Cause or Cure? Treating the plague

It's 1665 and London is a bustling, crowded metropolis. The cobbled streets, slippery with animal dung and slops, are narrow and full of people, and the stench of rotten food and sewage fills the air. Increasing numbers of people begin to fall ill with a disease known as the Black Death, and feared above any other. Michelle Wallis is a PhD student researching the history of medicine. She explained to Chris Smith what London would have looked like at the time of the plague, before putting our audience's 17th Century medical skills to the test...

Michelle - Well first of all, the red crosses were a big thing. You would look around your parish because this thing was sort of enlisted on a parish level and you would see the houses of your neighbours shut up. And you could see them in there having food passed in and know that they were dying and you would remember the last plague of 17 years before and you would see the dead carried out and just the atmosphere of fear, and everybody who could leave doing so, and leaving you behind.

Chris - What was it actually like in London at that time? How many people lived in the average house? What were conditions like to live in?

Michelle - For the poorer sort of people, lots and lots of overcrowding, and that was probably something that absolutely contributed to the plague. You would have large families pushed into very, very small dwellings.

Chris - When someone did die, what provisions were made for dealing with dead bodies?

Michelle - Not sufficient ones. Basically again, that was handled on the parish level. So basically, once your parish grave digger caught the plague or the clerks who record the death and the people who pick up the bodies, you just end up getting piles and piles of corpses that instead of being buried properly we might be thrown into a large pit with a small sprinkling of lime over them and they wait for the next one.

Chris - People in those times though had no concept of what disease really was, what caused disease or caused disease to spread. So, did they regard these bodies as an infectious disease threat or did they think only the living person was a disease threat?

Michelle - They absolutely regarded them as a threat. They had very different ideas about what caused disease but they absolutely had an idea of contagion. They just thought of the contagious thing, rather than being a bacteria as we think of it, as a bad air. If you think about it, corpses produce quite a lot of bad air. So, they were definitely seen as being a problem.

Chris - So, what was their concept then of what these bad airs were and how they spread and how the plague was getting around?

Michelle - Well, they were exhaled by people. You took them in through the pores of your skin. So, that's why you would smoke tobacco because that's a nice sweet, strong smelling thing that protect where you breathe. It's not just the people who had the plague who were shutting up their houses. People would voluntarily not nail the doors shut obviously, but keep all their doors and windows closed, light large fires, throw sweet-smelling things like herbs on those fires. And basically, if you saw like an object that you thought might be infected with plague, there's a great one in Defoe's Journal of a Plague Year - was a pocket watch they think was dropped by a plague victim. And they blow it up with gunpowder.

Chris - Well, timely. There were also reports of people doing things like - I mean, they regarded anything that someone had touched as potentially infectious. They would make people pass money through pots of vinegar or acid and things to cleanse it.

Michelle - Yes, absolutely. So, you can't think of a miasma just as in the way that we think of it.

Chris - Miasma is the stink that you're referring to.

Michelle - Yeah, the bad air. We would refer to as a miasma. But think of it as particles that cling to things. So for instance, they also definitely had a concept of it being transferred in cloth. Cloth is something that is often seen as a transmitter of plague and yes, money absolutely. And so, they would burn the belongings of people who died of plague.

Chris - Were there any doctors around who did epidemiology, the science of actually looking at how things spread around? Was anyone trying to work out at that time for academic or other reasons what was going on?

Michelle - To me, there's two questions there because epidemiology today is very much a question of statistics. They were obsessed with the statistics of the Black Death. Plastered up on walls, everywhere you looked would be posters that included the number of people who had been shut up or had died of plague.

Chris - So people were writing that down.

Michelle - Absolutely. we have very, very good records of that up until the point the parish clerk starts dying. But this is something people are very interested in. So not just the statistics of the current plague, but you would have in very, very cheap print that was put up on the walls everywhere and handed out in the streets, you would have list of the statistics for the last plague, for a plague that happened in the time of Queen Elizabeth. And then the question of physicians - what are physicians doing? Well, lots of things and 1665 is very interesting because there's been lots and lots of plagues in England before. But by this point, there are a couple of different strands of medicine kind of fighting for dominance in London and there's the established Royal College of Physicians who practiced what we called Galenic medicine which is about balance. And we have the Society of Chemical Physicians which is a little bit different and they're both trying to get you to take their drugs and use their methods.

Chris - It sounds like today.

Michelle - Yeah, a little bit like that.

Chris - I bet posting all these plague numbers on walls did wonders for morale.

Michelle - Well, it did when they started dropping! So, it's all about information. If you feel informed, you feel in control.

Chris - Is this why we have such a good insight into the history that you're relating to us because we've got those records?

Michelle - Yes, absolutely. We don't just have the records kept by the parishes themselves, but they were all collated at a central point every day. We have that in huge numbers, so we know exactly where the first plague case was in each outbreak, which parish it spread through first, which is how we can see how it fits with overcrowding, poorer areas, bad sanitation. Not that anywhere in London had good sanitation at this time, but yes.

Chris - Thank you very much, Michelle. Stay there because Ginny has got a little game in mind for us now. Ginny, what are you going to do?

