The Disease Commonly Called The Sweate
January 24, 2010 10:02 AM   Subscribe

In the mood for a good epidemic? Try the English Sweating Sickness. To get a full picture of the horror and uproar a fast spreading disease with frighteningly sudden onset caused in Tudor England, here is an amazingly complete account by a contemporary physician. The exact etiology of the disease is still a mystery - perhaps a viral pulmonary disease (PDF in link).
posted by grapefruitmoon (30 comments total) 19 users marked this as a favorite
THE SWEATE: Coming this Fall!
posted by The Whelk at 10:04 AM on January 24, 2010 [3 favorites]

I think it was season 2 of "The Tudors" when this comes up, but could be end of season 1. Anyway, I remember looking at almost all of these links back then. What was weird to me was the break between onslaughts and why it was confined to only the areas where it struck. It's also strange that it's never come up again.
posted by cjorgensen at 10:12 AM on January 24, 2010

(Season 1 of the Tudors, and yes, I confess, the inspiration for this post though I also have a kind of historical girl-crush on Anne Boleyn and thus a bit of an underlying obsession with all things Tudor.)
posted by grapefruitmoon at 10:20 AM on January 24, 2010 [1 favorite]

"Its first appearance in London caused near panic. It began without warning and usually at night or in the early morning. The patient initially experienced chills and tremors and these were followed by a high fever and a great weakness. The body was covered with perspiration and, in most cases, a rash. It was extremely rapid in its course, being sometimes fatal even in two or three hours, and some patients died in less than that time. More commonly it was protracted to a period of twelve to twenty-four hours, beyond which it rarely lasted. Those who survived for twenty-four hours were generally safe and the perspiration was replaced by an abundant flow of urine. Recovery was complete within a week or two at the utmost. In those who did not recover the perspiration was quickly followed by a great thirst, intense headache, convulsions and coma with death arriving in an incredibly short space of time."

This is terrifying. Fine, fine fine, go to bed - BAM! Sweating, shaking and knowing you could die within hours.
posted by The Whelk at 10:22 AM on January 24, 2010

Let me guess, you just finished Wolf Hall?

I know I looked this up as soon as I was done. It's intense that they still don't really know what it was.

(Now I've moved onto the good old plague. I just finished Defoe's Journal of a Plague Year, and I've moved on to Year of Wonders by Geraldine Brooks. (So far, it's great.)

Nice post!
posted by OmieWise at 10:23 AM on January 24, 2010

Oh, sorry, I see it was the Tudors. Oh well.
posted by OmieWise at 10:23 AM on January 24, 2010

Too exhausting to read. Only made it this far: "Man beyng borne not for his owne vse and comoditie alone, but also for the comma benefite of many, (as reason wil and al good authoures write) he whiche in this world is worthy to lyue, ought al wayes to haue his hole minde and intente geuen to profite others." Tudor text with prologue by Karl Marx.
posted by A-Train at 10:23 AM on January 24, 2010 [1 favorite]

Hand-held fan
(Lyle travels through the living room, agitated by drink.)

Mr. Bear sits on the sofa with a hand-held fan.
Mr. Bear: AHHHH
Lyle appears with a bottle of liquor.
Lyle: Oooh! Look at the big woman with his little fan! Are you sitting on a doily, Mr. Lady-Lady?
Lyle: Better not get that too close to your uterus! It might freeze your dainty little ovaries!
Mr. Bear: Oh please. I'm just feeling a little hot.
Lyle: Maybe it's menopause! you ever hear of that, you dumb old broad? Ha ha ha!
Lyle gives Mr. Bear the finger
posted by Inspector.Gadget at 10:27 AM on January 24, 2010

Metafilter: Uery necessary for euery personne, and muche requisite to be had in the handes of al sortes, for their better instruction, preparacion and defence...
posted by Multicellular Exothermic at 10:31 AM on January 24, 2010 [3 favorites]

Was the 'ue' in 'uery' pronounced as a v at that time or as a w? Anyone know?
posted by spicynuts at 10:38 AM on January 24, 2010

Let me guess, you just finished Wolf Hall?

