Pandemic



Humans have always lived with various communicable diseases and to a large extent an equilibium based on immunity develops. More serious issues arise when a new disease enters a human population. This can occur due to contact between previously separate human populations, such as the introduction of diseases into the Americas by Europeans, or by transfer from another species. Up to 95% of the indigenous population of the Americas (estimates vary) are believed to have been killed off by diseases brought by the Europeans. Species which can harbour diseases capable of spreading to humans include livestock such as swine, poultry and cattle, as well as migratory bird species. Other host species include rats, bats and insects. Aggravating factors in the spread of epidemics to become pandemics have always included long-range trade, climatic change (possibly leading to changes in bird migration patterns or the range where insects such as the mosquito can survive) and social disturbances such as war. Pandemics can themselves lead to further social and economic changes due to factors which include a breakdown of authority or changes in the labor market.

This article looks at the pandemics which have affected Chester and some of their possible causes and social consequences. Of course, it is impossible to say "what might have been" had a particular person not died young as a result of disease, but it is possible to note where the death does seem worth considering in the light of related events concerning Chester. One thing that this perhaps illustrates is the "chaotic" nature of history. With the benefit of hindsight it is possible to try to explain how an event came about. However, as illustrated with particular reference to pandemics it is probably impossible to predict the longer-term consequences of a pandemic in any detail. As the table in the links shows almost every year up to the end of the 19th Century had an outbreak somewhere in Britain. In some cases these were restricted in area, but as communications improved even the less virulent pathogens had the opportunity to spread quickly and widely.

165: The Antonine Plague


The Antonine Plague of 165 to 180 AD, also known as the Plague of Galen (after Galen, the physician who described it), was an ancient pandemic brought to the Roman Empire by troops who were returning from campaigns in the Near East. Scholars have suspected it to have been either Smallpox or, less likely, a form of Measles. These diseases were not differentiated by medical writers until the 9th century. Both are highly infectious viral diseases. Measles is so contagious that if one person has it, 90% of nearby non-immune people will also become infected. Smallpox is effectively less contagious because of the obvious signs of disease. Neither appears to have an animal host other than humans, which indicates that people have been living with the disease for a very long period, although Camelpox, which humans can catch a mild case of, is the closest relative of Smallpox. The Measles virus appears to have evolved from a common ancestor with the now largely eradicated but formerly widespread Rinderpest virus, which infected cattle.

Ancient sources agree that the plague appeared first during the Roman siege of the Mesopotamian city Seleucia in the winter of 165–166. The following year as the Legions returned to Rome, the plague swept across the Roman empire and may have even, from the evidence of a mass grave in Gloucester (discovered in 2008), have eventually reached Britain. The haphazard character of the burials in Gloucester suggests a community under severe stress, with ritual norms being overridden by the need for the emergency disposal of a large number of corpses. In Rome itself, the most densely inhabited location within the Empire, thousands of the dead were carted unceremoniously away for disposal. The Antonine Plague provides an early example of mass-transport systems facillitating the spread of disease. Prior to large scale or rapid movement of people it is possible that a virulent and often fatal condition would "burn-out" before it could spread far. However an army on the move can, by serial infections, maintain cases of the disease and carry it from place to place. The typical Roman legion comprised about 5000 individuals, and while they might have only been moving at marching pace, this would mean that any infective agent would remain endemic within the legion as it covered large distances.

In the period of disturbance which followed the outbreak tribes along the Danube took the opportunity to make incursions into Roman teritory: the first time that this had happened for over two centuries. One further possible consequence of the pandemic was that the Romans could no longer simply use Roman citizens to make up the legions. In 175, 8000 Samartian cavalry were recruited into the army. Of these 5,500 were redeployed to Britain, also suggesting that the plague had reached Britain along Roman trade or military supply routes, depleting the garrisons there. This may have had a rather strange consequence. The Dragon or "Draco" ("dragon" or "serpent", plural dracones) was a military standard of the Roman cavalry. Carried by the Draconarius, the Draco was the standard of the auxiliary cohort as the eagle (aquila) was that of the legion. The Draco may have been introduced to the Roman cavalry by auxiliary units in the 2nd century. It was rather like a wind-sock than a simple banner and may be derived from the Dacians. A tombstone showing a Dacian or Sarmatian rider with a Draco from Roman Chester is on display at the Grosvenor Museum. The missing portion of the stone would have shown that the rider is holding a dragon standard, for which the Sarmatians were known and feared. It consisted of a bronze dragon’s head, with fanged jaws wide open, mounted on top of a long pole. The back of the head was also open, and on to it was fastened a long tube made out of brightly coloured fabric. When the horseman rode into battle at full speed the wind rushed into the dragon’s mouth. The size and shape of the holes in the head were cunningly made, so that the force of the wind not only filled out the tail but made a terrifying shrieking sound. It has been suggested that the "Welsh Dragon" may be derived from this Roman military symbol, via the post-Roman military forces which existed after the departure of the Romans.

The Romans departed from Britain around the year 400 as part of a general collapse of the Western Empire. The people left behind included a Romanised native population and a number of Roman settlers, many of whom would be retired military. These "remainers" would have organised some form of military defence and security forces amongst this "sub-Roman" society. This possibly survived for quite some time in Wales, i.e. that part of the country which is furthest from the eastern coast which was to become threatened by the Anglo-Saxons. The church as introduced by the Romans survived in Wales and made use of many Roman sites, and presumably the roads.

541: The Plague of Justianian
Very shortly after the Roman departure, about the year 444, Britain was apparently hit by a plague which may have been a variant on the Cyprian Plague. This may have disrupted society in a manner which led to the "invasion" of the Ango-Saxons, but the evidence is very scant. Similarly Nennius records a plague associated with the pseudo-historical Arthur in 537:


 * "..the battle of Camlann in which Arthur and Medraut fell. And there was plague [mortalitas] in Britain and Ireland".

The Plague of Justinian or Justinianic Plague (541–549 AD) was possibly the beginning of the first Old World pandemic of Bubonic Plague, the contagious disease caused by the bacterium Yersinia pestis. There had almost certainly been earlier pandemics, but much less is known about them, and as is discussed above their consequences can only really be the subject of speculation as regards events in and around Chester.

Yersinia pestis can cause several different types of disease depending on the route of infection. The natural hosts are rodents, but the disease can be spread by fleas. Y. pestis is a versatile killer. In addition to rodents and humans, it is known to have killed camels, chickens, and pigs. People can be exposed by coming into contact with an infected animal (dead or alive), or inhaling infectious droplets that a sick dog or cat has coughed into the air. DNA evidence published in 2015 indicates Y. pestis infected humans 5,000 years ago in Bronze Age Eurasia, but genetic changes that made it highly virulent did not occur until about 4,000 years ago.



The Plague of Justianian afflicted the entire Mediterranean Basin, Europe, and the Near East, severely affecting the Sasanian Empire and the Byzantine Empire and especially its capital, Constantinople. From historical descriptions, as much as 40% of the population of Constantinople died from the plague. It is named after the Eastern Roman (Byzantine) emperor Justinian (11 May 482 – 14 November 565). The plague weakened the Byzantine Empire at a critical point, when Justinian's armies had nearly retaken all of Italy and the western Mediterranean coast. The evolving conquest would have reunited the core of the Western Roman Empire with the Eastern Roman Empire. Some historians have suggested that the plague was the final stage in the collapse of the Western Roman Empire and the onset of the "Dark Ages". Some historians believe the plague of Justinian was one of the deadliest pandemics in history, resulting in the deaths of an estimated 25–50 million people during two centuries of recurrence, a death toll equivalent to 13–26% of the world's population at the time of the first outbreak, others see these figures as an exaggeration. However, the plague was almost certainly the most severe pandemic until the Black Death.

A noted death at around this time was that of Maelgwn Gwynedd who died c.547. The traditional version of his death from Welsh history records:


 * "And Maelgwn Gwynedd beheld the Yellow Plague through the keyhole in the church door and forthwith died. One account of the Yellow Plague is as a strange beast with yellow eyes, teeth, and hair; another describes it as a column of vapour rising from the earth to heaven and sweeping along the ground. The church where he died was thought to be Eglwys Rhos, not far from his court"

Surviving records suggest he held a pre-eminent position among the Brythonic kings in Wales and their allies in the "Old North" along the Scottish coast. According to legend, Maelgwn was buried on Ynys Seiriol (now known as Puffin Island in English), off the eastern tip of Anglesey. By tradition, his llys (English: royal court, literally hall) was located at Deganwy, in the Creuddyn peninsula of Rhos. Deganwy appears to have been the capital of Gwynedd at this time, but this was later moved to Aberffraw on Anglesey. The hill on which the castle was built was fortified many times over the centuries. It was the site of a Norman castle built around 1082 and occupied by Robert of Rhuddlan, and later by Llywelyn the Great and Llywelyn ap Gruffudd. Deganwy Castle was later demolished by Llywelyn ap Gruffydd in 1263 so that only ruins remain today. Maelgwn's death shows that the infrastructure still existed for disease to travel long distances.

Gildas, writing about 540 comments extensively on Maelgwn but does not mention his death, which helps to date the text of Gildas. If Maelgwn had already died of a pestilence Gildas would undoubtedly have ranted on for pages about it. Gildas makes an allegorical condemnation of five British kings by likening them to the beasts of the Book of Revelation 13:2 - the lion, leopard, bear, and dragon, with the dragon supreme among them. He says that Maelgwn is the "dragon of the island", and goes on with a litany of moral accusations, in the process describing him almost as a regional high king over the other kings (the power-giving dragon of the Apocalypse). The fact that the plague managed to spread to North Wales shows that there was still some movement of goods or people between Europe and Britain, however the route which the pandemic took is not established. Indeed the Byzantine historian Procopius records of Justianian: "On all his [Justinian's] country's potential enemies he lost no opportunity of lavishing vast sums of money ... as far as the inhabitants of Britain."

