The theory and practice of seventeenth century medicine is as foreign to us now as antibiotics and chemotherapy would have been to people then. Although scientific advances were made during this time, medical practice still relied largely on the teachings of the Greek physician Galen, who had died 1500 years earlier. He taught that there were four humours in the body: blood, phlegm, choler (or yellow bile) and black bile and that their balance in the body determined health. If there was an excess of one humour, disease could result, so, for example, too much black bile caused fever. Surplus humours could accumulate in the body and cause putrefaction. Blood-letting and purging were the only ways to treat these excesses.
Galen also developed miasma theory, which held that a polluted atmosphere, that is to say bad smells, carried disease such as plague. Miasma could be carried in clothes or bedding, and domestic animals, especially dogs, cats and pigs might carry it on their bodies from house to house.
Both these theories ran alongside a belief in divine intervention in the affairs of man. God could, and did, send plague and other epidemics to punish men for their sins. And to confuse matters further there was some understanding of contagion, that a disease could be passed somehow from person to person.
‘Miasma’ was a particular problem in parts of Hythe, as it would have been in any town. For reasons unknown, perhaps because it was private and not overlooked, the inhabitants used the lane leading to the Mount (now Mount Street) as an unofficial public convenience, or, as the corporation euphemistically put it ‘for easement of their bodies’. Naturally, it stank. The corporation introduced a fine of a shilling for anyone caught in the act, but it was not until the visit of the Lord Warden of the Cinque Ports in 1615 that the place was properly cleaned out. It must not be thought that the people of Hythe were exceptionally coarse in their habits: Samuel Pepys, on finding that no chamber pot had been provided in his lodgings, instead used the fireplace, twice, and Mrs Pepys was not embarrassed to use the corner of a street in London when caught short at the theatre.
Dangerous miasmas were also produced by people washing inappropriate things in the public water conduit, rather than carrying the water home with them and doing it there. In 1668 the corporation complained that ‘People are using the conduit to wash fish, innards, and clouts (probably babies’ diapers), whereby unwholesome savours do arise to the great prejudice and danger of the Inhabitants’. They imposed the usual fine, and people carried on just as before.
There were regular outbreaks of infectious diseases in every town. Smallpox became more prevalent during the seventeenth century. It killed about 15% of its victims, and often left survivors blind or scarred. The young were particularly at risk from measles, scarlet fever, whooping cough, influenza, and a multitude of now unidentifiable diseases. Locally, malaria was prevalent on the Romney Marsh, which was known as a ‘sickly and contagious place’ and ‘very aguish’ with high mortality from the disease.
It was, however, bubonic plague which, though relatively infrequent, was most devastating in its effects and most feared. The major outbreaks in England were in 1603, 1625, 1636, and 1665.
Hythe escaped the first bout, but was hit badly in 1625 when ninety-one people died, as against an annual average of about forty. In 1638, at the tail-end of the 1636 outbreak, there were eighty deaths.
In 1578 the government had issued Plague Orders, which with some modifications were in effect until 1666. Local magistrates were to raise a tax for the relief of the sick, order the burning of the clothes and bedding of victims, and funerals were to take place at dusk to deter onlookers. Houses where there was suspected infection were to be shut up for six weeks with all the members of the family, sick or healthy, locked inside.
The patterns of deaths seen in Hythe during outbreaks of plague tend to confirm that these orders were followed. In both 1625 and 1638 multiple deaths from single families are recorded, presumably because they had been quarantined. In a small town, this was a tough decision for the corporation to make. They were incarcerating their neighbours, friends and kinsfolk in the knowledge that this would almost certainly lead to agonising death.
The limited understanding of contagion led to other measures to protect the town. During the 1625 outbreak, the Cinque Ports Brotherhood and Guestling due to be held at New Romney in July was cancelled ‘by reason it pleased God to visit this kingdom with a great plague’. People took their own precautions, too. One Folkestone couple got a licence to marry in Hythe in December 1625, because the plague had run its course there whereas it was still ‘very hot’ in Folkestone, and ‘people are very fearful to meet together’. The Cinque Ports meeting was cancelled again in 1637 when the plague had reached New Romney. The burial records for Hythe for 1665, the year in which plague killed one-sixth of London’s population, are not extant so we do not know how badly it affected the town, but we do know that the corporation put the Plague Orders into effect. The fair was cancelled, and any innkeeper or other person accommodating someone from a plague area would be fined. The Mayor or a jurat was to approve bills of health for visitors to the town. Alexander Ames was shut up in his house as he exhibited signs of the sickness. He was one of the lucky ones, and survived another three years.
The haven in Hythe was another potential source of infection, as it brought in foreigners from infected areas. In 1629, the town was ordered to be especially careful as plague had broken out in Holland and France. Any vessel arriving from these areas was to be quarantined and all its goods to be thoroughly aired for as long as it took to ‘give hope and likelihood they are free from danger and infection’. As an additional precaution, one of the annual fairs in 1630 was cancelled.
Plague was often attributed to God’s judgement on a sinful nation, and towns wereL supposed to be particularly sinful. Since epidemic plague was concentrated in towns, the theory held water. The concentration of people and rats in towns was coincidental.
Remedies for plague included repentance and prayer, shutting south facing windows to keep out the injurious south wind, and burning the bedding of the sick (which may have helped). Theriac, commonly called ‘treacle’, was often prescribed. It contained opium (which also may have helped, at least with the pain) and viper’s flesh to destroy the poison of plague. A roasted onion stuffed with ‘treacle’ was the medicine most often recommended for the infected. If the patient did not respond, it was God’s will: medicines only worked by the grace of God, and as God has made us to die, medicines would do no good if the time had come. For the physician this was a splendid get-out clause.