History and Geography

"Scrophula," like "scurvy" and "syphilis," is not a term that was used by the ancients. Whereas there may be special reasons why the latter two were unknown (a distribution to the north of the ancient Mediterranean and a possible Columbian origin, respectively), there seems to be no reason to suspect that scrofula was a new disease. Or, at least, so it seemed to many of the humanist doctors of the Renaissance, trying to reconstitute Greek medicine. In fact, the best they could do in the case of scrofula was to claim that one of its chief symptoms, tumors in the neck, was to be identified with the struma of the classical physicians. But simple strumae in the ancient descriptions were not associated with the other features that Renaissance physicians knew were part of scrofula. But how did they "know" this? Where did their picture of scrofula come from?

The answer is that there were medieval descriptions of scrofula. Partly these came from a surgical tradition, which was less Hellenizing than the physicians' medicine of the Renaissance. And in part they came from a popular tradition in which scrofula was identified as the "King's Evil," and it was believed curable by the touch of a king. The essence of the medieval ceremony of touching in order to dispel the evil was that it demonstrated the quasi-sacerdotal nature of the office of kingship. The political advantages were clear, for a king, in performing the cure, showed that he was king in accordance with God's will. This was the important point in the seventeenth and eighteenth centuries, when the nature of scrofula was most energetically explored: The power of curing by the Royal Touch was a power vouchsafed by God only to the true line of kings. It could therefore be used to legitimate claim and accession to the throne. The kings of France continued to touch until the Revolution, and were emulated by other monarchs. In France and pre-Reformation England, the religious nature of the ceremony cemented the relationships and mutual stability of church and throne. It was a ceremony too miraculous for the taste of some Protestants, although the English Puritans at first tolerated it, and James I, although of a Calvinist background, found it increasingly expedient to use the Touch. But by the time of Charles I, his opponents saw it as a justification of absolute royal rule by a king who claimed to act as a representative of God. The Stuarts, whether on the throne or in temporary or permanent exile, continued to touch for the King's Evil, and their supporters continued to claim that their success in curing scrofula was a sure sign of their descent in the true line and thus the only legitimate monarchs. The Puritans and Parliamentarians saw the Touch as politically dangerous and tried to suppress it. Queen Anne was the last British monarch to use the Touch. The Hanoverians, as kings of political convenience, made no attempt to practice it, and their Whig supporters professed horror at a medieval and superstitious ritual.

The strongest passions were aroused in the conflicts that surrounded the issue. Crowds pressing around the Stuart kings to receive the Touch contained thousands of individuals; and there is no need to emphasize that in the Civil War the questions that split families were ones of religion and personal salvation, and of liberties and duties on Earth. Because the King's Evil was intimately bound up with the person of the king, if we look for a "distribution" of scrofula -for example, by examining seventeenth-century medical works - we find abundant references to the disease in Britain and France. But elsewhere the texts may be completely silent about the disease. Thus in Holland, recently freed from the rule of an absolutist and Catholic monarch, and a republic of sorts, scrofula had no place in the medical consciousness. Nor did Italian or German medical men, with no national attachment to a true line of kings, have much reason to emphasize scrofula as a disease entity, but rather viewed its separated symptoms as different entities. By the eighteenth century, some medical reference works betray an Enlightenment embarrassment in identifying scrofula as a disease that had a nonmedical cure, the Touch. In discussing the disease, British writers of the eighteenth century drew on a tradition of literature that rested on the works of Richard Wiseman, surgeon to Charles II. In the earlier nineteenth century, with the disappearance of the French line of kings, scrofula continued to be identified, although perhaps more regularly in its adjectival form and applied to a symptom. The notion that lay behind the name did not long survive germ theory, when attention turned away from collections of symptoms to causative microorganisms.

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