The Sweating Sickness, known in Latin as Sudor Anglicus, was a highly infectious disease that swept through England during the late 15th and early 16th centuries. It first appeared in 1485, coinciding with the beginning of the Tudor era. The illness was acute and deadly, with victims often succumbing to death within 24 hours of the first symptoms. This rapid progression made it a source of widespread panic and an enduring historical mystery.
Clinical Description and Rapid Progression
The Sweating Sickness progressed swiftly through distinct stages. The onset was abrupt, often beginning without warning. The initial phase was the intense cold stage, involving severe shivering, dizziness, headache, and profound exhaustion. This cold phase, accompanied by aches in the neck, shoulders, and limbs, lasted from a half hour up to three hours.
Following the cold stage, the body transitioned abruptly into the “hot and sweating” phase. Violent, drenching perspiration broke out, accompanied by a high fever, a rapid pulse, and intense thirst. Victims frequently experienced apprehension, palpitations, and pain near the heart, sometimes leading to breathlessness.
The final stage was exhaustion and collapse. Many victims experienced an overwhelming, irresistible urge to sleep, which contemporary physicians believed was fatal if indulged. The disease’s lethality was defined by its speed, as death or recovery typically occurred within 8 to 24 hours of the first symptoms. Survival beyond the first day usually meant recovery, but the overall mortality rate was estimated between 30% and 50% in many outbreaks.
The Five Major Outbreaks (1485–1551)
The English Sweating Sickness occurred in five major waves over a 66-year period. The first outbreak in 1485 coincided with Henry VII’s ascension to the throne and raged in London until October. The second epidemic appeared in 1508, lasting from June to October, but remained mostly confined to England.
The third wave of the sickness struck in 1517, centered around London. This was followed by a much more severe outbreak in 1528, which was the only time the disease spread widely outside of England. It traveled across the English Channel to continental Europe, sweeping through Hamburg, Scandinavia, and toward Russia, though it largely bypassed France and Italy.
The fifth and final major outbreak occurred in 1551, terrorizing England but failing to spread to the continent, Scotland, or Wales. A distinctive feature was its tendency to disproportionately affect young, healthy, and affluent individuals. The disease was nicknamed “Stop Gallant,” as it seemed to strike the wealthy more readily than the elderly or the poor.
Historical Response and Contemporary Treatments
In the 15th and 16th centuries, medical understanding linked illness to corrupted air (miasma) and imbalances in the body’s humors. Physicians like John Caius, who documented the 1551 outbreak, advised people to avoid “evil mists” and maintain good hygiene, reflecting the belief that the disease was caused by atmospheric corruption.
The most common treatment was forcing the patient to sweat, based on the assumption that a noxious vapor needed to be expelled. Victims were immediately put to bed, covered with heavy blankets, and given herbal concoctions to encourage profuse perspiration and prevent exposure to cold air. Patients were also advised to abstain from solid food for the entire 24-hour course of the illness.
These contemporary remedies were largely ineffective given the high mortality rate. Public health responses included the flight of the wealthy from infected cities, such as the royal court frequently relocating. Attempts at quarantine and closing public spaces were made, but the swift nature of the sickness often rendered these measures moot.
Modern Hypotheses on Causation
The abrupt disappearance of the Sweating Sickness after 1551 makes its etiology a persistent medical mystery. Modern investigation focuses on identifying a viral agent that aligns with the disease’s unique profile. The leading theory suggests the cause was a viral hemorrhagic fever, specifically an unknown species of hantavirus or a closely related virus.
Hantaviruses are carried by rodents and cause severe, flu-like symptoms, with some strains leading to fatal pulmonary or renal syndromes. This aligns with historical descriptions of respiratory distress and rapid collapse. The association of the disease with periods of prolonged rainfall and flooding, which can increase human-rodent contact, also supports a rodent-borne pathogen theory. However, this theory is challenged because the Sickness seemed to transmit person-to-person and was geographically specific to England for most of its history.
Other discarded theories include relapsing fever, spread by ticks and lice, and various forms of influenza. Relapsing fever was ruled out due to the absence of a characteristic rash in most accounts. The disease’s sudden disappearance suggests the causal agent may have become extinct, possibly due to changes in viral virulence, shifts in rodent populations, or environmental factors.