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The great leveller: humanity's struggle against infectious disease

Plague 1665

Opening showing front pastedown and inscription on first free endpaperFront pastedown and inscription on first free endpaperThis image is from a copy of the first English edition of Nathaniel Hodges’ treatise on the plague, which was published in Latin: the customary scholarly language of physicians until well into the 18th century, in 1672.

The date of publication is significant, as the plague struck the French port of Marseille in 1720; this was the last confirmed outbreak of bubonic plague in Western Europe and Daniel Defoe’s A journal of the plague year was also published at this time. 

The anonymous contemporary inscriptions shown here refer to sections of the book which deal with the environmental causes and symptoms of plague. Plague did not reach Britain after 1665, in part because of effective quarantine measures at ports. When it claimed a British victim in Glasgow in 1900, this happened partly because regulations had been relaxed, in the name of free trade.

Nathaniel Hodges (1629-88) achieved some fame in his lifetime as one of the few physicians who stayed in London during the outbreak of plague in 1665. He did so at the behest of the Royal College of Physicians, which knew that the flight of their members during previous outbreaks had wrought immense damage to their collective reputation. That of apothecaries and surgeon-apothecaries with whom, to some extent, physicians saw themselves in competition, had increased. As long as rich clients still patronised them, physicians’ incomes were secure. However, they would not be able to defend their privileges against other parts of the medical profession without royal approval.

While Hodges’ decision to remain in London was not entirely altruistic, and not entirely his own, he nevertheless exposed himself to extreme danger. The costume which plague doctors wore (which covered the face) could afford only partial protection. Hodges relied on alcohol to keep him going during the plague, which may have become alcohol dependency, setting him on the sorry road to indebtedness, a debtor’s prison and obscurity.

The interest of Loimologia lies mostly in its being a first-hand account of the aetiology, epidemiology and symptoms of the plague. Hodges’ views diverge to some extent from the medical orthodoxy of his day, although he retained the basics of humoural physiology. He believed, along with Robert Boyle, that invisible particles, which were not necessarily localised, could cause disease, as well as localised environmental causes.

His perspective on orthodox treatments is more unconventional. He takes a dim view of phlebotomy, and thinks that purgative medicines are permissible only in certain circumstances. In this, Hodges reflects the influence of the 16th century medical theorist Paracelsus and the movement which he inspired. He was in favour of isolation of infected patients and shipping quarantines, practices which had spread throughout early modern Europe from 15th century Italian city-states.

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