An interview with Carole Rawcliffe
This interview with Dr Carole Rawcliffe (CR) was carried out by Juniper Communications (JC) for the Channel 4 programme The Great Plague. Dr Rawcliffe teaches the social history of medicine at the University of East Anglia's School of History.
Contents
• The fear of the disease
• Causes of the plague
• Preventing the plague
• Treating the disease on the Continent
• Religion and medicine
• The effects on society
JC: Why is the plague so much scarier than anything else?
CR: I think plague is so particularly terrifying because it's so sudden. It strikes you almost unannounced. It's also frightening because it strikes everybody. It's easy to argue that it's the consequence of sin, but it's a consequence of collective sin. It's not like syphilis, which strikes down the philanderer, the playboy, the prostitute. Plague is something that can kill a small child and can kill them very quickly. It's indiscriminate and it's sudden. It leads to wholesale social dislocation and fear on a tremendous scale, and that, I think, is what makes it so remarkable and so fearful.
JC: Is it also terrifying because of the buboes? Do we know how painful it was?
CR: It's agonisingly painful. We know from people who have survived it that, when the buboes first appear, they really hurt. I think that it was in Turkey that Lady Mary Wortley Montagu [1689-1762] discovered that an ideal way of surviving would be to have your buboes lanced. This in itself is a tremendously painful experience.
And the disease – which is, after all, called the Black Death, isn't it? – transforms the body. And anything that makes the human body appear revolting or ugly, like leprosy or syphilis, is particularly fearful.
JC: There was actually a survival rate? You didn't necessarily die?
CR: No, quite a few people do survive. We can't possibly estimate the survival rate because we don't know how many people had it and recovered. We only know the numbers of people who actually had it and are believed by the Bills of Mortality to have expired. But in many cases, the Bills often conceal plague deaths, so the figures may have been much higher than those actually recorded. After all, if you have plague in your community, you're not going to advertise the fact to the world if you can help it.
Causes of the plague
JC: When plague came, what did people think caused it?
CR: There are a huge raft of explanations for plague. These ranged from the vengeance of God, which there was not much you could do about, to ideas about diseases borne on vapours or in seeds, and you could certainly take steps against that. The idea was that smells or vapours – little droplets – came in through the nose, into the brain and were transmitted through the body. They weakened the function of the brain, the heart, and the stomach, and therefore you would fall ill, you would contract a disease.
JC: London must have been teeming with dogs and cats.
CR: London was full of dogs and cats running around in the streets. This was long before there was an RSPCA or a Canine Defence League to neuter your pet. And there was a hierarchy of dogs, just as there was a hierarchy of humans. At the top, you have the greyhounds, the sporting dogs, the ladies' dogs, the butchers' dogs, the farmers' dogs. Then you have the curs and the mutts – these are vermin. They're rather like the sick poor lying in the gutter.
The dogs were literally exterminated. The rationale for this was that the seeds and vapours of disease clung to their mangy coats. And you're not going to have a dog come into your home if it's going to bring disease with it. They were a source of pestilence.
JC: What were the dog whippers?
CR: Dog whippers go back to pre-plague days, when their job was to get dogs out of churches. In those days, churches were very busy places with all sorts of people in them. In plague times, dogs had to be rounded up and exterminated as quickly as possible and this is what the whipper would do. The records of cities throughout England record astronomical numbers of dogs rounded up and slaughtered as a sanitary measure at exactly the same time as the streets were being cleaned and refuse was being removed.
JC: Is there any way of telling how many dogs were slaughtered in 1665?
CR: Oh, thousands and thousands. Civic records in various parts of England record numbers of almost 5,000. They're being rounded up more than rats. The dog, rather than the rat, is seen as an agent, a vector of disease. It's only much later, in the 19th century, that the rat becomes this figure of fear and loathing. In 1665, people are focusing on dogs and cats.
JC: It's ironic that killing dogs and cats eliminated the natural predators of the rat.
CR: It's ironic that all these animals are being exterminated when, in fact, they would be able to kill the rats that are spreading the disease. But this is an age before microscopes. It's an age when people believe that the seeds of disease adhering to these mangy curs are actually causing them to fall ill. And given the fear and terror that people felt, you would take any measure to clean your streets and protect yourself.
JC: These dogs could move around the parish and transport the disease across large areas.
