Posted By Claire on August 13, 2010
In June 1528, when Henry VIII was courting Anne Boleyn, one of Anne’s ladies was suddenly taken ill with sweating sickness. Henry, who was paranoid about illness “took off on a flight from safe house to safe house” and Anne went into quarantine at Hever, the Boleyn family home in the Kent countryside. There, Anne became ill with “the sweat” and Henry dispatched his second-best doctor, William Butts to Anne with a love letter from Henry.
Anne Boleyn was one of the lucky ones, she survived sweating sickness, but others, including her brother-in-law, Sir William Carey, and Thomas Cromwell’s wife and daughters, lost their lives to the sickness.
But what was sweating sickness?
Sweating Sickness or English Sweat
Sweating sickness, the English Sweat or Sudor Anglicus, first reared its ugly head in England in 1485, at the beginning of Henry VII’s reign, and there were four further outbreaks, in 1508, 1517, 1528 and 1551, before it completely disappeared, never to be seen again. It seems to have been a highly contagious disease which decimated towns around England, sometimes taking thousands of lives, and, as John Caius, the English physician, wrote in 1552, towns thought themselves lucky if half the population survived.
Thomas Forrestier’s account of the epidemic in 1485 shows just how quickly the disease took hold and killed people:-
“We saw two prestys standing together and speaking together, and saw both of them dye sodenly. Also in die proxima we se the wyf of a taylour and sodenly dyed. Another yonge man walking by the street fell down sodenly. Also another gentylman ryding out of the cyte [21 September 1485] dyed. Also many others the which were to rehearse we have known that have dyed sodenly.”1
and Forrestier vividly described the symptoms of the 1485 outbreak:-
“And this sickness cometh with a grete swetying and stynking, with redness of the face and of all the body, and a contynual thirst with a grete hete and hedache because of the fumes and venoms.”2
Forrestier went on to mention “pricking the brains” and that some people “had black spots, as it appeared in our frere ?Alban, a noble leech on whose soul God have mercy!”
Although Forrestier wrote of the disease starting in London on the 19th September 1485, Wylie and Collier3 argue that there is evidence that sweating sickness had already broken out in the north of England during the summer of 1485 and that it did not originate in the capital. Wylie and Collier write of how Thomas, Lord Stanley, who was in the process of changing sides in the Wars of the Roses, “gave as his excuse to disobey Richard III’s summons to rejoin the Yorkists that ‘he feared that he had contracted the Sweating Sickness’ ” and there are records of the disease being prevalent in the York area in June 1485.
The next recorded epidemic of sweating sickness was in 1508, although some suggest that it may have caused the death of Prince Arthur in 1502 and there was an outbreak of an unknown disease in Chester in 1507. Wylie and Collier write of how Thomas More wrote to Cardinal Wolsey in 1508 to draw his attention “to the severe depredations of the sweating sickness among the young gentlemen of Oxford and Cambridge.”
Records show that the disease struck again in 1517. In his Chronicle, Edward Hall wrote:-
“…sudainly there came a plague of sickness called the Swetying Sickness that turned all his [the King's] purpose. This malady was so cruell that it killed some within three houres. Some within two houres, some merry at dinner and dedde at supper. Many died in the Kynges courte, the lorde Clinton, the lorde Gray of Wilton, and many Knightes, gentelmen and officiers. For this plague Mighelmas Terme was adiorned…”4
and the Venetian Ambassador reported on the 6th August 1517:-
“This disease makes very quick progress proving fatal in 24 hours at the furthest and many are carried off in 4 or five hours. The patients experience nothing but a profuse sweat, which dissolves the frame, and when once the 24 hours are passed all dangers are at an end… many of his [King Henry VIII's] household are sick and Ammonio, his Latin secretary died. Few strangers are dead but an immense number of natives.”5
The next outbreak of sweating sickness was in 1528. This time, the disease spread across the English Channel, but only affected the English outpost of Calais, where, as Wylie and Collier point out, it only seems to have affected Englishmen. It affected the English Court in London in May 1528, causing the court to be broken up and the King and Queen to flee. Wylie and Collier write of how there was an outbreak at a convent in Wilton in July 1528, an outbreak in Lincolnshire which killed four priests and two “lay brethren” and an outbreak at the Charterhouse in London, which caused many deaths. Cardinal Wolsey’s household was affected by the disease, although the Cardinal escaped infection, and we know from the reports of the French Ambassador, Du Bellay, that 18 of the Archbishop of Canterbury’s (William Warham) domestic staff died of the disease.