Ginny - Well, now you know a little bit about how doctors try to treat the plague and how people believed it spread. We're going to play a game of Cause or Cure. So, I've got some items here on the table. What I want you guys to do is have a guess as to whether you thought that this item is something that back then they believed could cause the plague or at least make you more likely to get it or whether it's something that they thought could cure the plague or prevent you getting it if you didn't have it yet. What should we ask them about first? 

Michelle - It's so hard to choose. Should we start with this one?

Ginny - Okay, so what we've got here is a pair of ballet shoes and that represents dancing. Dancing and leaping. I'm going to ask you if you think it's a cause or cure and I want you to cheer for which one you think it is. So, who thinks it's a cause? Who thinks it's a cure?

Audience - Clapping.

Ginny - Now, that's interesting. Well, I guess dancing, leaping exercise is quite a healthy thing we think of now. What do they think back then?

Michelle - They thought it opened the pores of your skin and let the plague in. So you're all wrong, sorry.

Ginny - So, no dancing if you want to stay safe from the plague. Now next, I've got a lovely bunch of rosemary which I picked from my garden this morning. So, who thinks that's a cause?

Audience - Few cheers.

Ginny - And who thinks rosemary could be a cure?

Audience - More cheers.

Ginny - So, that's a very strong smelling herb. So, I guess that was to prevent the miasmas from getting to you.

Michelle - Yeah and absolutely, it's a very popular one to burn inside your house.

Ginny - So, there were loads of different herbs that they thought were curative or preventative at least. What should we go for next? This is a slightly suspect looking, little vial of a sort of yellowish liquid. Can anyone guess what that might be?

Male - Urine.

Ginny - Urine, yes. Well, it's not. It's apple juice, but for the sake of today, we're going to say that's urine. It's actually special urine. It's urine from a healthy male virgin. So, who thinks that could be a cause of the plague?

Audience - No answer.

Ginny - No. Who thinks it could be a cure?

Audience - Clapping.

Ginny - So, what are we supposed to do with that?

Michelle - You're supposed to mix it with Venice treacle but it's a very expensive ingredient and it's not actually treacle. It also involves viper flesh, for instance, and with another sort of plague water and then you drink it, often.

Ginny - Anyone fancy trying it? No? No takers? What about some strawberries? They look a bit tastier. Who thinks they could be a cause?

Audience - Cheers.

Ginny - Who thinks they could be a cure?

Audience - Cheers.

Ginny - A split about 50/50 on that one so who's right?

Michelle - They are a cause. You should abstain from sweet fruits. If you must eat fruit, go for the sour ones.

Ginny - Smiley face. So, this is representing happiness. Who thinks happiness would be a cause of the plague?

Audience - Few cheers.

Ginny - Not sure on that one. Who thinks it would be a cure?

Audience - More cheers.

Ginny - What's the answer?

Michelle - Yes, you should try and keep happy as your friends and relatives are dying around you.

Ginny - So on the contrary, sadness was seen as, if you're sad, you're more likely to get the plague.

Michelle - Yes, absolutely. if you're sad, if you're melancholy, that's bad for your balance and you might die of the plague.

Ginny - Now, this is an interesting one. What I've got here is a collection of feathers. They're quite brightly coloured feathers. So, they're not necessarily a normal chicken but they are to represent a plucked chicken or pigeon.

Michelle - Preferably pigeon.

Ginny - So, who thinks a plucked chicken could be a cause of the plague?

Audience - Few cheers.

Ginny - And who thinks it could be a cure for the plague?

Audience - More cheers.

Ginny - We're about 50/50 again on that one.

Michelle - It's a cure. The question is, where is it plucked? And what do you do with it? You take a pigeon for preference and you pluck the feathers out around its bum and you put it bare bum side down on whatever blotches, whatever buboes, whatever swellings you have, whether they're in your neck, your armpit or your groin. And you leave it there for a while and it's supposed to draw the poison out. And so then basically, you remove said bare bummed pigeon and hope that it dies because if it dies, that means it's taken all the poison out.

Ginny - And if it doesn't die?

Michelle - Yeah, it's not good for you.

Ginny - Poor pigeon.

Michelle - Yeah, well hopefully.

Ginny - Okay, last two. We've got some dried figs and some walnuts. Now, this one looks a bit more appealing. Who thinks that's a cause?

Audience - Silent.

Ginny - Who thinks that's a cure?

Audience - Cheers.

Michelle - Yeah, you're absolutely right. There's a really popular recipe that they've put in the broadsheets I was talking about. For a fig that you cut it open and you put a herb called Rue in it and then you'll hold it in your mouth or close to your mouth or chew it when you go out of the house and expose yourself to danger.

Ginny - But isn't a fig quite a sweet fruit?

Michelle - Yeah. So, early modern medicine quite contradictory.

Ginny - And one final one, God. Who thinks God is the cause of the plague?

Audience - Few cheers.

Ginny - And who thinks God was the cure for the plague?

Audience - More cheers.

Ginny - Well, you're all right. Everything was put down to God.

Michelle - Absolutely. They went into all the stuff about bad airs and so on and so forth, but ultimately, you had to start praying.

Ginny - Fantastic! Thanks, Michelle and well done everyone. I think you all could probably go out now and be early modern doctors if you wanted to be.