Gildas appears to be writing at a time when there was a pause in the settlement of Britain by the Anglo-Saxons. This pause may have been associated with an instance of "climate change" brought about by volcanic activity. The extent to which Western Europe was afflicted by famines through an “Extreme Weather Event” of circa 535 AD is disputed, but in 535 Procopius recorded in his (AD 536) report on the wars with the Vandals,


 * "..during this year a most dread portent took place. For the sun gave forth its light without brightness ... and it seemed exceedingly like the sun in eclipse, for the beams it shed were not clear..".



Gildas perhaps alludes to a similar dense cloud:


 * "a certain thick mist and black night of their offences sit(s) upon the whole island"

It is possible that this weakening of the sun was due to a volcanic eruption. Tree ring data shows that there was a sudden cooling in around the year 540. Various candidates have been put forward for the location of this volcano (including Krakatoa in 535), but none has been identified with certainty. The co-incidence of plague, war and climatic events has led to much speculation about how these events might be inter-related. Procopius also writes that the plague followed after a series of devastating earthquakes, and that Justinian refused to expend public funds on the repair to the damaged aqueduct at Constantinople - so that only a fraction of the previous clean water flow was available; the baths were closed, and the public fountains were the only water source for many.

Shortly after these events, there was a period of considerable political flux in Britain, with a large number of conflicts taking part in the years 600-685. As part of this cycle of conflicts Chester saw the Battle of Chester c.616. At that time Chester appears to have been a city of the British (i.e. Welsh) and was possibly an ecclesiastical center.

The extent to which history, especially local history in Cheshire and North Wales was influenced by pandemics is not well understood. An infection could decapitate a society by removing its leadership, or weaken it severely if it became established in military forces, especially when these were on campaign and needed to move and camp together.

664: The Anglo-Saxons
The early Anglo-Saxons wrote down very little about their times, and so what we know of the early period of "English" history is derived from the Welsh through Gildas and Nennius. Until we come to the Ecclesiastical History of Bede, the only other authorities are the Irish annals; and in them, the first undoubted entry of a great plague corresponds in date with that given in Bede’s history, the year 664. The plague of 664 is the only epidemic in early British annals that can be regarded as a plague of the same nature, and on the same great scale, as the devastation more than a century earlier. Bede wrote:


 * "In the same year of our Lord 664, there happened an eclipse of the sun, on the third day of May, about the tenth hour of the day. In the same year, a sudden pestilence depopulated first the southern parts of Britain, and afterwards attacking the province of the Northumbrians, ravaged the country far and near, and destroyed a great multitude of men."

This was also the year of the Synod of Whitby when King Oswiu of Northumbria ruled that his kingdom would calculate Easter and observe the monastic tonsure according to the customs of Rome rather than the customs practised by Irish monks at Iona and its satellite institutions.

Bede hismself had direct experience with the pandemic. Born on lands belonging to the twin monastery of Monkwearmouth-Jarrow in present-day Tyne and Wear, Bede was sent to Monkwearmouth at the age of seven and later joined Abbot Ceolfrith at Jarrow, both of whom survived a plague that struck in 685/6, an outbreak that killed a majority of the population there and devastated much of Britain, but not apparently to the extent of that in 664. The traditional version (not reported in Bede's own Life of Ceolfrith) is that the plague killed almost all the Benedictine monks in the monastery of Monkwearmouth–Jarrow, aside from Abbot Ceolfrith and one small boy - the future scholar Bede, who would have been about 12 at the time. A description of their situation makes grim reading: for a week, the abbot and the boy recited the psalter, but (as everyone else was dead) without the responds (antiphons) that should properly have accompanied the psalms:


 * "..but at length, with tears and lamentations, the abbot could bear it no longer, and so he decided that that psalms should be sung with antiphons, as before."

Better times did come. The plague abated, more men came to be monks at Jarrow, the Irish Abbot Adomnán of Iona came to visit Jarrow, and Bede was ordained to the diaconate at the early age of 19 – a sign, perhaps, that clergy were in short supply after the ravages of the plague.

There were other instances of disease: in the year 829, all the monks at Canterbury save five are said to have died of pestilence, so that the monastery was left almost desolate. This was the same year that Ecgbert of Wessex gained several military victories, including his raid on Chester as commemorated at the Town Hall, but whether there is a link between this military activity and the outbreak of disease is not certain. There were other things happening in the same year: for example the River Nile froze-over due to "freak" weather. Chester's Annals recorded another visitation of the plague in 868, the year in which Alfred the Great married Ealhswith and came to the aid of Burgred of Mercia, who was being attacked by Danes.

For the Anglo-Saxons "cwealm" (from which comes the somewhat milder feeling of "qualm" but also the German "Qualm" meaning a noxious miasma) and "wol" were both "pestilence". "Adl" was illness. For the pagans any conditions associated with illness were seen as a personification of something to be expelled. Others, especially in christian religious writings swung between pestilence being the act of a vengeful god to something which was more of a trial for the faithful, even where the same outbreak of plague was concerned, or where a supposed saint was known to have died of disease. Clearly, the view of the causes of pestilence needed to be a complex one.

Of special significance for Chester is the possible plague which raged in the camp of the Vikings at Repton in 875 and may have led directly to the translation of the relics of Werburgh to Chester. Archaeological work at Repton is still ongoing (2020) and it is unclear whether there was an outbreak of disease. One interpretation of the mass grave found there is that Viking dead from elsewhere had been relocated to the site for a ceremonial burial, taking over the former royal burial place of the Mercians and incorporating destroyed Christian stonework into new funerary monuments to make a clear assertion of political power and control of the land. Whatever the circumstances this does seem to be the event which in the year 873, triggered the "Men of Hanbury" to translate the remains of Werburgh to Chester, where her cult was later promoted by Æthelflæd.



11th-13th Cent: Leprosy and Famine
Gerald of Wales (c. 1146 – c. 1223) was familiar with what he would have considered "pestilence" and attributes it to what would later be known as the "Miasma theory", comparing the climate of Ireland with that of the Middle East:


 * "... [In Ireland there is] no disease-bearing cloud, or pestilential vapour or corrupting breeze... All the elements in the East, though created for the help of man, threaten his wretched life, deprive him of help, and finally kill him... if you drink unmixed water or merely smell dirty water with your nostrils, death is upon you... We have no fear of any breeze, piercing in its coldness, fever laden with its heat, or pestilential in what it brings..."

There were major outbreaks of famine-pestilences in 1196, 1258 and 1315, and many shortages and outbreaks in between. Only one of these is mentioned in the records at Chester and that is the famine following events in 1315. The Great Famine of 1315–1317 (occasionally dated 1315–1322) was the first of a series of large-scale crises that struck Europe early in the 14th century. Most of Europe (extending east to Russia and south to Italy) was affected. The famine caused many deaths over an extended number of years and marked a clear end to the period of growth and prosperity from the 11th to the 13th centuries. The onset of the Great Famine coincided with the end of the Medieval Warm Period. Between 1310 and 1330, northern Europe saw some of the worst and most sustained periods of bad weather in the entire Middle Ages, characterized by severe winters and rainy and cold summers. The Great Famine may have been precipitated by a volcanic event, perhaps that of Mount Tarawera, New Zealand, which lasted about five years. The effects were certainly felt in Chester as Chester merchants were licensed to go to Ireland to buy corn and other victuals for the king (Edward II).

The incubation period of Leprosy can range between 9 months and 20 years. It appears to be one of the oldest human diseases having infected hominids for millions of years. The long incubation period and relatively slow disease progress is often characteristic of a disease which has been evolving along with its host for an extended period. The pre-human host has not been identified, although it may be rodents, in particular red squirrels. Leprosy grew into a pandemic in Europe in the Middle Ages, resulting in the building of numerous leprosy-focused hospitals to accommodate the vast number of victims. Exactly what constituted "Leprosy" in various historical times extended somewhat beyond the modern definition of the disease, and at times it appears to have been used as a "catch-all" for any kind of disfiguring ailment or progressive skin disease. Leprosy was apparently a particular concern of the Normans, with the French being noted for outbreaks of Ergotism ("ignis") and the English notorious for famine in general. A medieval proverb reads:


 * "Tres plagae tribus regionibus appropriari solent, Anglorum fames, Gallorum ignis, Normannorum lepra" - Quoted, without date, by Marchand, Étude historique et nosographique sur quelques épidémies et endémies du moyen âge. Paris, 1873.

The Norman familiarity with "Leprosy" may be one reason why the development of at least some primitive "hospitals" started after the conquest. This indicates some progress away from simply shunning those who were suffering from the disease. The Leper Hospital at Chester was located near the site of St Giles Cemetery at Boughton, and gave the area its sometime name of "Spital Boughton". In 1870-72, John Marius Wilson's Imperial Gazetteer of England and Wales described Spital Boughton so:


 * "BOUGHTON (Spittle), an extra-parochial tract, in Great Boughton district, Cheshire; contiguous to St. John Baptist parish within Chester city."



