Guest article written by: JoAnn Spears
Part I: Working up a sweat, bugs indeterminate, and a man named Butts
The courtship of Anne Boleyn and Henry VIII is the stuff of legend. Tudor history buffs and Anne Boleyn fans alike will already know that Anne Boleyn was the first and foremost proponent of ‘if you like it… put a ring around it’. By 1528, after about two years of courtship, Henry had yet to do so. Anne parried with a retreat from Henry’s court to her family’s country home at Hever. Romantically enough, she was suffering from, or at risk of contracting, a catching ailment. There was a real chance she could die from it. More romantically still, she hastened away to protect Henry from the contagion.
On a less romantic note, Henry himself did not follow Anne to Hever. His devotion only stretched to his sending, in his stead, his second-best physician. Less romantically still, that physician was called Butts, and the disease he was to treat Anne Boleyn for was known as ‘The Sweat’.
Life-threatening plagues and infectious diseases were a feature of life in Europe during the Middle Ages and the Renaissance. Some of these illnesses are fairly well understood retrospectively. For example, a good deal is known today about the causation, mode of transmission, treatment, and natural course of Yersinia pestis, or Plague. The Sweat, however, remains, like its star sufferer, something of an enigma.
The Sweat debuted in England around the same time that the Tudor dynasty did, in 1485. It recurred in 1508, 1517, 1528 and 1551; as far as we know, it did not recur thereafter. Each of these outbreaks began in England, and four of them had little or no spread outside of the British Isles. The fourth, the outbreak of 1528, made its way across much of northern and eastern Europe.
Two Tudor physicians, Thomas Forestier and John Caius, are the sources of much of the extant medical information about The Sweat. The accounts these two physicians give of the condition are like bookends to its history. Forestier speaks from the perspective of the first outbreak of The Sweat, in 1485. He isolates The Sweat from other pestilences and poxes of the time by identifying the primary way in which it was unlike them; the absence of rash, pustule, buboe, or other manifestation on the skin. “The exterior is calm in this fever”, Forestier explained, “and the interior excited.”
John Caius authored “A boke or counseill against the disease commonly called the sweate or sweatyng sicknesse” in 1552, after the last outbreak of The Sweat. He felt confident enough in his experience and findings to subtitle the work “uery (very) necessary for everye personne and much requisite to be had in the hands of al (all) sortes, for their better instruction, preparation and defence, against the soubdein (sudden) comyng, and fearful assaultyng of the same disease”.
Prominent as Forestier and Caius were as practitioners, they do not have the same Tudor cache as the man who was on the job when Anne Boleyn commenced The Sweat: Dr. William Butts. Other than his Sweating-Sickness association with Boleyn, little is known about the man. Just what would the second-best Butts encounter when he arrived at Hever to tend his King’s lady love? It’s difficult to tell the exact point in Anne Boleyn’s Sweat trajectory at which Butts came into the picture.
Part 2: Running hot and cold
Anne Boleyn retreated to Hever when an unidentified lady-in-waiting of hers contracted The Sweat in June, 1528. Butts, however, is reported to have treated Anne herself for the ailment when he was dispatched to Hever.
Butts would have been under tremendous pressure, certainly, to pull his patient through, or suffer the ire of the infatuated Henry VIII. The prospect of that must have loomed large for poor Dr. Butts. Since Anne Boleyn was stricken during one of the midcourse outbreaks of the disease, it would likely have been established by then that mortality rates were high with this condition–as high as 70%–even in heretofore healthy individuals.
Pressure aside, Butts would have been faced with a patient who was enduring, had endured, or was about to endure a grueling progression of symptoms. The acute trajectory of The Sweat was rapid. From time of onset, death or a turning point toward survival typically occurred within 24 hours or, as Caius would have it, ‘one natural day’.
Anne may have gone through the prodromal symptoms of violent chills and a feeling of doom before Butts got to her. It’s possible that he arrived in time to see Anne through the second phase of the illness, characterized by severe cephalgia (aching and pain in the head and neck), diffuse myalgia (pain in the limbs), and prostration. Even if he missed these prodromals, perhaps Butts was present for the eponymous symptoms that would have followed.
Caius relates that several hours after the initial vague symptoms of The Sweat set in, more telling symptoms followed. He speaks of the “fight, trauaile (travail), and laboure of nature againste the infection receyued (received) in the spirites, whervpon (whereupon) by chaunce foloweth a Sweate’.
As described by Caius, profuse and copious sweating and ‘heat’ were the manifestations of the fight of the patient’s constitution against the depredations of The Sweat. Caius, and poor Dr. Butts, practiced medicine in an era in which temperature, blood pressure, and electrolytes could not be accurately measured. It seems likely though, that high fevers and autonomic instability were part and parcel of the acute phase of The Sweat. This phase of symptoms would be followed by cardiopulmonary symptoms, according to Caius: heart palpitations and chest pain, labored breathing, and an overall feeling of heaviness. Gastrointestinal symptoms such as nausea and ‘wind’ might also occur. Eventually, exhaustion and a desire to sleep set in.
Anne Boleyn survived her experience with The Sweat and eventually went on to marry Henry VIII and give birth to his daughter, Elizabeth I. Given Anne’s mercurial ways, it’s not surprising that there are some who say that she never had The Sweat at all. Could it be that she merely used the circumstances that prevailed in the summer of 1528 to manipulate the besotted Henry VIII and advance her own agenda? This scenario is certainly not outside of the realm of possibility.
An interesting side-note to the story of Dr. Butts is the fact that his daughter, Anne, married Sir Nicholas Bacon. Historical rumor and conspiracy theory have it that two scions of the Nicholas Bacon family, Anthony and the legendary genius Sir Francis Bacon, may actually have been the illegitimate children of Elizabeth I, and therefore the grandchildren of Anne Boleyn.
As for the dreaded Sweat, it remained contemporaneous with the Tudor dynasty through the reign of Mary I, known as ‘Bloody Mary’. The Sweat bowed off the Tudor stage in time to spare the subjects of the last of the Tudors–Anne Boleyn’s daughter, the glorious Elizabeth I– from its ravages.
About the Author
JoAnn Spears couldn’t decide whether to major in English or History in college. Life stepped in, and she wound up with a Master’s Degree in Nursing instead. A twenty-five year nursing career didn’t extinguish that early interest in books and history-especially Tudor history. It did, however, stoke a decidedly gallows sense of humor.
Eventually, JoAnn read just about every spin there was on the stories of Henry VIII and the extended Tudor family. Every spin, that is, except the one with the gallows humor. The Tudors certainly qualified for it, but it just wasn’t out there. JoAnn decided that with gallows humor to spare, she would do her best to remedy the Tudor comedy gap. A little inspiration from the classic “Wizard of Oz” showed her the way to go, and “Six of One”, a new kind of Tudor novel, was born.
JoAnn thought “Six of One”, her story about Henry VIII’s six wives, would be an only literary child. Then, two years after its birth, she was caught by surprise with the idea for a sequel. In October, 2015, “Seven Will Out” made its debut and bought the latter-day Tudors into the comedy mix.
JoAnn enjoys writing but maintains her nursing license because a) you never stop being a nurse and b) her son thinks she should be sensible and not quit her day job. She also enjoys life in the beautiful mountains of northeast Tennessee, where she gardens, embroiders antique reproduction samplers, and teaches yoga in her Methodist church basement. JoAnn shares her home with three cats and the works of Jane Austen, Barbara Pym, Louisa May Alcott, and of course, Alison Weir.