Sweating sickness, also known as the English sweat or sudor anglicus, emerged in England during the late 15th and early 16th centuries, briefly extending its reach to parts of continental Europe. It was characterized by an abrupt onset of symptoms and a remarkably rapid progression, often leading to death within hours. This mysterious illness instilled widespread fear, distinct from other maladies of the time due to its sudden appearance and speed. Its swift and devastating impact made it a significant chapter in medical history.
The Mysterious Outbreaks
The English sweating sickness manifested in five significant epidemics within England: 1485, 1508, 1517, 1528, and 1551. The first recorded outbreak in August 1485 coincided with the end of the Wars of the Roses, leading to speculation that it may have been introduced by French mercenaries.
While primarily confined to England, the 1528 epidemic notably ventured into continental Europe. This particular outbreak spread from England to Hamburg, then northward into Scandinavia and eastward through Lithuania, Poland, and Russia. The disease’s mortality rate was exceptionally high, with some estimates suggesting between 30% and 50% of those afflicted died.
Victims often succumbed within 3 to 24 hours of symptom onset, with some reports indicating death in as little as two hours. Unlike many epidemics of the era that were urban and long-lasting, sweating sickness cases spiked and receded quickly, often impacting rural populations.
Unraveling the Symptoms
Sweating sickness began with intense chills, sometimes accompanied by violent tremors, dizziness, and a severe headache. Pains in the neck, shoulders, and limbs were common, alongside a profound sense of exhaustion. This initial “cold stage” could last anywhere from half an hour to three hours.
Following the cold stage, a profuse, drenching sweat emerged, often accompanied by a foul odor. As the disease progressed, patients frequently developed a sensation of intense heat, delirium, a rapid pulse, and an unquenchable thirst. Palpitations and pain in the heart were also reported.
If a patient managed to survive beyond 24 hours, recovery was usually complete. Notably, observers did not report any skin eruptions with the English sweating sickness, distinguishing it from other conditions.
The Enduring Mystery of Its Cause and Disappearance
The precise cause of sweating sickness and the reason for its mysterious disappearance remain subjects of ongoing debate. Historical theories for its origin ranged from divine punishment to environmental factors like “loathsome vapours.” Modern medical advancements have allowed for more specific hypotheses, though none have been definitively proven.
One prominent modern theory suggests an unknown species of hantavirus as the causative agent. Similarities in symptoms, such as sudden onset fever, joint pains, and headache, along with a rapid progression to pulmonary issues, have been noted between sweating sickness and hantavirus pulmonary syndrome. Hantaviruses are zoonotic, carried by rodents, and some of their epidemiological patterns, like seasonal occurrences, align with observations of sweating sickness.
Other proposed causes include relapsing fever, an infection spread by ticks and lice, which also occurs during summer months. However, relapsing fever typically presents with a black scab at the bite site and a rash, neither of which were consistently described for sweating sickness. Anthrax poisoning has also been suggested, with a theory that victims could have been exposed to spores in raw wool or infected animal carcasses.
The disease vanished as suddenly as it arrived after its last outbreak in 1551. Its unique clinical features and epidemiological patterns make it difficult to definitively link to any currently known disease.