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by Paul Slack, Routledge & Kegan Paul, 1985
When he wrote this book Paul Slack (at the time a Fellow and Tutor in Modern History at Exeter College in Oxford) was more interested in the social response to the disease than in the disease itself, devoting almost half of the book to this subject. But he also realized that to understand the social response he needed to understand aspects of the disease itself, such as frequency of occurrence, which social groups and locales were affected and the mortality rates. The addressing of these questions occupies the first half of the book. The time period that he is covering, as indicated by the title, is the sixteenth and seventeenth centuries.
Part I of the book gives us an introduction to the disease and its manifestations, as well as an overview of its impact on society and the attitudes and actions that resulted. The cause of the plague was not known, and it was attributed to both natural and supernatural agents. Similarly, the treatment of it incorporated both natural and supernatural elements. Books and pamphlets were published that included both herbal remedies and prayers. Special sermons were preached during plague outbreaks, and sometimes plague fasts were held. Diagnosis was not exact and there were other diseases prowling the populations such as typhus, the sweating fever and malaria, leading to further confusion and uncertainty. The plague itself was manifested in several ways. There was the bubonic plague with its carbuncles, buboes and spots, which sometimes occurred in a mild form, without marked visible symptoms. A more deadly variant of the disease was septicaemic plague, in which the bacilli invaded the blood stream, causing death before the external symptoms of plague had time to appear. A third variety is pneumonic plague, which may begin as a case of bubonic plague that becomes complicated by pneumonia. This latter variant changes the disease vector from fleas to humans as the bacteria is coughed out in the sputum of the victims and inhaled by the people around them. It was highly contagious, had a shorter incubation period than bubonic plague, and left untreated was almost 100 percent fatal.
Along with the fear and uncertainty that an outbreak of plague invoked, it also placed a much more practical strain on the society in the loss of its members, sometimes in large numbers (a quarter to a third of a town’s population). This depressed the economy as well as straining the infrastructure as those as yet untouched by the disease struggled to deal with the dead bodies that needed to be disposed of as quickly as possible. Knowledge of the plague was passed down essentially unchanged from the time of the Black Death. The first medical book printed in English was a Little Book on plague, published in 1486 probably as a result of an outbreak of the sweating sickness. Outbreaks of diseases often seemed to inspire the printing of books on the plague, and in the second half of the sixteenth century a growing number of them were religious tracts and sermons.
Part II of the book examines the frequency and severity of outbreaks using parish records and the number of wills probated as indicators of the presence of plague. Slack examines the records of Essex and Devon counties in an attempt to understand what kinds of communities were most likely to be affected by the plague. From there he moves on to the urban settings of Exeter, Bristol and Norwich and then to the metropolitan setting of London. From his case studies in the counties of Essex and Devon he draws two conclusions: 1) bubonic plague could cause a greater number of mortalities in a shorter time span than any other epidemic disease; and 2) that most communities suffered at least one epidemic during the course of a century and were lucky if they did not suffer more. The risk was generally greater in towns than in rural areas, although living in the country was not a guarantee of safety.
He finds a more consistent picture when he examines the records of Exeter, Bristol and Norwich. Although they differ in the timing and severity of the epidemics in all three cities the occurrence of plague was connected with the economic and social conditions of the communities. Plague was a part of urban life. It was a regular visitor to all three cities. It struck Norwich in 1544, 1554, 1579, 1584 and 1589. The frequency and severity in Norwich may be due to the fact of its nearness to the Low Countries and its large immigrant population. It struck Bristol in 1565 and 1575 and Exeter in 1570 and 1590. It tended to be concentrated in fringe parishes that were primarily inhabited by poor laborers. In urban areas the occurrence of plague had a definite social dimension.
By the sixteenth century London had already gained a reputation as being filthy and plague was seldom completely absent from it. The best records come from the city itself in the bills of mortality that it published in the seventeenth century. These documented not only the number of deaths but also their locations, making possible the charting of the progress of the disease through the city. A fresh outbreak would often begin, as would be expected, in the east, near the river and the docks, although that was not always the case. Once again, the most affected parishes were on the fringes of the city where the poor resided.
Part III of the book examines the social reactions to the plague and the actions that resulted. The strategies to battle the plague began in London as part of the government’s general pursuit of social policies that might benefit the common man and improve social order. England lagged behind other countries in their adoption of measures to control the spread of plague and often simply adopted and adapted strategies already in use abroad. In 1518 Cardinal Wolsey founded the College of Physicians to improve English medical care, which also marked the beginning of public policy regarding plague. Those policies primarily focused upon separating out the infected to pesthouses or shutting them up in their own homes. Neither policy was rigorously enforced, the former because of the cost of establishing and running pesthouses and the latter in part because of the humanitarian issues raised and in part because of the difficulty of enforcing the isolation. It was much better to prevent the outbreak of plague itself, and to that end quarantines were enforced on ships and goods arriving from areas where a plague outbreak was known to have occurred.
The publication of the bills of mortality in London documented for all to see the incidence and location of plague deaths. The advent of newspapers helped to spread this information outside of the city. This unprecedented supply of information allowed patterns of infection to be seen and helped to rationalize the reactions to plague, at least among the educated. Although the carriers of the plague were not identified and without a germ theory of disease its cause remained unknown it did help to destroy the claims of its supernatural origins.
Plague broke down the social order, existing divisions were often exacerbated. The people resisted the efforts of the officials to impose plague regulations because they saw them to be as threatening as the disease itself. The public resisted the imposition of the regulations and the plague rate rose, which led the government to go to greater and greater lengths to enforce them. While the public were concerned with the suffering of themselves and their fellows, the officials were concerned with maintaining order, and they viewed the plague as part of the broader problem of poverty.