The association with St Johns is evident from the much damaged statue above the doorway of St Johns. This shows the figure of St Giles whose patronage extends to many forms of disability, and to leprosy and lepers. The third Lateran Council (1179) based one of its decrees upon what must have been a common experience, namely, that lepers were unable to mix freely with others, and that they were objected to in the same church, and even as corpses in the same churchyard. Segregating them at the city limits (an area also used for public executions) was possibly not the most harsh solution. The inscription on a stone slab marking the cemetery reads:


 * "Here stood the Leper hospital and chapel of St Giles founded early in the 12th Century and endowed by successive Norman earls of Chester they remained in constant use until 1643 when defensive measures during the siege of Chester necessitated the demolition of buildings outside the city walls. The cemetery remained to mark the site and in time the little village of Spital clustered round it. In 1644 the royalist defenders suffered great loss of life in a gallant sortie in Boughton and many of the fallen were buried here. It was also used for victims of the plagues which ravaged the city in the 16th and 17th centuries. Being extra-parochial the site was granted to the corporation by Charles II in 1685 as a burial ground and through a period in the charge of St John's parish it remains in their hands. When the protestant martyr George Marsh was burnt at the stake on Gallows Hill close by his ashes were collected by his friends and buried here. The last burial took place in 1854."

While the hospital is said to have been founded by Ranulf de Blondeville, earl of Chester but the hospital possibly existed before 1181 as 20 shillings. a year was paid to the "infirm" of Chester during the minority of Ranulph and that sum was paid in the 14th century to the lepers of Boughton as "ancient alms". Ranulph gave an annual rent charge of 10s. to St. Werburgh's from which the monks were to feed 100 paupers once a year and to give 20d. a year to the lepers of Boughton to commemorate his father Hugh de Kevelioc. Another foundation of Henry II.’s reign was the leper-hospital of St Mary Magdalen at Sponne, outside the walls of Coventry. It was founded by:


 * ".. an Earl of Chester, who, having a certain leprous knight in his household, gave in pure alms for the health of his soul and the souls of his ancestors his chapel at Sponne with the site thereof, and half a carucate of land for the maintenance of such lepers as should happen to be in the town of Coventry. There was one priest to celebrate, and with him were wont to be also certain brethren or sisters together with the lepers, praying to God for the good estate of all their benefactors."



The earl in question is believed to have been Hugh de Kevelioc, and the knight who came down with leprosy, was the one that he has sent on crusade in his stead.

"Leprosy" (or "Hansens's Diseease") is a long-term infection by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. Leprosy has a low pathogenicity and 95% of people who contract M. leprae do not develop the disease. Despite the establishment of some "hospital" facilities, the social perception of leprosy in medieval communities was generally one of fear, and people infected with the disease were thought to be unclean, untrustworthy, and morally corrupt. Segregation from mainstream society was common, and people with leprosy were often required to wear clothing that identified them as such or carry a bell announcing their presence. However, the inmates of the hospital at Boughton enjoyed extensive privileges, which included a toll on all food bought for sale in Chester and a fishing boat on the Dee. The hospital also came to possess land and rents in and near Chester - some came to the hospital with new inmates: land in Eastgate Street was given by the relatives of Yseult, who, "smitten by the scourge of a visitation from on high", had been admitted to the hospital. When Henry III annexed the earldom of Chester after 1237 he proved a generous patron of the hospital. Between 1237 and 1240 he gave £5 yearly and in 1238-9 and 1240 additional grants of 10 marks towards its maintenance. The relations of the hospital with the citizens of Chester and the monks of St. Werburgh's were not always happy. Around 1300 the masters were involved in legal disputes concerning detention of rents, tolls or alms, the Dee fishery, and usury. The privilege of collecting the tolls was still being claimed in 1499 and exercised in 1537 when the city authorities pointed out that, whereas the privilege had originally been granted to relieve the sick, the inmates of the hospital were able-bodied; it was ordered that admissions should be confined to the sick of the city of Chester on penalty of loss of the market tolls. Also in 1537 the inmates were forbidden to wash food or clothes in the newly built conduit at Boughton (which transported water from the Boughton springs to the town and abbey) and were ordered to prevent their animals damaging the conduit and to see that the pipes were properly covered.

1350: The Black Death
The most authoritative contemporary account of the Black Death is found in a report from the medical faculty in Paris to Philip VI of France. It blamed the heavens, in the form of Saturn, Jupiter, and Mars conjoined in the sky, under the sign of Aquarius, and a solar eclipse on the same day. This March 24th, 1345 event was interpreted as causing a "great pestilence in the air" (according to the "miasma theory").

The predominant modern theory is that due to climate change in Asia, rodents began to flee the dried-out grasslands to more populated areas, spreading the disease. The mechanism by which Y. pestis is usually transmitted was established in 1898 by Paul-Louis Simond and was found to involve the bites of fleas whose midguts had become obstructed by replicating Y. pestis several days after feeding on an infected host. This blockage starves the fleas and drives them to aggressive feeding behaviour and attempts to clear the blockage by regurgitation, resulting in thousands of plague bacteria being flushed into the feeding site, infecting the host.

The most likely of the fourteenth-century English annalists to have given us a good account of the Black Death was the historian Ranulphus Higden, author of the Polychronicon, who became a monk of St Werburgh’s abbey at Chester about the beginning of the century, and lived to see the disastrous year of 1349, although by then he was very old for his times. Under the year 1348 he begins the subject of the great mortality, speaks of the incessant rains of the second half of the year from Midsummer to Christmas, refers to the ravages of the plague at Avignon, the then ecclesiastical capital of Christendom, just mentions England and Ireland, and then lets the pen fall from his hand. The period from 1348 to 1352 is an absolute blank. He comes to the edge of the great subject of that time, as if he had intended to deal with it comprehensively, beginning with a notice of the previous weather, which is by no means irrelevant, and after two or three lines more he breaks off. Most of the monastic chronicles are interrupted at the same point; if there is an entry at all under the year 1349 it is for the most part merely the words "magna mortalitas". Higden's sudden silence at the end of his epic work, clearly indicates the massive impact of the pestilence.

Responsible for the death of one-third of the world population, this second large outbreak of the Bubonic Plague possibly started in Asia and moved west in caravans. Entering through Sicily in 1347 A.D. when plague sufferers arrived in the port of Messina, it spread throughout Europe rapidly. Edward III, crowned king of England in 1327, lost his fourteen-year-old daughter Joan to the lethal clutches of are earlier wave of plague. Nearly fifty years later, his grandson King Richard II was stricken with the same grief when his wife, Queen Anne of Bohemia, succumbed to it. Historians have speculated that her counsel had a moderating effect on Richard during her lifetime and that his tyranical behaviour towards the end of his rule, which wouls eventually lead to his downfall at Chester, was in part a result of her death.



The development of quarantine was one consequence of the Black Death. The word "quarantine" originates from quarantena, the Venetian language form, meaning "forty days". This is due to the 40-day isolation of ships and people practised as a measure of disease prevention related to the plague. A document from 1377 states that before entering the city-state of Ragusa in Dalmatia (modern Dubrovnik in Croatia), newcomers had to spend 30 days (a trentine) in a restricted place (originally nearby islands, such as Lokrum) waiting to see whether the symptoms of Black Death would develop. The Venetians possibly realised that the time from infection until the development of the disease could be longer than thirty days, and increased the length of this period giving rise to the modern term. Venice founded the first lazaret (on the small island of Lazzaretto Vecchio adjoining the city) in 1403. A lazaretto or lazaret (from Italian: lazzaretto a diminutive form of the Italian word for beggar) is a quarantine station for maritime travellers. Where no shore facilities are provided a vessel might be quarantined with crew and passengers remaining onboard in which case it will then usually wear the "Lima" black and yellow signal flag. The plain yellow flag ("Quebec" or “Q” in international maritime signal flags), perhaps derives its letter symbol for its initial use in “quarantine”, but this flag in modern times indicates the opposite — a ship that declares itself free of quarantinable disease, and requests boarding and inspection by Port State Control to allow the grant of "free pratique". The black and yellow "warning colouration" of wasps and bees appears to serve the same function and the inhibition of predators caused by the black and yellow pattern is attributed to a genetically fixed predisposition to avoid warningly coloured black and yellow prey which is the result of evolutionary adaptation and is "built-in" rather than learned.

There was no effective cure for the Black Death, although some ineffective methods were suggested. One of the most popular cures was the “Vicary Method”, named after the English doctor Thomas Vicary, who first proposed it. A healthy chicken was taken and its back and rear plucked clean; this bare part of the live chicken was then applied to the swollen nodes of the sick person and the chicken strapped in place. When the chicken showed signs of illness, it was thought to be drawing the disease from the person. It was removed, washed, and strapped back on and this continued until the chicken or the patient (or both) died.

The Black Death would have indirect consequences for Chester. At the start of the 14th century, the majority of English people worked in the countryside economy that fed the country's towns and cities and supported an extensive international trade. Across much of England, production was organised around manors, controlled by local lords – including the gentry and the Church – and governed through a system of manorial courts. Then the Black Death arrived. After an initial period of economic shock, England began to adapt to the changed economic situation. The death rate among the peasantry meant that suddenly land was relatively plentiful and labourers in much shorter supply. Labourers could charge more for their work and, in the consequent competition for labour, wages were driven sharply upwards. In turn, the profits of landowners were eroded. The trading, commercial and financial networks in the towns disintegrated. The authorities responded to the chaos with emergency legislation; the Ordinance of Labourers was passed in 1349, and the Statute of Labourers in 1351. These attempted to fix wages at pre-plague levels, making it a crime to refuse work or to break an existing contract, imposing fines on those who transgressed. The plague hit the monastic institutions hard leading to a shortage of clerics and this class of writers and record keepers were needed for the rapidly changing economy. Monastic vows of chastity did not sit well with many of this class of scribes and the first stirrings of what was to become Protestantism were seen, as well as doubt in the power of the established church. One result was the Peasants' Revolt of 1381, which should be seen as indicative of wider social changes rather than an isolated event. The Peasants' Revolt was followed by the reign of Richard II, a king very much associated with Chester. Possibly to avoid the on-going social and political uphevals in the south, Richard established a power-base at Chester (and kept his Royal Treasure nearby).