Hey, I'm reading that right now, and it's about 1000 times better than The Tudors
posted by KokuRyu at 10:41 AM on January 24, 2010

The symptoms are so close to those of malaria that it's odd Kaye doesn't compare it to marsh fever or ague, which, one would assume, a physician of his prominence would know all too well.
posted by Sys Rq at 10:55 AM on January 24, 2010 [1 favorite]

But does malaria kill overnight?
posted by KokuRyu at 11:07 AM on January 24, 2010

Anyone know who drew that first picture, in the first link? Two skeletons are dancing, and it looks like the one holding its intestines is twirling one of them. Sort of awesome.
posted by shinyshiny at 11:34 AM on January 24, 2010

Was the 'ue' in 'uery' pronounced as a v at that time or as a w? Anyone know?

"u" and "v" were not yet distinct letters. Read the "u" as "v" where it should seem to be a "v", if that makes sense.
posted by DecemberBoy at 11:39 AM on January 24, 2010

SysRq I suspect KokuRyu's idea is what kept them from a diagnosis of ague. various fevers and agues and malaria, generally, tend to have a much slower onset and rate of progression and though any of them can most certainly be fatal, I've never encountered a historical episode of an epidemic of fever (ie 'tertian fever') with that sort of mortality rate...

if you are interested in disease in history The Encyclopedia of Plague and Pestilence is a lotta fun!!!
posted by supermedusa at 11:40 AM on January 24, 2010 [1 favorite]

I'm going to take a wild guess and assume Madagascar closed its ports then, too.
posted by WolfDaddy at 11:49 AM on January 24, 2010 [7 favorites]

How utterly fascinating!
posted by gomichild at 12:53 PM on January 24, 2010

Oh yeah, I remember this disease being referred to in some of Alison Weir's various accounts of the Tudors. Henry 8 was super-paranoid about illness anyways, right? I bet this totally did his head in.
posted by gaspode at 1:07 PM on January 24, 2010

I think it was in Bill Bryson's (excellent) A Short History of Nearly Everything that I read the theory was that some diseases like syphillis used to be more intense, in that they killed you faster and more gruesomely than they do now; however this also made them die out or evolve because they killed people too fast to spread the disease, and were at a disadvantage to chronic, longer lasting diseases, evolutionarily speaking. He mentions the "sweate" as possibly one of these.

Must also mention Connie Wills' Doomsday Book, which has time-traveling and the plague and lots of fascinating history bits in it. Though it is sadly dated due to Ms. Willis not anticipating cell phones, and tying some plot lines to being unable to get through to people on the phone. Otherwise, good stuff.
posted by emjaybee at 1:07 PM on January 24, 2010 [1 favorite]

Was it too early for cholera?
posted by jokeefe at 1:54 PM on January 24, 2010

Wills' book is good.

I think what's so terrifying about these plagues, or perhaps uncanny, is that they only have the faintest idea of what transmitted the infection. So the sickness really does seem supernatural. In a weird way Journal of a Plague Year tracks better with Aharon Appelfeld's novels, where the Holocaust is about to happen but no one fully understands why or how (In The Land of the Cattails features a young man seeking out a train station so he can get on a train going to the camps, because he's lonely and no one actually knows where the trains go), than it does with Camus' The Plague, where there is horror from the disease, but the mechanics of it are fully understood.
posted by OmieWise at 2:58 PM on January 24, 2010

it ravaged the whole of England but always stopped at the Scottish border.

Aha, there's your vital clue! Round up the Scots!

Excellent post, thanks much. And I look forward to Wolf Hall.
posted by languagehat at 3:12 PM on January 24, 2010

Wow I just finished Wolf Hall this morning. This could not have come at a better time. Thanks!
posted by nev at 3:45 PM on January 24, 2010

Let me guess, you just finished Wolf Hall?

No, but it's been suggested to me and I'm gonna get right on that as soon as I'm done with the book I've got going now. (At the rate I'm progressing, I'm guessing that'll be somewheres around March.)

Henry 8 was super-paranoid about illness anyways, right? I bet this totally did his head in.