Henry VIII managed to avoid the disease and his sweetheart, Anne Boleyn, survived it.
Twenty three years later, the disease struck again and this is the epidemic that the famous, contemporary, English physician, John Caius, recorded in his “A boke, or counseill, against the disease commonly called the sweate or sweating sicknesse” (1552) and which Dr A Dyer analysed in his 1997 article “The English sweating sickness of 1551: an epidemic anatomized”. It was also the epidemic that took the lives of the Duchess of Suffolk’s son’s, Henry and Charles.
Caius writes of how the disease began in the middle of April in Shrewsbury, bringing “great mortalitie to Ludlowe, Prestene, and other places in Wales, then to Westchestre, Couentre [Coventry], Oxenfoorde, and other tounes in the Southe, and such as were in and aboute the way to London.”6 It affected London from the July and then moved to Eastern England and the North, where it began to diminish until the end of September when it finally died out.
A Summer Disease
According to John Caius, the 1518 epidemic affected England from July until mid December, the 1528 epidemic ran from May until July and the 1551 one from April to the end of September. We know from records that the other epidemics affected England in the summer, so it seems to have been a summer disease.
The famous Tudor physician, John Caius, wrote of the disease in his “A boke, or counseill, against the disease commonly called the sweate or sweating sicknesse” (1552), where he, like Forrestier, described the speed of the disease:-
“But that immediatly killed some in opening theire windowes, some in plaieng with children in their strete dores, some in one hour, many in two it destroyed, & at the longest, to the that merilye dined, it gaue a sorowful Supper. As it founde them so it toke them, some in sleape some in wake, some in mirthe some in care, some fasting & some ful, some busy and some idle, and in one house sometyme three sometime fiue, sometyme seuen sometyme eyght, sometyme more sometyme all, of the whyche, if the haulfe in euerye Towne escaped, it was thoughte great fauour.”7
Caius described the “signes” or symptoms of the sweat as:-
- Pain in the back, shoulder and extremities, accompanied by a “flusshing” – Muscle pain (myalgia) and redness
- “Grief” in the liver and stomach – abdominal pain
- Headache and “madnes” – Headache and delirium
- “Passion of the hart” – Cardiac palpitation
- “A marueilous heauinesse and a desire to sleape”
- “The short abidinge” – Possible death within 12 to 24 hours of the first symptom
Arthropod Borne Virus
Using 680 extant parish registers from the 16th century, Dr A Dyer8 analysed the demographic impact of the five outbreaks of sweating sickness and concluded that:-
- Young, rich males seemed to be predisposed to sweating sickness
- The disease was predominantly rural
- There may well have been occurrences outside of 1485, 1508, 1517, 1528 and 1551
Dyer concluded that the fact that it was a summer disease and that it affected predominantly rural communities suggested that sweating sickness was an arthropod-borne virus with a rodent host. However, he also noted that the “very rapid transmission by travellers along the road system is clearly the agency by which the sweat epidemic of 1551 was spread from June onwards”9 and Taviner, Thwaites and Gant point out that “this present us with aetiological difficulties since arboviruses are only ever transmitted via an arthropod vector – never by human-to-human transmission.”10
Wylie and Collier agree with Dyer’s conclusion, saying that “the very suddenness of the end of the epidemics lends support to the view that an unidentified rodent reservoir of the virus was susceptible to an epizootic and was killed off, ending a rurally orientated small mammal population explosion that, under favourable environmental circumstances, usually reaches its zenith in August.”11 Wylie and Collier support their theory that sweating sickness was caused by an arbovirus infection with the following points:-
- In the 15th and 16th centuries, England had many wooded areas which were habitats for wild birds, mammals and mosquitoes.
- The majority of arboviruses cause febrile illnesses of varying severity.
- Men’s occupations and recreations take them into wooded areas where they may be bitten by insects carrying the disease.
- “The long and irregular intervals between epidemics of sweating sickness accord with the behaviour of certain arbovirus infections.”