Several "Plague Pits" have been identified in Chester. One was just outside the City Walls near the Watertower and Infirmary, and close to the site of the cabins in which the sick were quarantined. The site cannot be built upon. In June 1986, during building work on the site of the new magistrates courts in Chester a plague graveyard was uncovered where the victims of an Anthrax outbreak were believed to have been interred. This required the treatment of the ground with lime. Anthrax spores can survive for very long periods of time in the environment after release. Gruinard Island which was used for biological tests in 1942 was judged too hazardous and expensive to decontaminate the island sufficiently to allow public access, and was quarantined indefinitely until its decontamination in 1986-90.

1485: Sweating Sickness


Sweating sickness, also known as the sweats, English sweating sickness, English sweat or sudor anglicus in Latin, was a mysterious and contagious disease that struck England and later continental Europe in a series of epidemics beginning in 1485. The last outbreak occurred in 1551, after which the disease apparently vanished. Nothing is known for certain about whether it had an animal carrier. Relapsing fever, a disease spread by ticks and lice, has been proposed as a possible cause. It occurs most often during the summer months, as did the original sweating sickness. Specific similarities between the English sweating sickness and diseases caused by various species of hantavirus indicate that a hantavirus may have been the cause of the sweating sickness. Humans may become infected with hantaviruses through contact with rodent urine, saliva, or feces, although human to human transmission is rare.

The onset of symptoms was sudden, with death often occurring within hours. As the first confirmed outbreak was in August 1485 at the end of the Wars of the Roses, which has led to speculation that it may have been brought over from France by the French mercenaries whom Henry Tudor used to gain the English throne. However, an earlier outbreak may have affected the city of York in June 1485, before Tudor's army landed, although the record of that disease's symptoms is not adequate enough to be certain. The Croyland Chronicle mentions that Thomas Stanley, 1st Earl of Derby used the sweating sickness as an excuse not to join with Richard III's army prior to Tudor's victory over Richard at the Battle of Bosworth.

In March 1502, Arthur Tudor and his wife Catherine were afflicted by an unknown illness, "a malign vapour which proceeded from the air". While Catherine recovered, Arthur died on 2 April 1502 at Ludlow, six months short of his sixteenth birthday. The sickness did seem to be more fatal for men: at Chester in 1507 it is said, the sweating sickness destroyed 91 in three days, of whom only four were women. A 1517 record at Chester mentions an outbreak of "plague", which is taken to mean sweating sickness; it is said also to have been "probably more serious than in 1507"; many died, others fled; and the grass grew a foot high at the High Cross.



The final wave of Sweating Sickness saw the death of Gregory Cromwell who died of it on 4 July 1551 at his home, Launde Abbey, Leicestershire. Cromwell's death led to one of the more interesting unsolved mysteries as regards Chester. He was married to wife Elizabeth who was the sister of Anne Boleyn. A Holbein portrait which appears to be of her was for many years believed to be of Catherine Howard and a copy of this portrait turned up at Overlegh Hall, near Chester. This was somehow mis-identified as being a different Elizabeth Cromwell, who was not even born until after the death of Holbein. Just how the portrait came to be at Overlegh and how the confusion arose has never been clarified. For more information on this see: Cowper.

1492: Syphilis
As noted elsewhere in this article pandemics can be particularly severe when a disease which is already well adapted to humans enters a new population which has never been exposed to it before. Europeans have been living with their domestic animals for centuries and many diseases of of these animals can also affect people or have close analogs which affect people. Over the centuries a certain amount of resistance to these diseases has evolved. When Europeans began to expand to the rest of the world they found themselves faced with "new" diseases to which the local population may have had some degree of adaption but against which the Europeans had little or no defence. Similarly, Europeans could bring diseases with them which were lethal to the indigenous population. The term "Virgin soil epidemic" is often used in connection with such instances and cultural impacts such as the introduction of alcohol, slavery and general societal and environmental change brought about after first contact can boost the effects of disease taken alone.

One of many examples, although sometimes disputed, is that syphilis was brought back from the Americas by the crew of Christophen Columbus's expedition in 1492. Syphilis was present in the Americas before European contact and the first written records of an outbreak of syphilis in Europe occurred in 1494 or 1495 in Naples, Italy, during a French invasion (Italian War of 1494–98). Since it was claimed to have been spread by French troops, it was initially called the "French disease" by the people of Naples. In 1530, the pastoral name "syphilis" (the name of a character) was first used by the Italian physician and poet Girolamo Fracastoro as the title of his Latin poem describing the ravages of the disease in Italy. It was also called the "Great Pox".

In the 16th through 19th centuries, syphilis was one of the largest public health burdens in prevalence, symptoms, and disability, although the social stigma associated with it mean that records can be scarce. Fortunately records were compiled at Chester Infirmary by Dr John Haygarth, a dedicated compiler of statistics who "noted and classed the cases of 10549 patients" (as well as those of "a large number of persons in the lower ranks of life"). Haygarth turns up in the diaries of Hester Thrale (1741-1821) who wrote that her niece Cecilia Margaretta, having made a runaway marriage (to Gretna Green) with one John Moston, was "frightened into fits on her wedding night" and that "her husband got Dr Haygarth to prescribe for her at Chester".

Haygarth's careful record keeping at the Infirmary in Chester has enabled historians to study the prevalence of "venereal distemper" for the three consecutive years, 1773, 1774 and 1775 of which there were around 174 cases. For those with infection by the bacterial spirochaete, Treponema pallidum, which is today known to cause the STI defined as syphilis, there was some hope of treatment: as John Haygarth himself put it after several decades of medical practice in Chester,


 * "Except Mercury in the Syphilis, there are few or perhaps no examples where a remedy can produce such speedy relief and perfect recovery in so formidable a disease."

The treatment then available typically consisted of 5-7 weeks of continuous supervised mercurial infusion, ingestion or injection. This caused quite serious side-effects. The rates based on the Infirmary records are surprisingly high: among the Chester population c.1774, 7.851% of females and 7.411% of males had been treated for "the pox" (syphilis) in Chester Infirmary by the time they reached age 35. Corrections need to be made for those who would have sought treatment at the Workhouse, those who avoided treatment (or only resorted to "quack therapies") and those of the "gentile classes" who were treated privately. Studies which have attempted to correct for the missing genteel fraction of society seem to put the overall infection rate at about 8% for those under 35 - comparable with that in London. The estimated rate in Cheshire outside of Chester was significantly lower, a little under 1%.

The transfer of diseases to the Americas was even more calamatous. Columbus built his first town on the nearby island of Hispaniola, where the local Taino numbered at least 60,000 and possibly as many as 8 million, according to some estimates. But by 1548, the Taino population there had plummeted to less than 500. Lacking immunity to Old World pathogens carried by the Spanish, Hispaniola’s indigenous inhabitants fell victim to terrible plagues of smallpox, influenza, and other viruses. Epidemics soon became a common consequence of contact. In April 1520, Spanish forces landed in what is now Veracruz, Mexico, unwittingly bringing along an African slave infected with smallpox. Two months later, Spanish troops entered the capital of the Aztec Empire, Tenochtitlán, and by mid-October the virus was sweeping through the city. Before the arrival of the Europeans, the Mexican population is estimated to have been around 25 to 30 million. Fifty years later, the Mexican population was reduced to 3 million, mainly by infectious disease. A 2018 study by Koch, Brierley, Maslin and Lewis concluded that an estimated "55 million indigenous people died following the European conquest of the Americas beginning in 1492."

Tudor Smallpox


The young monarch King Edward VI was just fourteen when he fell prey to smallpox and measles, and despite a relatively swift recuperation, then succumbed (1553) to a bout of tuberculosis which was attributed to the compromised state of his immune system. Although Edward reigned for only six years and died at the age of 15, his reign made a lasting contribution to the English Reformation and the structure of the Church of England. The last decade of Henry VIII's reign had seen a partial stalling of the Reformation, a drifting back to more conservative values. By contrast, Edward's reign saw radical progress in the Reformation. In those six years, the Church transferred from an essentially Catholic liturgy and structure to one that is usually identified as Protestant. Queen Mary's attempts to undo the reforming work of her brother's reign faced major obstacles, but had Mary lived longer, her Catholic reconstruction might have succeeded, leaving Edward's reign, rather than hers, as a historical aberration. On Mary's death in 1558, the English Reformation resumed its course, and most of the reforms instituted during Edward's reign were reinstated in the Elizabethan Religious Settlement.

Edward VI left his mark on Chester in the form of the motto "The Fear of the Lord is a Fountain of Life" found on a house in Park Street. This is sometimes said to be the inscription on an "ancient" (some say Roman) coin found on the site, - it is also found in Proverbs [14:27] (so unlikely to be on a Roman coin). However almost the same words: "TIMOR . DOMINE . FONS . VITAE" were struck onto a (now incredibly rare) issue of silver shillings of Edward VI in 1549, as well as on the gold half-sovereign of the same year (and some groats amd other coins). Just because something is written in latin, that does not mean that what it is written on is a Roman relic!