When he wrote this book Paul Slack (at the time a Fellow and Tutor in Modern History at Exeter College in Oxford) was more interested in the social response to the disease than in the disease itself, devoting almost half of the book to this subject. But he also realized that to understand the social response he needed to understand aspects of the disease itself, such as frequency of occurrence, which social groups and locales were affected and the mortality rates. The addressing of these questions occupies the first half of the book. The time period that he is covering, as indicated by the title, is the sixteenth and seventeenth centuries.
Part I of the book gives us an introduction to the disease and its manifestations, as well as an overview of its impact on society and the attitudes and actions that resulted. The cause of the plague was not known, and it was attributed to both natural and supernatural agents. Similarly, the treatment of it incorporated both natural and supernatural elements. Books and pamphlets were published that included both herbal remedies and prayers. Special sermons were preached during plague outbreaks, and sometimes plague fasts were held. Diagnosis was not exact and there were other diseases prowling the populations such as typhus, the sweating fever and malaria, leading to further confusion and uncertainty. The plague itself was manifested in several ways. There was the bubonic plague with its carbuncles, buboes and spots, which sometimes occurred in a mild form, without marked visible symptoms. A more deadly variant of the disease was septicaemic plague, in which the bacilli invaded the blood stream, causing death before the external symptoms of plague had time to appear. A third variety is pneumonic plague, which may begin as a case of bubonic plague that becomes complicated by pneumonia. This latter variant changes the disease vector from fleas to humans as the bacteria is coughed out in the sputum of the victims and inhaled by the people around them. It was highly contagious, had a shorter incubation period than bubonic plague, and left untreated was almost 100 percent fatal.
Along with the fear and uncertainty that an outbreak of plague invoked, it also placed a much more practical strain on the society in the loss of its members, sometimes in large numbers (a quarter to a third of a town’s population). This depressed the economy as well as straining the infrastructure as those as yet untouched by the disease struggled to deal with the dead bodies that needed to be disposed of as quickly as possible. Knowledge of the plague was passed down essentially unchanged from the time of the Black Death. The first medical book printed in English was a Little Book on plague, published in 1486 probably as a result of an outbreak of the sweating sickness. Outbreaks of diseases often seemed to inspire the printing of books on the plague, and in the second half of the sixteenth century a growing number of them were religious tracts and sermons.
Part II of the book examines the frequency and severity of outbreaks using parish records and the number of wills probated as indicators of the presence of plague. Slack examines the records of Essex and Devon counties in an attempt to understand what kinds of communities were most likely to be affected by the plague. From there he moves on to the urban settings of Exeter, Bristol and Norwich and then to the metropolitan setting of London. From his case studies in the counties of Essex and Devon he draws two conclusions: 1) bubonic plague could cause a greater number of mortalities in a shorter time span than any other epidemic disease; and 2) that most communities suffered at least one epidemic during the course of a century and were lucky if they did not suffer more. The risk was generally greater in towns than in rural areas, although living in the country was not a guarantee of safety.
He finds a more consistent picture when he examines the records of Exeter, Bristol and Norwich. Although they differ in the timing and severity of the epidemics in all three cities the occurrence of plague was connected with the economic and social conditions of the communities. Plague was a part of urban life. It was a regular visitor to all three cities. It struck Norwich in 1544, 1554, 1579, 1584 and 1589. The frequency and severity in Norwich may be due to the fact of its nearness to the Low Countries and its large immigrant population. It struck Bristol in 1565 and 1575 and Exeter in 1570 and 1590. It tended to be concentrated in fringe parishes that were primarily inhabited by poor laborers. In urban areas the occurrence of plague had a definite social dimension.
By the sixteenth century London had already gained a reputation as being filthy and plague was seldom completely absent from it. The best records come from the city itself in the bills of mortality that it published in the seventeenth century. These documented not only the number of deaths but also their locations, making possible the charting of the progress of the disease through the city. A fresh outbreak would often begin, as would be expected, in the east, near the river and the docks, although that was not always the case. Once again, the most affected parishes were on the fringes of the city where the poor resided.
Part III of the book examines the social reactions to the plague and the actions that resulted. The strategies to battle the plague began in London as part of the government’s general pursuit of social policies that might benefit the common man and improve social order. England lagged behind other countries in their adoption of measures to control the spread of plague and often simply adopted and adapted strategies already in use abroad. In 1518 Cardinal Wolsey founded the College of Physicians to improve English medical care, which also marked the beginning of public policy regarding plague. Those policies primarily focused upon separating out the infected to pesthouses or shutting them up in their own homes. Neither policy was rigorously enforced, the former because of the cost of establishing and running pesthouses and the latter in part because of the humanitarian issues raised and in part because of the difficulty of enforcing the isolation. It was much better to prevent the outbreak of plague itself, and to that end quarantines were enforced on ships and goods arriving from areas where a plague outbreak was known to have occurred.
The publication of the bills of mortality in London documented for all to see the incidence and location of plague deaths. The advent of newspapers helped to spread this information outside of the city. This unprecedented supply of information allowed patterns of infection to be seen and helped to rationalize the reactions to plague, at least among the educated. Although the carriers of the plague were not identified and without a germ theory of disease its cause remained unknown it did help to destroy the claims of its supernatural origins.
Plague broke down the social order, existing divisions were often exacerbated. The people resisted the efforts of the officials to impose plague regulations because they saw them to be as threatening as the disease itself. The public resisted the imposition of the regulations and the plague rate rose, which led the government to go to greater and greater lengths to enforce them. While the public were concerned with the suffering of themselves and their fellows, the officials were concerned with maintaining order, and they viewed the plague as part of the broader problem of poverty.
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