CR: This is very much the case. If you look at depictions of medieval or early modern towns, there's always a dog there. There are packs of feral dogs roaming around London parishes, and the obvious response is to get them off the streets. Pigs, too – people are supposed to keep their pigs at home. When you think about it, this is not what you should be doing in a time of disease. But it's taking the filth and the squalor away from the public places, and this is what people are keen to do.
JC: So when plague started to rage a little hotter and it jumps from the west of the city right to its heart, it must have seemed quite logical that it was carried by dogs.
CR: Yes, it's very obvious that, when you see plague moving so quickly, there is a specific vector. The dog is easy to blame because it is visible – dogs are running around in the streets and, of course, dogs are found in houses of people who die of plague. You put the dog down if there are plague deaths in the house. It's one of the first measures that you take.
Preventing the plague
JC: Did people use alcohol, tobacco and drugs during the plague?
CR: You can't really distinguish between prophylactic [preventatives] and treatment for the plague – the two merge together. Using opiates, for example, would induce a sense of well-being. Physicians argue that your mental state is crucial because, if you're miserable or fearful, you're more likely to succumb. So that helps to keep up your spirit. The idea is that you prevent corrupt material coming into the body but, at the same time, you fortify the body against it and keep away the miasmas of disease. Tobacco would certainly have done this, because it got rid of all those droplets in the air, replacing them with a sweeter-smelling, more agreeable savour, at least to the people of the time.
JC: When plague first came and started to move across the city, it must have been terrifying.
CR: Absolutely terrible. This is one of the great problems because people believed that fear would make you vulnerable to disease, that it would weaken your vital spirits and make you more susceptible to it. So something like having a good drink that would make you feel more cheerful was medicinally OK.
JC: The bizarre treatment of suckling a woman – can you give some logic to that?
CR: Boghurst writes about having a mastiff at the breast of a woman to protect her against the plague. This must seem to us to be one of the wildest and weirdest ideas about disease, but in fact, it is medieval tradition. You apply an animal to one of your lower extremities – often a decapitated pigeon or cock – and that sucks out the corrupt humours from your body through the pores and makes you fit. So there is a logic behind it, albeit one that we would find rather bizarre.
JC: People believed that if you caught a sexually transmitted disease, this helped to stop you getting the plague?
CR: A few people had the idea that, if you got yourself infected with syphilis or the pox, that would prevent you from being infected by plague. The rationale behind this is quite logical: you use one poison to drive out another poison.
JC: Would any of the preventatives or treatments tried then have really worked?
CR: I think there are one or two precautions that would have been successful. Let me cite one, which is James Angier, who was a celebrated authority on fumigation. He persuaded the Privy Council to let him experiment in High Holborn where he burned quantities of saltpetre, brimstone and amber. The stench must have been so astonishing that any rat with a vestige of sense mechanism in its body would have fled.
Ideas about cleaning houses would have been relatively effective, too. Burning infected clothing and, of course, quarantine may have been very effective, if done in time. The problem is that you're quarantining healthy people as well as sick ones, which is a desperately serious business and one that made people so frightened and want to flee.
JC: As the epidemic strikes the city of London, coming to the edge of your street, coming to your neighbours, presumably you would do everything you could to protect yourself?
CR: What I would do if I could is run. If I couldn't leave the city, I would invest very heavily in perfumes, in fumigants. I would keep myself to myself, avoid contact with other people and barricade myself with sweet- smelling odours, clean the house, make sure there are no corrupt smells around and kill off any stray cats or dogs or wandering geese or other animals that happened to be in the vicinity.
Treating the disease on the Continent
JC: Can you compare the response to the plague in England and on the Continent?
CR: In London, the facilities for incarceration of people in plague hospitals are not so well developed as they are on the Continent. Rather than removing infected people out of the city, London tends to go for shutting people up in houses, which has a terrible effect on those who are left behind. The despair and fear this engendered must have been tremendous.
The effects go far beyond this. How are you going feed people once they are locked up and shut away? The infrastructure is often not there to make this possible, and that is something that heightens the sense of fear, detachment and isolation in ordinary people. What you're doing is sacrificing the few in the interests of the many.
JC: Is there any way of judging if pest houses – plague hospitals – on the Continent actually were more successful in preventing plague epidemics than shutting people up in houses?
CR: It's very difficult to tell. What we do know is that quarantine regulations may have been one of the great contributors to the disease disappearing. Quarantine is obviously one of the best means of dealing with a disease.