1665: The Great Plague
In another devastating appearance, the bubonic plague led to the deaths of 20 percent of London’s population. As human death tolls mounted and mass graves appeared, hundreds of thousands of cats and dogs were slaughtered as the possible cause. The plague had not gone away completely since the last outbreak. In Chester there was an outbreak in 1558. The records atate that many fled the town, although the deaths were few. A State paper of February 25, 1559, speaks of the county of Cheshire as "weakened by the prevalence of plague". The plague struck again in 1574, when "plague began, but was stayed with the death of some few in the crofts", although it apparently spread through Chester to Ireland. "The crofts" is possibly a reference to the quarantine measures that the then local government had installed, placing the sick in cabins near the later site of the Infirmary.

One interesting consquence of the plague in London is that it was possibly the reason why John Vanbrugh's father moved to Chester around 1665/6.

Chester in 1603-5
For Chester there are full particulars of a great plague. It began in September, 1602, in a glover’s house in St John’s Lane, where 7 died, and kept increasing until the weekly deaths reached 60. In 1603 there died of the plague 650, and of other diseases 61. In 1604 the plague-deaths were 986, of which 55 were in one week. From October 14, 1604, to March 20, 1605, 812 died, and about 100 more until the 9th January, 1606, when the infection ceased for a time. Cabins outside the city were erected for the plague-stricken. In some houses, especially of sailors, five or six of the same family died in the course of two or three weeks.

Although the Midsummer show and fair were cancelled, citizens seem to have flouted safety measurers: John Aldersey, for example, was moved from Eastgate Street to Watergate Street while sick. Richer citizens, perhaps more worried about the state of their businesses after the first phase than about the disease itself, may have delayed flight too long. William Aldersey, another former mayor, left only when the weekly death-toll reached 58 and his next-door neighbour's family had been almost wiped-out.



In the long term, the double epidemic of 1603-5 was not a serious demographic setback for Chester. Only in the "final" year was there a net loss in numbers of householders and for a time afterwards families may have been on average smaller. The plague did not go away completely: in 1608 14 died of it "at the Talbot" (on the site of the Grosvenor Hotel) and in 1610 "many died of the plague".

Henry, Chester's Prince (died 1612)
The fact that the plague was still active in Chester in 1610 may have been one reason why the young Earl of Chester did not attend an entertainment "Chester's Triumph" which was put on with him in mind.

Henry Frederick Stuart, Prince of Wales and Earl of Chester was the eldest son of James VI and I, King of England and Scotland, and his wife Anne of Denmark. By 1610 Chester had spent some time without an Earl and James I, Elizabeth and Mary had taken little interest in the city with the last Earl to have played much of a part in city affairs having been the young Arthur Tudor.

Chester's economy had grown steadily from 1550 to c. 1600, not least because in the early 1580s and later 1590s the passage of troops bound for Ireland created more demand for goods and services: although recovery from the plagues of 1603-5 was hampered by national economic difficulties and by recurrent, though limited, local epidemics. Henry was seen as "the coming man", yet his father was still young enough that he could be expected to be Earl of Chester for some years. Undoubtedly one object of the "Triumph" enacted in 1610 was to gain the attention, and hence the favour, of Prince Henry.

It was not to be. The "coming man" did not come to Chester for the Triumph. At the age of 18, the man who had been prepared for rulership all his life was taken ill after a swim in the Thames near his home at Richmond. His symptoms suggest he had water-borne typhoid fever, from which he died. The diagnosis can be made with reasonable certainty from written records of the post-mortem examination, which was ordered to be carried out in order to dispel rumours of poisoning. Charles eventually inherited the throne 13 years later, having had little of the preparation Henry had for the role. His reign ended with the English Civil War and the king being executed, sparking a century of tumult and conflict. Chester sided with Charles and he used the City to prosecute a war for his own ends, and lost all. For Chester, the consequences of that war and the plague which followed left the city with social and economic difficulties from which recovery was very slow.



Chester in 1647
Number 9 Watergate Street is famous for the inscription on the Row fascia reading "God's Providence is mine Inheritance", said to be in thanks for deliverance from the plague of 1647-8. While the Civil War siege of Chester had been lifted with the surrender of the City on the 3rd Feb 1646, the effects of famine and other privations were such that in 1647 the plague broke out. It is worth noting that the house bearing the inscription was built in 1652 (the earlier building having been destroyed in the Civil War), by which time the plague was over, and so the inscription, if it does have anything to do with the plague, actually relates to the earlier (presumably seriously damaged) house on the same site. As for the origin of the quote: the motto "God's Providence is mine Inheritance" belongs, according to Burke's Peerage, to Richard Boyle, Earl of Cork, who rose from a poor background to become one of the richest men in England by the 1630's. This family is closely identified with Frome, Somerset, where a very similar inscription appears on a public fountain. The building features in the novel "God's Providence House: A Story of 1791" (1865) by Isabella Varley (later Mrs George Linnaeus Banks). She included the "plaque" story and it stuck.

The plague arrived in June 1647, perhaps with troops bound for Ireland. The onslaught was unprecedented. In 16 weeks 1,863 people died. The first week alone claimed 64 victims, more than the week of highest mortality in 1605. The peak was the seventh week, with 209 dead, and the worst of the epidemic was over in the sixteenth week with 52 dead, after which there was a long tail of intermittent deaths, lasting until April 1648 and numbering 236. The plague was reported as taking its victims 'very strangely, strikes them black of one side, and then they run mad;. . . they die within a few hours'. It was evidently bubonic plague, and Chester was one of two places in the British Isles hit hardest in the outbreak. Total deaths between June 1647 and April 1648 amounted to 2,099, perhaps 35 per cent of the population if it had remained stable after the end of the siege. By contrast with the epidemic of 1603-5, recovery was slow. In the 1650s even prosperous parishes like St. Peter's and St. Michael's had only two thirds of their pre-plague population. The plague lingered into 1651, but was then mostly present in the surrounding villages. Whitmore writes:


 * "It is well known,” he says, “that this disease in the year 1651 [the same fever that he describes more fully for the years 1658 and 1659] first broke out by the seaside in Cheshire, Lancashire, and North Wales.... In Cheshire in the year 1651 this disease seized most upon the country people who were laborious, the seeds being sooner dispersed in them through the agitation of the humours and spirits in their harvest labours, than on those who lead a more sedentary life; and that might be one reason why we were so free in the city of Chester, when within three or four miles of us round about, whole towns were infected with it, there being 80 and 100 sick at a time in small villages, as at Stanney, Dunham-on-the-hill, Norton and all there abouts by the water side it extremely raged."

Chester did not recover from the combined effects of the siege and the epidemic until perhaps 1700, but even that may have been at someone else's expense. Nationally, the closing decade of the seventeenth century saw the generally favourable economic conditions that had dominated since the Restoration of the monarchy in 1660, come to an end. The 1690s marked the lowest point of the Little Ice Age, of colder and wetter weather. This reduced the altitude at which crops could be grown and shortened the growing season by up to two months in extreme years. There were four years of failed harvests (1695, 1696 and 1698–99). Climatic conditions were so poor that the "seven ill years" was a period of national famine in Scotland which killed 5–15 per cent of the Scottish population. In 1698 the privy council openly admitted that Scotland was in the grip of:


 * "..not only a Scarcity, but a perfeit Famine, which is more sensible than ever was known in this Nation"



The massive eruptions of volcanoes at Hekla in Iceland (1693) and Serua (1693) and Aboina (1694) in Indonesia may have polluted the atmosphere and filtered out significant amounts of sunlight. In addition, the "Maunder Minimum" which occurred between 1645 and 1715, and when very few sunspots were observed, may have had climatic effects. With the Nine Year's War (1689-87) in progress, merchants (and the gentry) looking to use their idle capital became supporters of trading in shares. Construction of "The Exchange" at Chester may well have been prompted by this time of financial speculation which saw not only the first major stock-market boom but also the creation of the Bank of England (and bank-notes).

The Upton Plague-Stone
Plague stones were set up in order that the people might barter for food. People from the afflicted districts came to the district plague stone and placed money in a bowl which contained disinfectants (such as vinegar) and then retired to a safe distance. Food, in exchange, was placed on or near the stone. One of the most notable plague stones is at Eyam in Derbyshire. Upton also lays claim to a plague stone. The Upton stone formerly stood at the Upton cross-roads. The "bowl" was restored by Mr. J. Collins, The Blue Coat School, Chester, in 1938 and is now located in the churchyard. It is locally referred to as the "Wealstone" by some. Comparatively little is known about the stone, especially as regards its history.

Upton certainly appears to have been hit hard by the plague which followed the Civil War seige of Chester. It is said that there are a large number of burials at St Mary on the Hill which relate to families from Upton in 1650. This is not however clear from the available Register as reproduced by Earwaker. The name "Wealstone" also has other interpretations. The stone is roughly round with a hole through the center and therefore bears some resemblance to a wheel. It is possible that a boundary stone ("Vínheíþr-stan" in Icelandic) existed at Upton giving rise to the name of "Wealstone Lane". The reference to "Vínheíþr" is interesting as "Vin Heath" is mentioned in Egils Saga (see Chapter 52) as being the location of the Battle of Brunanburh. Æþelstān was encamped prior to the battle at a town a little way to the south and, given the time that it took for messengers to ride between the opponents, this may well have been Chester. "Vin" is often interpreted as a personal name, but the so-called "Wirral Micro-climate" may be such that it was possible to grow grape-vines there in Viking times, so the "Vin" may be a reference to a place where grapes grew. There is a further reference to vines on the 1735 map of Upton. Port-, Tapa- and Wing-Fields are grouped together along Liverpool Road behind the Egerton Arms (now "The Mill") – Upton Drive area.

