From a disease standpoint, Shakespeare was living in arguably the worst place and time in history. Shakespeare's overcrowded, rat-infested, sexually promiscuous London, with raw sewage flowing in the Thames, was the hub for the nastiest diseases known to mankind. Here are the worst of the worst.
It is little surprise that the plague was the most dreaded disease of Shakespeare's time. Carried by fleas living on the fur of rats, the plague swept through London in 1563, 1578-9, 1582, 1592-3, and 1603 (Singman, 52). The outbreaks in 1563 and 1603 were the most ferocious, each wiping out over one quarter of London's population.
Lucky Elizabethans would contract the basic bubonic plague with their odds of survival around fifty percent. Symptoms would include red, grossly inflamed and swollen lymph nodes, called buboes (hence the name bubonic), high fever, delirium, and convulsions. However, if the bacterial infection spread to the lungs (pneumonic plague) or to the bloodstream (septicemic plague) the unfortunate victim would certainly die, usually within hours with symptoms too horrific to recount.
The Elizabethan pamphleteer Thomas Dekker wrote a chilling account of the chaos and despair brought by the plague:
Imagine then that all this while, Death (like a Spanish Leagar, or rather like stalking Tamberlaine) hath pitched his tents, (being nothing but a heape of winding sheets tacked together) in the sinfully-polluted Suburbes: the Plague is Muster-maister and Marshall of the field: Burning Feauers, Boyles, Blaines, and Carbuncles, the Leaders, Lieutenants, Serieants, and Corporalls: the maine Army consisting (like Dunkirke) of a mingle-mangle, viz. dumpish Mourners, merry Sextons, hungry Coffin-sellers, scrubbing Bearers, and nastie Graue-makers: but indeed they are the Pioners of the Campe, that are imployed onely (like Moles) in casting up of earth and digging of trenches; Feare and Trembling (the two catch-polles of Death) arrest every one: No parley will be graunted, no composition stood vpon, But the Allarum is strucke up, the Toxin ringes out for life, and no voice heard but Tue, Tue, Kill, Kill. (The Wonderful Yeare, 1603)
During the outbreak of 1592-93, the Crown ordered the complete closure of all theatres in London. Shakespeare, then working with Lord Stranges Men at the Rose theatre, would have been in the midst of a run of his Henry VI history plays (Bradbrook, 65), and likely financially devastated by the edict.
Shakespeare mentions plague in several plays, including The Tempest (1.2.426), Timon of Athens (4.3.120), and King Lear:
But yet thou art my flesh, my blood, my daughter;
Or rather a disease that's in my flesh,
Which I must needs call mine: thou art a boil,
A plague-sore, an embossed carbuncle,
In my corrupted blood. (2.4.242), Lear, describing his daughter, Goneril
Shakespeare also describes the act of searching out plague victims and quarantining them in Romeo and Juliet (5.2.7). Incidentally, plague is the indirect cause of the deaths of the star-cross'd lovers.
One of the worst outbreaks of smallpox occurred two years before Shakespeare's birth, in 1562. Queen Elizabeth herself, then 29, was attacked by the virus that causes high fever, vomiting, excessive bleeding, and pus-filled scabs that leave deep pitted scars. Although the Queen recovered she was rendered completely bald and forced to wear an extra thick layer of make-up made from white lead and egg whites.
Syphilis, one of the deadliest of all venereal diseases, spread rapidly throughout Europe in the 15th century. A current theory on the origin of the outbreak argues that Spaniards carried the disease home from the Americas in 1493. Elizabethans had many names for this foul malady; the most popular being the French pox, the Spanish sickness, the great pox, and simply, the pox.
Without antibiotics, Elizabethans would have experienced the full effects of syphilis, which included raging fever (referred to as "burnt blood"), tortuous body aches, blindness, full body pustules, meningitis, insanity, and leaking heart valves, known today as aortic regurgitation. According to a document written in 1585 by the famed Elizabethan barber-surgeon William Clowes, the victims of syphilis were so numerous that London hospitals had no room for the "infinite multitude."
Interestingly, Shakespeare's most famous mention of disease: A plague on both your houses!" (Romeo and Juliet), was, in the original printing of the play (the first quarto), "A pox of your houses" (3.1.60).
Shakespeare mentions syphilis often in his work and in Timon of Athens he alludes to the calamitous Elizabethan treatment of syphilis: the inhalation of vaporized mercury salts:
Give them diseases, leaving with thee their lust.
Make use of thy salt hours: season the slaves.
For tubs and baths; bring down rose-cheeked youth.
To the tub-fast and the diet. (4.3)
Epidemics of louse-borne typhus ravaged London several times during the reigns of Elizabeth and James I. Crowded, filthy conditions and a near total lack of bathing made room for body lice, which, when scratched, would defecate on a person's skin. It would take just one minor cut or sore for the typhus infected feces to enter the victim's bloodstream, and soon high fever, delirium, and gangrenous sores would develop.
The disease was a huge problem among prisoners. The poor wretches, most of them beggars, drunks, petty thieves and pamphleteers, who found themselves in the Newgate jail, would typically die before they could serve their full sentences. Shakespeare felt their pain:
If we mean to thrive and do good, break open the gaols and let out the prisoners. (2 Henry VI, 4.3.15)
Although we will likely never know what really caused Shakespeare's own death, a serious outbreak of typhus in 1616 lends credibility to the story that he succumbed to a fever.
Known to the Elizabethans as ague, Malaria was a common malady spread by the mosquitoes in the marshy Thames. The swampy theatre district of Southwark was always at risk. King James I had it; so too did Shakespeares friend, Michael Drayton. Without antimalarial medications, many Londoners would have experienced dreadful symptoms, including fever, unbearable chills, vomiting, enlarged liver, low blood pressure, seizures, and coma.
Shakespeare's characters speak often of ague. A common belief was that the sun spread the fever by sucking up the vapors from the marshes. In The Tempest, Caliban describes the process while cursing Prospero:
All the infections that the sun sucks up
From bogs, fens, flats, on Prosper fall and make him
By inch-meal a disease! (2.2)
So too does Hotspur in 1 Henry IV:
Worse than the sun in March,
This praise doth nourish agues. (4.1)
The facts are mind-boggling, especially when you consider that London's population hovered around a mere 150,000 during Shakespeare's lifetime. It is little wonder that the average life expectancy was 35 years.
How to cite this article:
Mabillard, Amanda. Worst Diseases in Shakespeare's London. Shakespeare Online. 20 Aug. 2000. < http://www.shakespeare-online.com/biography/londondisease.html >.
Adams, Simon. Elizabeth I : the outcast who became England's queen. Washington, D.C. : National Geographic, 2005.
Bell, Walter George. The great plague in London . London : Folio Society, 2001.
Bradbrook, M. C. Shakespeare, the poet in his world. London : Weidenfeld and Nicolson, 1978.
Picard, Liza. Elizabeth's London. London: Phoenix Press, 2003.
Singman, Jeffrey L. Daily Life in Elizabethan England. Westport: Greenwood Press, 1995.