Louis XV.

Smallpox raged in Europe for a long time, even before the term “picote” designated it in France, in the XIIIth Century.  The word was replaced by that of “variole” [“pox” in English] or “verole”, which is of Italian origin, from the XVth Century.  In the XVIth Century, “petite verole” [“small pox”] or “petite variole” is distinguished from the “grosse verole”, syphilis, also known as “French pox” or “Napolitan pox”, which was perhaps imported from the recently conquered New World.

It is thought that it was the Arabian conquests that, from the early Middle Ages, had disseminated the disease throughout all the Western countries.  However, Gregoire de Tours evokes it as early as the Merovingian times.  The Muslim Doctors Rhazes and Avicenne were particularly interested in this disease, which was very common in the Europe of the Middle Ages, and quickly reached the New World, where it decimated the Amerindian populations, from the XVIth Century on.  However, the illness did not really reach South America until the XVIIth Century, along with South Africa and Southern Asia, from Sri Lanka to the Philippines.  When the King dies from it in 1774, smallpox is a real plague:  it provokes roughly one tenth of all mortality.

Louis XV.

Presenting various forms, the illness reveals itself after an incubation period of two weeks.  After a phase marked by a certain lassitude and headaches, the patient suffers nauseas, perspiring and fever, soon followed by an eruption of blisters, firstly on the face, then on the whole of the body.  After a few days, the blisters suppurate and the fever worsens.  The moment is delicate, for two hypotheses are then presented:  either the organism succeeds in surmounting the illness, the blisters dry up and a cure follows, even if it leaves its sad stigmata of scarred skin – that of a Mirabeau for example –  or the blisters invade all of the body (known as the “confluent”) and join up, which prepares death by asphyxia, for the respiratory organs are soon affected.  The intensity of the disease can vary.  The “discrete” smallpox only kills one tenth of the patients, the one that is baptised “malignant” kills one fifth of them, while the “confluent” spares only half, or even one third of its victims.

Louis XV.

Multiple complications alter the different organic functions, notably sight, but also respiration or digestion.  This is why the fragility of his respiratory passages, inherited from his smallpox, cost the life of Louis XV’s son, the Grand Dauphin Louis, who died in 1765.  What can be said about the not very attractive aspect that the illness gives to faces, and the terrible sequels that it leaves behind?  According to Doctor Husson, who wrote these lines in 1821,

“it covers the skin with a thousand hideous difformities:  in one place there are vast scars, in others repulsive excavations and excrescences, and not only does it deform and mutilate the appearance, but it often annihilates the most precious senses;  deafness, loss of sight and the complete disorganization of the eye are some of its ordinary effects”.

***

In the XVIIIth Century, smallpox is said to have caused up to sixty million deaths and was, without a doubt, the primary cause of mortality, until the arrival of the vaccine popularised by Edward Jenner.  Both endemic and epidemic, smallpox engendered spectacular spikes of mortality over the course of the XVIIIth Century:  14,000 deaths in Paris in 1710 and 20,000 in 1723, 6,000 deaths in Rome in 1752, 6,000 also in Naples sixteen years later…  While only 60 deaths occurred in London in 1684, in 1763, there were 3,528 in the English capital.  Without taking into account its various forms, it is generally estimated that around 10% of all deaths in the XVIIIth Century were due to smallpox.

The illness strikes children in priority, and more than 90% of its victims are under ten in XVIIIth Century France.  The popular classes are the most exposed to it, because of the lack of hygiene and the promiscuity born of poverty.  In the world of the nobility, the disease is contracted more often in adulthood and the scarred skin that it leaves on its surviving victims is mourned.  A number of monastic vocations are revealed in this way, after the passage of the terrible “picote”, and people do not refrain from nastily underlining the marks that it leaves behind it, in this world devoted to appearance.  Madame de Sevigne, who will die from it in 1711, is therefore able to present a friend of Fouquet who had survived the disease, as someone who is

“abusing the permission that men have to be ugly”.

To compensate for the ugliness thus engendered, people had recourse to often surprising remedies, among which

“lard from a very fat male pig, sperm from a whale, white vinegar mixed with urine from a young female who drinks only wine, bulbs of white lilies in urine from a girl of nine or ten, slugs crushed with sugar candy… “

A very singular therapeutic arsenal which does not contain anything to calm the anguish born of the monstrous illness.  Camphor, marine salt or antimony are advised for preventing the illness but, since Avicenne, people also think that emptying the umbilical cord of its blood at the moment of birth guarantees against smallpox, which is supposed to come from the uterine impurities transmitted to the child via the umbilical canal…  To affront the illness once it has declared itself, the doctors of yore firstly relied on the “heating” or “phlogistic” method, which consisted in placing the patient inside an overheated room, under a pile of blankets, so that he could “expulse” the unhealthy principle which was at the origin of the illness.  Diverse alcohols and remedies based on viper flesh could only aggravate his case, as the absence of hygiene favorised the progress of the infection.  Recommended at the end of the XVIIth Century by Sudenham, the “refreshing” or antiphlogistic method became the rule at the epoch of Light.  The lightly-dressed patient was exposed to air currents, he was made to drink cool teas, he was made to vomit, he had cataplasms applied to him which were supposed to accelerate the suppuration, and multiple cold baths were administered, while at the same time, his sheets and lingerie were frequently changed.  Certain charlatans, such as Hecquet and Chirac, praised the virtues of blood-letting, but others feared that it deprived the patient of the necessary strength to fight against the illness.  The virtues of the clyster were believed for a long time, and the unfortunate Louis XV had to suffer a memorable enema, recounted by the Duke de La Rochefoucauld-Liancourt.  With the results that we have seen…

To be continued.

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