1702: Ergotism, Crop and Livestock Disease
Human society is also affected by diseases of crops. The best known example as regards Chester being the Irish Potato Blight of 1845 and the following years which had a significant effect on migration from Ireland. It is estimated that at the eve of the famine 30% of Irish people were largely or wholly dependant on potatoes for their food. Matters were complicated by the subsequent outbreak of a Cholera epidemic in Ireland, which added significantly to the death toll. Actual starvation killed very few, with most of the fatalities being due to malnutrition-related diseases (such as dysentry and scurvy) as well as Cholera. Overall, perhaps 12% of the population of Ireland perished as a result of the blight and the associated epidemic.

1702 brought Cheshire a rare outbreak of what was most likely Ergotism. Historically, eating grain products, particularly rye, contaminated with the fungus Claviceps purpurea was the cause of ergotism. As the disease is one of crops it cannot be passed from person to person. The results of ergot poisoning may be one of the causes of the medieval Dancing Mania otherwise known as "St Vitus Dance". Numerous hypotheses have been proposed for the causes of dancing mania, and it remains unclear whether it was a real illness or a social phenomenon. However one of the most prominent theories is that victims suffered from ergot poisoning, which was known as St. Anthony's fire in the Middle Ages. The "ergot" theory cannot account for all of the symptoms of the mania, such as the large numbers suddenly affected.



An account of might well have been the "index case" was sent to the Royal Society by Dr Charles Leigh:


 * "We have this year [1702] had an epidemical fever, attended with very surprising symptoms. In the beginning, the patient was frequently attacked with the colica ventriculi; convulsions in various parts, sometimes violent vomitings, and a dysentery; the jaundice, and in many of them, a suppression of urine; and what urine was made was highly saturated with choler. About the state of the distemper, large purple spots appeared, and on each side of ’em two large blisters, which continued three or four days: these blisters were so placed about the spots that they might in some measure be term’d satellites or tenders: of these there were in many four different eruptions. But the most remarkable instance I saw in the fever was in a poor boy of Lymm in Cheshire, one John Pownel, about 13 years of age, who was affected with the following symptoms:— Upon the crisis or turn of the fever, he was seized with an aphonia, and was speechless six weeks [? days], with the following convulsions: the distemper infested the nerves of both arms and legs which produced the Chorea Sancti Viti, or St Vitus’s dance; and the legs sometimes were both so contracted that no person could reduce them to their natural position. Besides these, he had most terrible symptoms, which began in the following manner: [description of convulsions follows] ... and then he barked in all the usual notes of a dog, sometimes snarling, barking, and at the last howling like an hound. After this the nerves of the mandibles were convulsed, and then the jaws clashed together with that violence that several of his teeth were beaten out, and then at several times there came a great foam from his mouth.... These symptoms were so amazing that several persons about him believed he was possessed. I told them there was no ground for such suppositions, but that the distemper was natural, and a species of an epilepsy, and by the effects I convinced them of the truth of it; for in a week’s time I recovered the boy his speech, his senses returned, his convulsions vanished, and the boy is now very cheerful. There have been other persons in this country much after the same manner."

This epidemic of 1702 in Lancashire and Cheshire was recorded as something unusual, and it indeed appears that while "Dancing Mania" and "St Anthony's Fire" were fairly common in Europe it was virtually unknown in England.

Livestock Disease
From early times human agriculture has faced difficulties with disease of cattle as well as crops. "Murrain" is an antiquated term for various infectious diseases affecting cattle and sheep and occurs frequently in medieval records. Murrain did not refer to a specific disease, but was an umbrella term for what are now recognized as a number of different diseases, including rinderpest, erysipelas, foot-and-mouth disease, anthrax, and streptococcus infections. Some of these could also affect humans. The term murrain also referred to an epidemic of such a disease. There were major sheep and cattle murrains in Europe during the 14th century, which, combined with the Little Ice Age, resulted in the Great Famine of 1315-1317, weakening the population of Europe before the onset of the Black Death in 1348.

As one local example the "rinderpest" cattle plague of 1865-66 left the county of Cheshire in debt for thirty years, and the strains arising from both the epidemic itself and the need to repay the debts incurred sharpened feelings between farmers and other sections of the community. The outbreak stemmed from a group of infected cattle imported into Hull from the Baltic in May 1865. Although the  outbreak had taken hold in other areas by June 1865, it was October before it reached  Cheshire, but once there it raged until the middle of 1866. From then on fewer cases were reported each month until the end of the year. The disease was almost uniformly fatal and affected 68% of cattle in Cheshire, which had largely dairy based agriculture. In all, the county lost 84,159 beasts through death by disease or preventative slaughter.

Because Cheshire was affected far more than any other county, feelings ran strongly, and in particular there were the questions of who was to blame for the disaster and who was to bear the cost. Total loss of stock amounted to more than 66,000 head, and it was necessary to obtain from the Treasury a loan of £270,000 on the security of the county rate, for purposes of relief and compensation. The 1865 outbreak of cattle plague was claimed by Cheshire churchmen to be divine retribution for sin of making cheese on a Sunday, leading to Cheshire cheeses being marketed as "made without Sunday labour" or described as "Monday Cheese".



1817: Cholera
Though cholera has been around for many centuries, the disease came to prominence in the 19th century where there were a series of pandemics. After the arrival of the Portuguese in India in 1498, various Europeans documented the presence of cholera. Gaspar Correa (1496–c. 1563), a Portuguese historian in Goa, wrote of a new sickness that he called “moryxi” in his book Legendary India (1543). He described vomiting and cramps that could kill a man by the end of the day. Other names for this condition evolved, such as the French term "mort de chien" (a dog’s death). The second pandemic originated in India and spread along trade and military routes to Eastern and Central Asia and the Middle East.



Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. It is spread mostly by unsafe water and unsafe food that has been contaminated with human feces containing the bacteria. Undercooked seafood is also a common source. Humans are the only animal affected. The word cholera is from Greek: χολέρα kholera from χολή kholē "bile". Cholera likely has its origins in the Indian subcontinent as evidenced by its prevalence in the region for centuries. The first cholera pandemic occurred in the Bengal region of India, near Calcutta starting in 1817 through 1824. The disease dispersed from India to Southeast Asia, the Middle East, Europe, and Eastern Africa. The movement of British Army and Navy ships and personnel is believed to have contributed to the range of the pandemic, since the ships carried people with the disease to the shores of the Indian Ocean, from Africa to Indonesia, and north to China and Japan.

The year 1816 is known as the "Year Without a Summer", also the "Poverty Year" and "Eighteen Hundred and Froze To Death". Evidence suggests that the anomaly was predominantly a volcanic winter event caused by the massive 1815 eruption of Mount Tambora in April in the Dutch East Indies (Indonesia). This eruption was the largest in at least 1,300 years (after the hypothesized eruption causing the extreme weather events of 535–536). The enormous cloud of sulfate gases Tambora ejected into the atmosphere slowed the development of the Indian monsoon, the world’s largest weather system, for the following two years. Drought brought on by the eruption devastated crop yields across the Indian subcontinent, and most likely gave rise to the new and deadly strain of cholera. The ash in the atmosphere after the 1815 eruption reflected significant amounts of solar radiation, causing unseasonably cool summers that contributed to food shortages around the world.

1832
By autumn of 1830, cholera had made it to Moscow. The spread of the disease temporarily slowed during the winter, but picked up again in spring of 1831, reaching Finland and Poland. It then passed into Hungary and Germany. The disease subsequently spread throughout Europe, including reaching Great Britain for the first time via the port of Sunderland in late 1831. The public became gripped with widespread fear of the disease and distrust of authority figures, most of all doctors. Unbalanced press reporting led people to think that more victims died in the hospital than their homes, and the public began to believe that victims taken to hospitals were killed by doctors for anatomical dissection, an outcome they referred to as "Burking". This fear resulted in several "cholera riots" in Liverpool during 1832. 1832 was also a year of political gatherings: the cholera had occurred at the same time as the struggle for parliamentary reform that culminated in the passage of the Great Reform Act in June 1832. Hostility was a common feature of the popular response to the epidemic across Europe. In European cities it often centred upon conspiracy theories about the poisoning of the poor by doctors on behalf of the upper classes.



Cholera riots were also not just an English phenomenon. The Cholera Riots (Холерные бунты) in Russia started due to the anti-cholera measures, undertaken by the tsarist government, such as quarantine, armed cordons and migratory restrictions. Influenced by rumors of deliberate contamination of ordinary people by government officials and doctors, agitated mobs started raiding police departments and state hospitals, killing hated functionaries, officers, landowners and gentry. In Britain the first riots appear to have been in Aberdeen. The city of Liverpool experienced more riots than elsewhere. Between 29 May and 10 June 1832, eight major street riots occurred, with several other minor disturbances. The "Burking" issue was of special concern to the Liverpool citizenry because in 1826, thirty-three bodies had been discovered on the Liverpool docks, about to be shipped to Scotland for dissection. Two years later a local surgeon, William Gill, was tried and found guilty of running an extensive local grave robbing system to supply corpses for his dissection rooms.