Religion and medicine
JC: What was the 'king's evil'?
CR: One of the things that we have to remember is that religion and medicine are closely intertwined in this period. This is quite apparent in the touching for the 'king's evil', or scrofula – a tuberculoid inflammation of the glands in the neck. This goes back to the time of Edward the Confessor in England. The king, the anointed of the Lord, is believed to have the power to touch and cure this disease.
When Charles II comes back in 1660 to reassert his royal power, his divine majesty, he begins to touch. The figures are astonishing – over 100,000 people are believed to have been touched for this and allied diseases during his 25-year reign. This sets the seal on his Stuart kingship, marking him out as elect, as chosen, and placing a great distance between him and the parliamentary regime that has gone before
JC: Was he touching rich and poor?
CR: Oh, he was touching everybody. He made a great thing about this – after all, it's wonderful propaganda, isn't it? People came from all over England, Scotland and Wales and queued up to have the royal hand passed very gently over them. They were given a medal, which became an amulet and had, people believed, healing properties itself. They went away at least comforted if not totally cured. This disease can go into periods of remission, so there was always a very good chance of a royal miracle.
JC: So very different to plague ...
CR: Very different to plague, but in the same continuum. The idea that diseases may be cured through God, or through God's representatives on earth, is always in the background when we look at the plague in London. People believed that it was caused because of divine displeasure, as well as through the more 'scientific' explanations of seeds of disease or vapours.
JC: So they must have been heartbroken when some of the clerics and so many of the doctors left?
CR: The sense of betrayal at the departure of physicians and, especially, of preachers must have been tremendous. Here were people who were supposed to intervene with God and they were abandoning their flocks. But this is a theme that goes right back throughout the history of plague. Physicians were particularly censored for this. Even the great Galen left Rome during an epidemic of the plague – he knew what was coming and he took the most sensible step.
JC: It must have been terrible for those who couldn't leave.
CR: It is almost impossible to evoke that sense of terror that people must have felt, a certainty that someone in their homes if not themselves would be struck down. And this feeling of fear, argue members of the medical profession, may actually contribute to one's likelihood of getting the disease. One's reaction would be to try and raise the spirits, possibly by turning to alcohol.
It's interesting that, at the start of the plague, [Samuel] Pepys says he's never felt so cheerful and so happy. But his feeling of euphoria evaporates very quickly as he begins to see death all around him. For the poor, it must have been infinitely worse.
The effects on society
JC: So does an epidemic like this change society? Does it change the way people relate to each other?
CR: Oh, it certainly does. It breeds fear, suspicion. People turn on each other. People become absolutely terrified of contagion. One can imagine what it would have been like – a great grim reaper creeping towards you – and you're going to take the most extreme steps to escape or get rid of it. On the other hand, some people are motivated by a religious imperative. We find people like Boghurst who is willing as an apothecary to go and visit his patients who have been struck down by the plague. So I think it's easy to paint a totally black picture of fear and loathing that isn't totally accurate.
JC: Was the plague something people were very used to?CR: By 1665, plague had been around in England for a very long time. It had been endemic since 1348/49. And it had broken out on, average, every 15 years or so, with local epidemics occurring in between. So every generation of people who had lived between those dates would have had some experience of bubonic, pneumonic or septacaemic plague. So they'd lived with it and had grown accustomed to it.
JC: You don't think people had forgotten about it?
CR: No, I don't think so. I think plague makes such an impact on the subconscious that it stays in the memory for a very, very long time. It's worth noting that, 40 or 50 years after the last plague in England, people were still very panicked when they heard that it was coming across the Mediterranean. They were still afraid that it would break out in England.
I think it's very hard for us to imagine the impact this had on the collective unconscious of people in this society. It's lurking there in the woodwork all the time, waiting to spring out. I think it was a very long time before people became comfortable and felt that it had finally gone away.
JC: Was it like waiting for the 'Big One' in California? Is that a relevant analogy?
CR: Yes, I think it may be. I think there's always something that worries us that will happen again, like waiting for the Big One in California. And although towns and cities such as London recovered quite quickly – surprisingly quickly to us – the knowledge that plague was there waiting to strike again did not go away. In cities such as Norwich, there was a constant reminder in the iconography – the pictures – with which people surrounded themselves. There were images of death and people lived with these. They saw them every day whenever they went to church. Death remained with them.