Wylie and Collier conclude that “the epidemiological and demographic records of the English sweating sickness, exiguous though they be, are, together with abrupt onset of fever, headache, rapid course, and high mortality as described in the historical accounts, characteristic of some arbovirus infections known to us today.”12
A Viral Pulmonary Disease
In their article “The English Sweating Sickness, 1485 – 1551: A Viral Pulmonary Disease?”, Taviner, Thwaites and Gant argue that “the causative agent for the sweat was a virus with a marked pulmonary component and few cutaneous signs”13. They use the symptoms recorded by Forrestier and Caius and the absence of “exanthematous [skin eruption] or haemorrhagic signs” to cast doubt on the theory that the disease was an abovirus as these types of infections are usually characterized by skin eruptions of some kind. They also note that the “rapidity of clinical course” of sweating sickness is also not characteristic of an arbovirus.
Taviner et al. also note that Forrestier mentioned breathlessness as a symptom:-
“but it is on account of the ill-natured, fetid, corrupt, putrid and loathsome vapours close to the region of the heart and of the lungs, whereby they grow ill, and the panting of the breath itself magnifies and increases and restricts: because of the external heat and fire itself near the heart”14
and this pulmonary aspect of the disease, combined with the summer preponderance and the rural nature of sweating sickness which point to “a viral infectious agent with a rodent reservoir”, have led them to point otut the similarities between sweating sickness and Hantavirus Pulmonary Syndrome (HPS). This syndrome is caused by catching a virus from infected small rodents and it has the following symptoms in succession:-
- Rapidly progressive noncardiogenic pulmonary oedema – 88% of patients require mechanical ventilation within 24 hours of admission to hospital.
- Death within 72 hours – Some people survive the disease but all those who die do so within 72 hours.
Bad Air, Dirty Houses and a Rich Diet
John Caius concluded that the disease was caused by:-
- “close, & unstirred aire”
- “impure spirits in bodies corupt by repletion” – Too much meat in the diet or eating infected fruits.
Erasmus, in a letter to Francis, physician to the Cardinal of York, wrote of how English houses were not constructed to make a through-draft possible and that their rush floors were unhygienic because sometimes they were not renewed for around twenty years and so they allowed “spittle, vomit, dog’s urine and men’s too, dregs of beer and cast-off bits of fish, and other unspeakable kinds of filth”15 to fester. Others blamed the damp, foggy English climate, but these factors are unlikely to have caused such an epidemic.
In the past, some have suggested that sweating sickness was actually relapsing fever, which is a disease spread by lice or ticks. Its symptoms include fever, chills, headache, joint and muscle ache, and nausea.
None of the theories seem to really fit the symptoms and spread of sweating sickness in the 16th century and perhaps this Tudor killer will always be a mystery. In an article “The Sweating Sickness Returns” in Discover Magazine, Gant and Thwaites point out that they could possibly test out their hypothesis (Hanta Virus Pulmonary Syndrome) by exhuming the body of Henry Brandon, Duke of Suffolk, who died from sweating sickness in 1551, but that they have no plans to disturb his grave because the odds of survival of this type of genetic material is very low. I guess we’ll just never know.
Notes and Sources
- T Forestier, Tractatus contra pestilentiam thenasmonem et dissinteriam, Rouen, 1490, quoted in The English Sweating Sickness (Sudor Anglicus): A Reappraisal, John A. H. Wylie and Leslie H. Collier.
- “The English Sweating Sickness (Sudor Anglicus): A Reappraisal”, John A. H. Wylie and Leslie H. Collier.
- Hall’s Chronicle, Edward Hall
- Quoted in “The English Sweating Sickness (Sudor Anglicus): A Reappraisal”, John A. H. Wylie and Leslie H. Collier.
- “A boke, or counseill, against the disease commonly called the sweate or sweating sicknesse” (1552), John Caius
- “The English sweating sickness of 1551: an epidemic anatomized”, A Dyer, Med. Hist., 1997
- “The English Sweating Sickness, 1485 – 1551: A Viral Pulmonary Disease?”, Mark Taviner, Guy Thwaites and Vanya Gant
- Wylie and Collier
- Taviner, Thwaites and Gant
- “The Correspondence of Erasmus: Letters 1356-1534, 1523-1524″ by Desiderius Erasmus, R. A. B. Mynors, Alexander Dalzell