1866
The 1866 Chester Cholera epidemic followed a cattle plague the previous year. At the time people believed that this was due to drinking water being contaminated by surface drainage from places where dead cattle had been buried in haste. At a meeting of the Assembly in May 1866 it was decided to provide two places for Cholera wards within the City in case the outbreak reached Chester. One of these was located in a disused farmhouse on the land which was to become Grosvenor Park. The heftiest women from the local workhouse were selected as potential nurses but there was some concern that they were neither honest nor sober, had no training and that it was unwise to put them in charge of either patients or medicines. Fortunately Frances Wilbraham (1815-1905) of Kings Buildings (King Street), a wealthy member of the local gentry volunteered to oversee them. The first two case of cholera appeared on 1st September 1866. One was a woman from a tenement in Goss Street the other Alderman John Trevor, a former mayor and editor of the Chester Chronicle: both were dead within days. The ward in the park was soon full of the sick and dying, but Francis Wilbraham nursed them tirelessly and by November the outbreak began to abate. The Duke of Westminster called Frances Wilbraham the "Florence Nightingale of Chester". The farmhouse was demolished before Grosvenor Park was opened.

The epidemics illustrated the weakness of the sewage system in Chester and in 1872–5, alarmed by analysis of the drinking water, and with George Angelo Bell as consultant, the council built intercepting sewers to collect the outfall from the existing drains, one running from the Bars to the Little Roodee and the other from Liverpool Road to a new treatment works by the Dee off Sealand Road, from where the treated effluent was discharged into the river.

Throughout the 19th century, the medical community was divided on the explanation for disease proliferation. On one side were the contagionists, believing disease was passed through physical contact, while others believed disease was present in the air in the form of "miasma", and thus could proliferate without physical contact. Florence Nightingale was a firm believer that disease passed through the air and she wrote:


 * "The idea of "contagion", as explaining the spread of disease, appears to have been adopted at a time when, from the neglect of sanitary arrangements, epidemics attacked whole masses of people, and when men had ceased to consider that nature had any laws for her guidance. Beginning with the poets and historians, the word finally made its way into scientific nomenclature, where it has remained ever since [...] a satisfactory explanation for pestilence and an adequate excuse for non-exertion to prevent its recurrence."

1899: Isolation Hospital


The idea of isolating patients suffering from infectious fevers in special hospital wards or confining them to their own homes was recognised at the end of the 18th century by Dr John Haygarth who retired to Bath after 30 years in Chester. His views were embodied in letters he wrote to British and American doctors which were read to the Bath Philosophical Society, although Bath did not establish an isolation hospital for many years. In Chester, Haygarth had put his ideas into practice at the Infirmary. In 1778 Haygarth helped found the Smallpox Society of Chester; the group advocated variolation, a form of inoculation which uses a live pathogen, an unpopular position at the time, and tried to educate the populace so as to avoid casual contraction of the disease. Edward Jenner's work on vaccination only followed some twenty years later and Haygarth is largely forgotten. See the Infirmary page for more details.

Only four years after this effort began, Chester's smallpox mortality rate had been reduced by almost 50%. In an experiment starting in 1785 Haygarth turned some lumber out of a long attic, got windows open and make a fever isolation ward. As typhus/typhoid (Enteric Fever) is transmitted by lice or rat-fleas, it was essential that floors were scrubbed, clothes and linen washed or disposed of and that all utensils were marked for use in this ward alone. Unfortunately, no-one would come and work there. Eventually a male patient who had had surgery volunteered to look after men, but he caught fever and died. Presently a nurse, Lowry Thomas, came forward. She served men and women for eleven years. Four times she contracted fever, the fifth time she died. There was also Jane Bird, catching fever twice in four years and then resigning. Haygarth complained they had done too much. Most patients survived, the spread of diseases was reduced and no-one in the rest of the hospital caught an infection.

The details of the infective agents involved in diseases were not really clarified until the 1930's. Bacteria were first observed by the Dutch microscopist Antonie van Leeuwenhoek in 1676, using a single-lens microscope of his own design. Robert Koch (11 December 1843 – 27 May 1910), a pioneer in medical microbiology, worked on cholera, anthrax and tuberculosis. In his research into tuberculosis Koch finally proved the "germ theory", for which he received a Nobel Prize in 1905. Louis Pasteur (December 27, 1822 – September 28, 1895) had been unable to find a causative agent for rabies and speculated about a pathogen too small to be detected by the microscopes then available. In 1898, the Dutch microbiologist Martinus Beijerinck had coined the term "virus", although there were still competing theories as to what they were. Antoine Béchamp proposed that tiny organisms he termed microzymas, and not cells, are the fundamental building block of life. Bechamp claimed these microzymas are present in all things—animal, vegetable, and mineral—whether living or dead. Robert Newstead (1859–1947), formerly of the Grosvenor Museum used the term "zymotic" in a 1908 publication in the Annals of Tropical Medicine and Parasitology, to describe the contribution of house flies (Musca domestica) towards the spread of infectious diseases. With further developments in the 1950's the theory of viruses became the established picture of how many diseases were transmitted.



The city council opened its own isolation hospital on the south side of Sealand Road almost at the city boundary in 1899 to meet its statutory obligation to provide treatment for patients with certain notifiable infectious diseases, among which scarlet fever, diphtheria, and typhoid were the most common. The hospital was designed by Harry Beswick with an administration block and four separate pavilion wards, accommodating 46 patients in all. It cost £21,300. In 1900 the corrugated-iron buildings at Infirmary field were moved to an even more remote site off Bumper's Lane, south of the isolation hospital, and arranged as two wards for up to 12 smallpox patients.

The hospital usually had between 10 and 20 patients at any one time, and coped with more serious outbreaks by putting up temporary accommodation. When smallpox infected 67 people in 1903, for example, the council's public health committee put up tents near the smallpox wards. Its other measures including opening vaccination points in Lower Bridge Street and Saltney, closing schools in Handbridge, and cancelling or postponing some of the regular summer entertainments, and fatalities were restricted to just six. In 1909 tents were again used for an outbreak of scarlet fever.

The smallpox wards, virtually disused after 1903, housed German prisoners of war in 1918–19. It seems to have played little part in the influenza outbreak. As part of the changes leading up to the creation of the National Health Service, the isolation hospital was closed in 1947 and patients were treated at Clatterbridge Hospital on Wirral until isolation wards were opened at the City Hospital. The buildings at Sealand Road were made over to the city council's public assistance committee and reopened in 1948 as an old people's home, Sealand House.

1918: Spanish Flu and the 20th Century
There are four genera of influenza virus, each containing only a single species, or type. Influenza A and C infect a variety of species (including humans), while influenza B almost exclusively infects humans, and influenza D infects cattle and pigs. The type A viruses are the most virulent human pathogens among the three "human" influenza types and cause the most severe disease. Flu viruses vary widely in their host range, infectiveness and the seriousness of infection. Migratory birds can spread influenza across long distances. An example of this was when an H5N1 strain in 2005 infected birds at Qinghai Lake, China, which is a stopover and breeding site for many migratory birds, subsequently spreading the virus to more than 20 countries across Asia, Europe, and the Middle East. The virus can be transmitted from wild birds to domestic free-range ducks and in turn to poultry through contaminated water and aerosols. Transmission to poultry typically occurs in backyard farming and live animal markets where multiple species interact with each other. However for some strains transmission between species is rare.



The word "influenza" comes from the Italian word influenza, from medieval Latin influentia, originally meaning "visitation" or "influence" of the stars (or of the wind). This referred to the disease's cause, which at the time was ascribed by some to unfavorable astrological conditions (or an "ill wind"). Before the start of the 20th Century it has been estimated that ther had been around ten flu' pandemics, or about three influenza pandemics in each century for the last 300 years. The most recent ones being the Asian Flu in 1957/8 and the Hong Kong Flu in 1968. These earlier outbreaks included the 1889–1890 pandemic, when the spread of that disease appears to have been assisted by worldwide transport. It was first reported in the Central Asian city of Bukhara in the Russian Empire, in May 1889. By November it had broken out and was in St Petersburg and Kiev. The infection spread via the Baltic shipping trade to Vaxholm in early November 1889, and then to Stockholm and the rest of Sweden, infecting 60% of the population within eight weeks. Rome and Paris were reached by December and it spread rapidly to Britain. The first case on American soil was reported on 18 December 1889. San Francisco and other cities were reached before the month was over. Durban had been reached by November and India by February 1890. Within four months of the break-out it had spread through the entire northern hemisphere, a much faster rate of spread than that of the early plagues which may have only moved at the speed of a Roman army.

Between March 1918 and May 1919, approximately 228,000 Britains lost their lives to what is often termed "the Spanish Flu". By comparison the deaths in Britain due to WW1 (1914-1918) were less than three times this figure: about 700,000. Worldwide, it had been estimated that the pandemic killed at least 20-50 million people (possibly as many as 100 million): more in one year than the Black Death killed in a century. Despite its name, the first recorded cases and deaths from Spanish flu were in the US (in Kansas), with later cases being identified in France, Germany, and the UK. However, the near-simultaneous appearance of influenza in March–April 1918 in North America, Europe, and Asia makes definitive assignment of a geographic point of origin difficult. Convincing evidence has been put forward that a significant part of the spread was through troops involved in the First World War.

