At Home - Bill Bryson [187]
The worst disease of all, because it was so prevalent and so devastating, was smallpox. (Smallpox was so called to distinguish it from the great pox, or syphilis.) Smallpox was of two principal types: ordinary and hemorrhagic. Both were bad, though hemorrhagic smallpox (which involved internal bleeding as well as skin pustules) was the more painful and lethal, killing 90 percent of its victims, nearly double the rate for ordinary smallpox. Until the eighteenth century, when vaccination came in, smallpox killed four hundred thousand people a year in Europe west of Russia. No other disease came close to the totals smallpox achieved.
For survivors, smallpox was a cruelly fickle disease, leaving many of its survivors blinded or dreadfully scarred, but others unscathed. It had existed for millennia, but didn’t become common in Europe until the early sixteenth century. Its first recorded appearance in England was not until 1518. A bout of smallpox began with the sudden onset of high fever, accompanied by aches, pains, and powerful thirst. On about the third day, usually, pustules began to appear and to spread across the body in quantities that varied from victim to victim. The worst news was to learn that a loved one was “exceeding full.” In such cases, the victim became essentially one large pustule. This stage was accompanied by more high fevers, and the pustules would break, releasing a foul-smelling pus. If the victim survived them she would generally survive the illness. But her problems were hardly ended. The pustules now scabbed over and began to itch in a most agonizing manner. Not until the scabs fell off did one know whether or how seriously one was scarred. As a young woman, Queen Elizabeth was nearly killed by smallpox, but she recovered completely and without scars. Her friend Lady Mary Sidney, who nursed her, was not so lucky. “I left her a full fair lady,” wrote her husband, “ … and when I returned I found her as foul a lady as the smallpox could make her.” The Duchess of Richmond, who modeled for the figure of Britannia on the English penny, was similarly disfigured a century later.
Smallpox also had much to answer for regarding the treatments of other diseases. The release of pus led to the conviction that the body was trying to rid itself of poisons, so smallpox victims were vigorously bled, purged, lanced, and sweated—remedies that were soon applied to all kinds of conditions and nearly always only made matters worse.
Clearly not all of these dreadful maladies were directly related to washing, but people didn’t necessarily know that or even care. Although everyone knew that syphilis was spread through sexual contact, which could of course take place anywhere, it became indelibly associated with bathhouses. Prostitutes generally were banned from coming within a hundred paces of a bathhouse, and eventually Europe’s bathhouses were closed altogether. With the bathhouses gone, most people got out of the habit of washing—not that many of them were entirely in it to begin with. Washing wasn’t unknown, just a little selective. “Wash your hands often, your feet seldom, and your head never” was a common English proverb. Queen Elizabeth, in a much-cited quote, faithfully bathed once a month “whether she needs it or no.” In 1653, John Evelyn, the diarist, noted a tentative decision to wash his hair annually. Robert Hooke, the scientist, washed his feet often (because he found it soothing) but appears not to have spent much time damp above the ankles. Samuel Pepys mentions his wife’s bathing only once in the diary