Oh yeah. He moved around like... a guy who moves around a lot. He wouldn't even LOOK at anyone who may have possibly been in contact with someone who might have had "the sweate." Anne Boleyn came down with a "mild" case of it and he sent his doctor, but refused to visit her personally.

The Tudors has a great scene with Henry's "medicine cabinet" of potions to "ward off" the sweat.
posted by grapefruitmoon at 4:19 PM on January 24, 2010

That reminds of the dancing mania
posted by Damienmce at 5:47 PM on January 24, 2010

I think what killed the people who got "the Sweate" is Malignant Hyperthermia.

The signs and symptoms are right, as are the commonness of death and the the very short interval until death in many cases.

In modern North America, we see MH when it's triggered by administering Halothane anesthetic to genetically susceptible individuals.

However, MH can also be triggered by malaria, and I am convinced Sys Rq's inspired observation is exactly right-- it looks like malaria because it is.

Malaria has been known in England possibly since Roman times, and there are six kinds of mosquitoes in England which can carry the parasite. Most telling of all, in my opinion, according to grapefruitmoon's third link, in every instance the outbreaks of the Sweate occurred in a year of extensive flooding, which would have had the effect of providing may more places for mosquitoes to breed in proximity to people's dwellings than would have existed in a normal year.

Why no outbreaks after 1581? Well, in the early 1600's "Jesuit's Bark" from Peru (containing Quinine) began to be available in Europe. In addition, the fact that infection conferred no immunity is consistent with malaria, and the fact that family members often tended to come down with the fever within hours of each other would be an expected pattern for a mosquito vector which could easily have exposed family members virtually simultaneously.

A number of the accounts mentioned in the links claim the disease tended to afflict mainly those of English blood, and spared foreigners living in their midst. I think this could be explained if people of English descent had had relatively less exposure to malaria historically than foreigners, under the assumption that malaria would have selected very strongly against the genotype which produces susceptibility to Malignant Hyperthermia. I was unable to find much information about ethnic background and MH, but what I did find tends to support the view that malaria reduces the level of MH in a population:

MH has been rarely reported in individuals of black African descent (4–7). Its incidence in individuals of African descent may be as small as 1:250,000, whereas another study reported one case of MH in 170,000 anesthetics (4,7). Further, in studies from South Africa, MH has been reported only in individuals of Caucasian or mixed race (9).

However, the level of the gene for sickle cell anemia, which is highly deleterious in ordinary circumstances, is found in some populations of African descent at levels approaching 50% because of the benefits it confers in areas where malaria is endemic.
posted by jamjam at 7:44 PM on January 24, 2010 [10 favorites]

I just wanted to say that John Caius has got an absolutely kick-ass tomb, featuring the excellently laconic epitaph 'FUI CAIUS'.
posted by hydatius at 6:55 AM on January 25, 2010

Wolf Hall is awesome. One of the best books I read last year. I cannot recommend it enough (Also, Hilary Mantel is an extraordinary writer).
posted by thivaia at 7:12 AM on January 25, 2010

The symptoms are so close to those of malaria

Not really. The cold sweats and violent shivering, yes, but with malaria you get extreme exhaustion. Also, malaria follows cycles as your blood cells are infected and act as incubators for the next round of infection: basically, you feel like shit, then you start to feel better, then you finally think you've turned a corner and it's all behind you, then your infected red blood cells burst with millions of new pathogens that go and infect the next round of red blood cells, causing the fevers/chills/violent shaking. Lather, rinse, repeat. With falciparum, you get maybe three weeks of this before your body starts to shut down. Your liver & spleen go, then your brain bakes during one of the fevers, then your lungs fill up with fluids and you die.

The worst part is the feeling of suffocating to death. Since your red blood cells are the primary means of oxygen distribution in your body, you basically are suffocating internally. Small movements take Herculean levels of effort and concentration. I remember trying to drink a glass of orange juice, thinking I had the worst case of flu imaginable. Took me almost an hour to finish the glass—every sip felt like I'd run a mile.
posted by Civil_Disobedient at 4:56 PM on January 25, 2010 [2 favorites]

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