64 • Beginningsizens spoke of buboes and tokens and the terrifying frenzy or stupor of a vic-
tim’s last hours. But could one be sure it was plague? What about all the
other possible diseases?
Since the previous autumn physicians had noticed an unusual amount of
sickness for any number of ailments, from the ever dangerous smallpox to a
respiratory ailment called tissick.Dr. Hodges had a heavier-than-ever work-
load of city patients. Out in Westminster Dr. Sydenham was finding the
same thing. The pattern held in the northwestern suburbs. “Small pox was
soe rife in our parish,” Boghurst reported, that about forty families were in-
fected by it within 120 paces of the church.
By all reports the increase in these sicknesses persisted through the winter
and was continuing into the spring season, along with the onset of plague.
But were all these other maladies killing people or just making them sick? In
short, were Londoners heading pell-mell into another great plague, or had a
Pandora’s box of many killing diseases sprung open?
Take smallpox, for example. It was a very serious contagious disease, and a
moderate epidemic of it was clearly under way. However, smallpox was not
known to be as lethal as would be indicated by the numbers reported in the
Bills of Mortality this April and May. In the winter, the city barrister Bul-
strode Whitelocke had kept his children at the family’s country home be-
cause of the threat from smallpox. Four of them came down with it despite
precautions, one after the other in a matter of days. By mid-February, all
were fully recovered, “through God’s goodness.” Smallpox epidemics could
occur in any season, and mortality could reach as high as 20 percent—high
enough to send waves of terror through any infected household but far lower
than the 50 – 80 percent routinely observed for plague.^20
Smallpox told only part of the story of increased mortality. In April and
again in May, an unusual variety of diseases claimed high numbers of vic-
tims, according to the reports of the parish clerks for the metropolitan Bills
of Mortality. The trend for these eight weeks broke sharply with that shown
during the same weeks in the previous decade (see appendix A). The causes
for the unusually high incidence of fatalities reported during this April and
May ranged from enteric ailments and dropsy (a swelling of the limbs) to
consumption (tuberculosis) and several nonplague contagious diseases, in-
cluding fever, spotted fever, measles, malaria, and smallpox.^21
Metropolitan London’s system for reporting its deaths started with a par-
ish searcher (sometimes accompanied by a physician) viewing the body and
reporting the cause of death to the parish clerk (and possibly the parish