibrio cholerae from other cholera patients...
. It arrived at
SwitzerlandSwitzerland , officially the Swiss Confederation , is a federal republic consisting of 26 states named cantons, with Bern as the seat of the federal authorities...
in December, then northwards to
DenmarkDenmark is a Scandinavian country in Northern Europe and the senior member of the Kingdom of Denmark. It is the southernmost of the Nordic countries; southwest of Sweden and south of Norway, and it is bordered to the south by Germany. Denmark borders both the Baltic and the North Sea...
,
SwedenSweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe...
and
NorwayNorway , officially the Kingdom of Norway, is a country in Northern Europe occupying the western portion of the Scandinavian Peninsula, as well as Jan Mayen and the Arctic archipelago of Svalbard under the Spitsbergen Treaty...
, and then eastwards to
LithuaniaLithuania , officially the Republic of Lithuania is a country in Northern Europe, the southernmost of the three Baltic states. Situated along the southeastern shore of the Baltic Sea, it shares borders with Latvia to the north, Belarus to the southeast, Poland, and the Russian exclave of...
,
PolandPoland , officially the Republic of Poland , is a country in Central Europe . Poland is 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
RussiaThe Grand Duchy of Moscow was a medieval Russian polity centered on Moscow between 1340 and 1547. The Grand Duchy of Moscow, as the state is known in Russian records, has been referred to by many Western sources as Muscovy. However, this term is also sometimes applied to the Tsardom of Russia...
. It never appeared in
FranceFrance , officially the French Republic , is a country located in Western Europe, with several overseas islands and territories located on other continents. Metropolitan France extends from the Mediterranean Sea to the English Channel and the North Sea, and from the Rhine to the Atlantic Ocean...
or
ItalyItaly , officially the Italian Republic , is a country located on the Italian Peninsula in Southern Europe and on the two largest islands in the Mediterranean Sea, Sicily and Sardinia. Italy shares its northern, Alpine boundary with France, Switzerland, Austria and Slovenia...
. It also emerged in
BelgiumThe Kingdom of Belgium is a country in northwest Europe. It is a founding member of the European Union and hosts its headquarters, as well as those of other major international organizations, including NATO...
and the
NetherlandsThe Netherlands is a country in Northwestern Europe, constituting the major portion of the Kingdom of the Netherlands. It is a parliamentary democratic constitutional monarchy. The Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east...
, probably transmitted direct from England as it appeared simultaneously in the cities of
Antwerp||-||-||-||}Antwerp is a city and municipality in Belgium and the capital of the Antwerp province in Flanders, one of Belgium's three regions. Antwerp's total population is 472,071 and its total area is , giving a population density of 2,308 inhabitants per km²...
and
AmsterdamAmsterdam is the capital and largest city of the Netherlands, located in the province of North Holland in the west of the country...
on the morning of 27 September. In each place which 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, it did not re-appear on mainland Europe.
The final outbreak
The last major outbreak of the disease occurred in England in 1551. An eminent physician,
John CaiusJohn 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
sweatingPerspiration 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,
deliriumDelirium is an acute and debilitating decline in attention-focus, perception, and cognition that produces an altered form of semi-consciousness. It is a systemic syndrome caused by a chemical or disease-process which is disrupting the neurons of the cerebral cortex...
, rapid pulse, and intense thirst.
PalpitationA palpitation is an abnormal awareness of the beating of the heart, whether it is too slow, too fast, irregular, or at its normal frequency. It can be caused by ectopic beat, which is a more specific diagnosis....
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 was thought to be fatal if the patient was permitted to give way to it. One attack did not offer
immunityImmunity 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 although a similar illness, known as the Picardy sweat, occurred in France between 1718 and 1861, but was less likely to be fatal and 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 general dirt and sewage of the time which may have harboured the source of infection. The first outbreak at the end of the
Wars of the RosesThe Wars of the Roses were a series of dynastic civil wars between supporters of the rival houses of Lancaster and York, for the throne of England. They are generally accepted to have been fought in several spasmodic episodes between 1455 and 1487...
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,
Thomas Stanley, 1st Earl of DerbyThomas Stanley, 1st Earl of Derby, KG , was 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, which suggests that the illness was already established in England before Henry Tudor's landing. The fact that the disease seems to have been more virulent among the rich than the poor suggests why it was judged noteworthy in comparison to the other illnesses of the time.
Relapsing feverRelapsing fever is an infection caused by certain bacteria in the genus Borrelia. It is a vector-borne disease that is transmitted through louse or soft-bodied tick bites.-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. However, relapsing fever is marked by a prominent black scab at the site of the tick bite and a subsequent skin rash, whereas contemporaries did not note these relatively obvious signs, so the identification is far from certain.
More recently, a
hantavirusHantaviruses belong to the Bunyaviridae family of viruses. The Bunyaviridae family is divided into 5 genera: Orthobunyavirus, Nairovirus, Phlebovirus, Tospovirus, and Hantavirus. Like all members of this family, hantaviruses have genomes comprised of three negative-sense, single-stranded RNA...
has also been proposed, and appears to be an interesting candidate for consideration in the
etiologyEtiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
of this illness. However, certain clinical features of hantavirus outbreaks do not seem to match the progression of the sweating sickness; specifically, while hantavirus has only rarely been observed to be transmitted from one human to another, this is believed to be a significant mode of transmission of the sweating sickness. Although hantavirus pulmonary syndrome outbreaks share a very similar clinical picture with descriptions of the sweating sickness, a number of questions yet to be answered leave the door open to other theories of etiology.
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