Most countries — already suffering from the devastating effects of World War I — imposed censorship on their press. But Spain remained neutral during the war, which meant national newspapers reported freely on the impact of the virus. This, and the fact that the Spanish King (Alfonso XIII) caught it, led to the false impression that the virus originated in Spain. Scientists offer several possible explanations for the high mortality rate of the 1918 influenza pandemic, including a severe 6-year climate anomaly that affected the migration of disease vectors and increased the likelihood of the spread of the disease through bodies of water. Others consider that the virus was a particularly deadly strain, while yet others have concluded that it was no more deadly than other strains and that malnourishment, overcrowded medical camps and hospitals, and poor hygiene, all exacerbated by the recent war, promoted bacterial superinfection (pneumonia) which killed most of the victims. Some writers appear to place much emphasis on particular reasons for the high mortality.



In England, the Registrar General’s figures showed four of the five towns with the worst death rates per 100,000 from Spanish Flu were in the North East and Yorkshire – Hebburn (1194); Jarrow (877); Kidderminster (849); Barnsley (835) and Wallsend (828). Comparing these figures with COVID-19, as of 16th March 2021 only Barnsley (782) is listed in the new areas, but comparisons might not be helpful as the two diseases have different age related morbidity and the population is quite different.

In 1918 American soldiers began to arrive in Chester and baseball matches were held to make them feel welcome. Despite the onset of the 'Spanish' influenza epidemic, peace was celebrated 'exuberantly', with huge bonfires. Attempts to contain the virus were made in some places. Relative to the average number of flu deaths per week over the course of the epidemic, the number of flu deaths at the peak was lower in cities that pursued more aggressive policies, such as school closing, public transport being shut down and prohibition of public gatherings (as in Spain), but the numbers are suspect simply because the measures that were put in place were typically only enforced for about one month. Spanish flu also had its share of "conspiracy theories": according to one account, the pandemic arrived in the US via a camouflaged German ship that infiltrated Boston harbor under cover of darkness and "released the germs that seeded the city" - a variant of the story uses a submarine. Another, equally scary version maintained that the germs were inserted into aspirin manufactured by the German pharmaceutical firm Bayer. In July 1918, the English satirical magazine Punch wrote that "Spain has rendered itself unpleasantly conspicuous by developing and exporting a new form of influenza". But in Madrid, the disease was dubbed the "Naples Soldier" (the name of a song from a popular operetta); in Italy, it was called the "German disease"; in Germany, the "Russian plague"; in Russia, the "Chinese sickness"; and in Japan, the "American disease".

Other Diseases
Overcrowding and poor sanitation encouraged the spread of tuberculosis and diphtheria in Chester. By the 1930's many "zymotic" diseases had begun to retreat, but diphtheria remained intractable. Between 1930 and 1942, when immunization was voluntary, there were 1,269 cases and 83 deaths in Chester. After compulsory vaccination was introduced in 1942, deaths from diphtheria ceased. While the overall death rate in Chester was not much higher than the national average, it always exceeded that for small towns, the category in which the city was classed.

By the 1970's vaccines had been developed against many of the common viruses and large scale immunization programs significantly reduced incidence in Britain. Smallpox was effectively wiped out worldwide. However new pandemics continued to emerge. Sometime in the early or mid 20th Century a simian immunodeficiency virus (SIV) that infects wild chimpanzees appears to have crossed into the human population. 1979 saw the first UK transmission of HIV in contaminated blood, with the first UK death in 1981. It would be over ten years before the first effective therapy was developed. Worldwide, as of 2020, over 30 million people have died of the virus or complications associated with HIV/AIDS.

Plagues and pestilences became something a tourist attraction in Chester in the 2016 when a somewhat grisly family attraction named "Sick to Death" opened at the Watertower. It was home to the "Plague Doctor" an actor dressed in the traditional garb who was hired to wander the streets of Chester to publicise the exhibit. In 2017 the exhibit was closed and rumours rapidly spread around Chester that this was due to an infestation of rats. In fact rats were not the only reason for the closure. Dean Panon, director of the managing company was reported as saying:


 * "We are having a big refurbishment; new stuff is going in and some old stuff is coming out. The council did pull out some trees in the Water Tower gardens and I think it disturbed a nest of rodents. We had one or two in the tower but that’s not the only reason for the closure."

Present technology provides a faster response to new pandemics than in the past but there is currently no technical prospect for preventing the emergence of new pathogens either by mutation of existing human pathogens or entry from an animal source. The quarantine techniques developed in the middle ages and the Track/Isolate/Innoculate techniques pioneered by John Haygarth at Chester are still among the most effective measures.

21st Cent: SARS, COVID
Coronavirus is the common name for Coronaviridae and Orthocoronavirinae, also called Coronavirinae. Coronaviruses cause diseases in mammals and birds. In humans, the viruses cause respiratory infections, including the common cold, which are typically mild, though rarer forms such as SARS (including the one causing COVID-19) and MERS can be lethal. Coronavirus is only very distantly related to the influenza virus. Both are Orthornavirae, but this "kingdom" includes a large proportion of all human, animal, and plant viruses. The corresponding level of relation for humans would be to all other members of the animal kingdom, e.g. the degree of relation between the common cold and influenza can be likened, in a very general sense, to that between a jellyfish and a wasp. As recent events have shown some few members of this family of viruses, particularly those in the genus "Betacoronavirus" are associated with serious health issues. Again, in very general terms, the common cold and COVID have the same (Genus) level of relationship as humans have to Homo floresiensis ("Flores Man"; nicknamed "hobbit"). The virus which cause COVID differs from the common cold in that it has newly entered the human population and appears to have far more asymptomatic carriers.

The full effect of the 2020 COVID outbreak on Chester is yet to be seen. As of 2021 the effects are significant but fall far short of the effects of, for example, the Black Death. The longer term effects of pandemics are often possible to speculate upon in hindsight, but impossible to predict in advance.



A Chester "lockdown" timeline
At the beginning of March 2020 life was still "normal". In early March 5,000 runners (the size of a Roman legion) hit the streets of Chester for the 2020 Aldi Chester 10K, and spectators packed The Rows.


 * Mar 2020: First wave starts. The extremely clinally vulnerable are told to avoid all face to face contact even with members of their own household. First virus cases in CW&C. Lockdown measures come into force. University classes suspended in Chester. UK death toll passses 1000. First deaths in Cheshire.


 * Apr 2020: Debenhams, owners of "Browns of Chester" goes into administration. Measures extended for "at least three weeks". UK death toll passes 10,000. PM announces that "we are past the peak of the pandemic"


 * May 2020: UK death toll become highest in Europe. First wave peaks.




 * Jun 2020: The extremely clinically vulnerable are allowed out. Cheshire death toll passes 1000;


 * Jul 2020: Hospitality venues allowed to re-open. Face coverings become mandatory in shops. Isolation period extended to ten days.


 * Aug 2020: "Eat out to help out scheme"


 * Sep 2020: Gatherings of more than six banned


 * Oct 2020: Second wave starts. CW&C placed in tier 2.


 * Nov 2020: Second lockdown starts. Second wave peaks. UK death toll passes 50,000.


 * Dec 2020: Second Lockdown ends. Rules relaxed for Christmas. Third lockdown starts. CW&C moves into tier 3.


 * Jan 2021: Third wave peaks. Cheshire infection rate peaks at over 2000 new cases a week. Clinically vulnerable in Cheshire asked to stay at home. UK death toll passes 100,000


 * Feb 2021: UK death toll passes 120,000.


 * Mar 2021:

Conclusions
One theory for the origin in some, but certainly not all, cycles of plague and other pandemic disease is that which links volcanic eruptions to instances of climate change, leading to crop failure and other ecological disturbance. The crop failures can in turn lead to societal changes through internal unrest and/or war and conquest.

Over the centuries Chester has been afflicted with many of the infections which have occurred elsewhere in Britain. The reasons for the outbreaks are much the same as elsewhere: new pathogen introduction from animals and/or mutation of an existing human pathogen, complicated by a lack of knowledge, and often one or more of poor living conditions, famine and war. Chester's function as a port at times made matters worse, especially where troops were involved.

John Haygarth's pioneering work at Chester Infirmary set the pattern for dealing with many infectious diseases, particularly Smallpox: find every case; isolate the infected individual and immunise all their contacts. This method of "ring vaccination" ensures that everyone who has been, or could have been, exposed to a patient receives the vaccine, creating a 'ring' of protection that can limit the spread of a pathogen. Haygarth achieved a partial success, but his efforts were hampered by the inefficiency of his "track and trace" system and distrust of the innoculation process, which used a weaker strain of Smallpox. What makes Haygarth's work all the more remarkable is that it was largely empirical - he would have known nothing of the modern theories of bacterial and viral infections and had only the most basic inoculation techniques available to him.

Sources and Links


The links below relate to the history of pandemics and, where possible, their impact on Chester. While it is useful to compare the past instances of pandemics with the present (2020/1) pandemic, the links should not be considered as a source of medical advice.

Related Pages

 * Infirmary:
 * Workhouse:
 * St Giles Cemetery:
 * Boughton;
 * Grosvenor Park:
 * Medical Museum:
 * Water Supply;

Online

 * List of famines & pestilences in England;
 * The Aurelian Plague; Pandemic Events and the Military;
 * Demography 1550-1762;
 * A History of Epidemics in Brtain;
 * Resolving Repton;
 * Stories of an influenza pandemic;
 * The Origin and Virulence of the 1918 “Spanish” Influenza Virus;
 * Concepts of Infectious, Contagious, and Epidemic Disease in Anglo-Saxon England;
 * Treatment Rates for the Pox in early modern England: a comparative estimate of the prevalence of syphilis in the city of Chester and its rural vicinity in the 1770s;
 * "The coming of the sewers to Hoole";
 * Haygarth and Perkins' Tractors;
 * Haygarth on Smallpox;