- Sweating sickness
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Sweating sickness, also known as the "English sweate" ( _la. sudor anglicus), was a mysterious and highly virulent disease which struck
Englandand later Europein 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.
Sweating sickness first came to the attention of
physicians at the very beginning of the reign of Henry VII. It was known, indeed, a few days after the landing of Henry at Milford Havenon 7 August 1485, as there is clear evidence of its being spoken of before the Battle of Bosworth Fieldon 22 August. Soon after the arrival of Henry in Londonon 28 August, it broke out in the capital. There, it killed several thousand people by its conclusion in late October that year. [cite book | first=Entick | last=John | year=1766 | title=A new and accurate history and survey of London, Westminster, Southwark, and places adjacent | location=London | pages=434, vol. 1 ] Among those killed were two lord mayors, six aldermen, and three sheriffs. [cite book | first=Walter | last=Harrison | year=1775 | title=A new and universal history, description and survey of the cities of London and Westminster, the borough of Southwark | location=London | pages=127 ] This alarming malady soon became known as the sweating sickness. It was regarded as being quite distinct from the plague, the pestilential feveror other epidemics 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 Ireland in 1492 when the Annals of Ulster (vol.iii, ed. B. MacCarthy, Dublin, 185, pp 358f.) record the death of James Fleming, baron of Slane from the pláigh allais, newly come to Ireland. The Annals of Connacht (ed. A.M.Freeman, Dublin, 1944, pp 594f.) also record this obit, and the Annals of the Four Masters (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 Typhus.
From 1492 nothing was heard of it until 1507, when a second, less widespread outbreak occurred, followed in 1517 by a third and much more severe epidemic. In
Oxfordand Cambridgeit 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 Calaisand Antwerp, but with these exceptions it did not yet spread beyond England.
The death of
Arthur, Prince of Wales, heir to King Henry VII, and husband to Catherine of Aragon, has been attributed to the "sweats" by some historians. He died in his home at Ludlow Castlein 1502, leaving his young wife a widow.
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, though not into the far north of England,
Scotlandor Ireland. In London the mortality was very great; the court was broken up, and Henry VIII left London, frequently changing his residence. The most remarkable fact about this epidemic is that it spread over Europe, suddenly appearing at Hamburgand 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 cholera. It arrived at Switzerlandin December, then northwards to Denmark, Swedenand Norway, and then eastwards to Lithuania, Polandand Russia. It never appeared in Franceor Italy. It also emerged in Belgiumand the Netherlands, probably transmitted direct from England as it appeared simultaneously in the cities of Antwerpand Amsterdamon 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 Caius, 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".
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 sweating 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, rapid pulse, and intense thirst. Palpitationand 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 tendency to sleep, which was thought to be fatal if the patient was permitted to give way to it. One attack did not offer immunity, 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.
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 Rosesmeans 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 Derbyused 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 feverhas 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 hantavirushas also been proposed, and appears to be an interesting candidate for consideration in the etiology of this illness. [ [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1043971 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1043971] ] 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. [ [http://www.findarticles.com/p/articles/mi_qa3874/is_200101/ai_n8939673 http://www.findarticles.com/p/articles/mi_qa3874/is_200101/ai_n8939673] ] 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.
* [http://ask.yahoo.com/ask/20000412.html Ask Yahoo -- What exactly was the sweating sickness?]
* [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11284216&dopt=Abstract E. Bridson - "The English 'sweate' (Sudor Anglicus) and Hantavirus pulmonary syndrome" in "Br J Biomed Sci." 2001;58(1):1-6.]
* [http://www.abc.net.au/rn/ockhamsrazor/stories/2007/2039403.htm "Sweating Fever"] Dr
Jim Leavesleycommemorates the 500th anniversary of the first outbreak - transcript of talk on "Ockham's Razor" ABC Radio National
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