But we have, moreover, to survey the disease in another point of view, namely, in relation to its peculiar character. In the outset we designatedthe Sweating Sickness as a rheumatic fever, and if we take the notion of a rheumatic affection, as in propriety we ought, in its widest acceptation, weighty and convincing grounds have been adduced in the course of our whole inquiry in confirmation of this view. When we observe that those very nations were visited by the Sweating Fever, which are characterized by a fair skin, blue eyes, and light hair—the marks of the German race, it may with justice be assumed, that even this peculiarity in the structure of the body rendered it susceptible of this extraordinary disease. It is this which causes the proneness to fluxes of all kinds, and which makes these diseases endemic in the north of Europe, whilst the dark-haired southern nations and the blacks in the tropical climates remain, under similar circumstances[376], more free from them. If it be remembered further how overcharged with water were the lower strata of the atmosphere in which the pestilent Sweating Fevers existed, what thick and even offensive mists prepared the way for the disease and indicated its approach, what rapid alternations of freezing cold and excessive heat took place in the summer of 1529; and, moreover, how frequent all kinds of fluxes were in this very year, the complete form of the rheumatic constitution will be recognised in every individual feature.
Did we possess in the showy systems of modern times a maturer knowledge of the electricity of living bodies, much light would of necessity hence be thrown on the great object of our research. We should not then be compelled to rest satisfiedwith the fact that a cloudy atmosphere abstracts electricity from the body, robs the skin and lungs of their electrical atmosphere, disturbs their mutual electrical relation with the external world, and by this disturbance prepares the body for rheumatic indisposition, with all that peculiar decomposition of the fluids, irritable tension of the nerves, fever, and painful affection of particular parts, with which it is accompanied. If this disturbance be represented according to certain new and inviting hypotheses, supported by some important facts[377], as being perhaps an accumulation of electricity in the interior of the body, owing to a morbid, isolating activity of the skin, we may expect a more perfect knowledge of the nature of rheumatism through the medium of future diligent researches; and until these be made, some evident signs of connexion between rheumatic affections and the English Sweating Sickness will perhaps be sufficient to demonstrate the rheumatic nature of this latter disease.
In the first place, the very greatsusceptibility of those affected with the Sweating Fever to every change of temperature—the decidedly great danger of chill. In no known disease does this irritability of the skin shew itself in so prominent a degree as in rheumatic fevers and in those non-febrile fluxes in which there even exists a very evident sensitiveness tometallicaction.
Secondly,The tendency of the rheumatic diathesis to come to a crisis through the medium of a profuse, sour and offensive perspirationwithout any assistance from art[378]. The English Sweating Sickness manifests this commotion of the organism in the most exquisite form hitherto known; for it admits of no kind of doubt that the sweat in this disease was of itself, and in itself, critical, in the fullest acceptation of the term.
Thirdly,The peculiar alteration in the fundamental composition of organic matterin rheumatic diseases, in consequence of which volatile acids of a strange odour are prevalent in the sweat, and urine, and animal excretions. The English Sweating Sickness exhibits also this result of morbid activity in a greater and more striking manner than any other disease. Nor can we regard the tendency to putridity, which has been observed, as any thing but an increased degree of this condition.
Fourthly,The shooting pains in the limbs, the most decided sign of rheumatism, were not wanting in the English Sweating Sickness; nay, they became developed even to the extent of an incipient paralysis, and even the convulsions of those affected with this disease may not unjustly be attributed to the same source.
Fifthly,The tendency of rheumatism when it takes an unfavourable course to pass into regular dropsy, which is a consequence of the peculiar decomposition, manifested itself in the Sweating Fever in so marked a manner that the dropsy itself gradually destroyed the patient.
Should the sceptical still need another link in the comparison, we may adduce the miliary fever, a disease of decidedly rheumatic character. We must not, however, take as our standard the degenerate forms of miliary fever existing in modern times, but those grand and fully developed forms of the disease which occurred in the 17th and 18th centuries, and in which we find a similar odour in the perspiration, the same oppression, and the same inexpressible anguish, with palpitation and restlessness. The arms became enfeebled as if seized with paralysis, violent pains of the limbs set in, and unpleasant pricking sensations in the fingers and toes, resembling in all these particulars the Sweating Sickness, only pursuing a more lengthened and irregular course, and becoming developed altogether in a different manner.
According to this representation, the English Sweating Sickness appears as a rheumatic fever in the most exquisite formthat has ever yet been seen in the world, violently affecting the vitality of the brain and spinal marrow with their nerves, without, however, at all molesting the plexuses of the abdomen.The immoderate excretion of watery fluid, which in the mild cases alone took place, through a spontaneous curative power, while in the malignant forms it betokened paralysis of the vesselsand an actual colliquation, directs our attention further to theconsequent state of inanition, which very probably passed into astagnation of the circulation, in the same manner as takes place after every other sudden loss of the fluids, whether from sanguineous effusion or evacuations by vomit and stool. Hence the uncommonly rapid course of the disease, and partly, too, the fatal stupor[379]; hence, likewise, the very pardonable misconception with respect to the nature of the Sweating Fever existing even in more modern times. The sequela was more important and more fatal than the original rheumatic affection itself, which in its minor forms was mild and easily managed.
And thus is explained the wonderfully fortunate result of the old English treatment, which prevented this sequela, and avoided increasing the already too powerful efforts of nature to effect a cure. We have, therefore, nothing further to add to this judicious and truly scientific practice but our unqualified approbation;for it is the part of the physician, in diseases which have a spontaneous power of curing themselves, to leave this power free scope to act, and merely by fostering care to remove all obstacles to its exercise. Should it be the destiny of mankind to be again visited by the disease of the sixteenth century, (and it is by no means impossible that at some time or other similar events may recur,) we would recommend our posterity to bear in mind this eternal truth, and to treasure up the golden words of the Wittenberg pamphlet, namely, to guard the healing art from strange and unnatural farragos,for it is only when it is subordinate to nature that it bears the stamp of reason—the mistress of all earthly things.