In 1613, William Upton, the ‘keeper’ (manager) of the City of London's pesthouse, complained to the justices of the peace in Middlesex that the suburban parish of St Giles Cripplegate was responsible for a child that had been abandoned at his gate. The pesthouse was a type of segregation facility for the plague sick and was located in the northern area of Cripplegate in Middlesex, beyond the City's formal jurisdiction. The justices argued that it was ‘exempt’ from the county and ‘reserved for the particular’ use of the City, and ordered Upton to ‘free’ the parish from the charge of the child.Footnote 1 Behind this decision lay complex issues of government in London's growing suburbs and these played a part in the failure of the City to develop a more extensive network of pesthouses to manage plague. This in turn influenced the limited use of the metropolitan facility by suburban parishes within the City's jurisdiction and the establishment of a local pesthouse by some without.
Although the pesthouse is an acknowledged aspect of the plague narrative in early modern England, it has received limited attention from historians. Jane Stevens Crawshaw argued that this relates to the focus of scholars on epidemics and periods of crisis, rather than thinking about the response to plague in the wider medical and social contexts.Footnote 2 This article addresses the historiographical oversight by situating the use of the pesthouse in London's suburbs in the context of issues arising from the enormous growth of the capital. These include the increasing suburban bias of plague, the intersection of disease with poverty, the development of urban public health policies, the nature of parochial government and the relationship between the City of London, the suburban parishes and the crown.
The article focuses on the years between the establishment of the City of London's metropolitan pesthouse in the northern suburb of St Giles Cripplegate in 1594 and the end of a period of endemic plague in 1648. The 1630s are a particular focus, as plague events were set against a forceful but unsuccessful push by the crown to expand the pesthouse network and to extend centralized government in the suburbs. The inadequate pesthouse provision that existed in 1665, and the attempt to scale up, were the result of the approach to the pesthouse taken earlier in the period. The pesthouse in 1665 was covered in some detail by Lloyd and Dorothy Moote in their expansive survey of the epidemic and is therefore not a focus of this study.Footnote 3 The year 1665 marked the beginning of a different phase in the approach to plague management and resulted in the new Plague Orders of 1666, for which the pesthouse was intended to be a key feature.
This article begins with a brief introduction to the English plague regulations and experiments with the pesthouse in British provincial towns and cities in the first half of the seventeenth century. The second section considers the City's pesthouse in Cripplegate, which was not a priority amongst other facilities and infrastructure they managed, but was run by experienced senior staff and was the focus of public health improvements. The third section considers the limited use of the City's pesthouse by the suburban parishes fully or partially under the jurisdiction of the City of London, and their view of the senior staff as public health officials. The final section is focused on the establishment of a local pesthouse in several suburban parishes outside the jurisdiction of the City and considers change and continuity in the use of the pesthouse in St Martin in the Fields in the 1630s and 1640s. The independence and power of parochial government was behind the flexible and pragmatic approach to plague management in the suburbs. This played a role in the different ways that parishes approached the pesthouse and the gradual shift in intention from segregation to improved public health and care.
The neglect of the pesthouse by scholars has also been attributed by Crawshaw to many facilities being temporary and leaving little trace in the archival sources.Footnote 4 Suburban parish records show how the pesthouse was used, but the evidence is indeed patchy. St Martin in the Fields has been included for the quality of their records and the possibility of assessing change over time in the operation of the local pesthouse. National and civic sources are used to show the context in which suburban parishes used the pesthouse and to provide some comparison to other British localities.
The role and function of the pesthouse in early modern Britain
Responsibility for the problem of plague in England was devolved to parishes by the national Plague Orders in 1578, which received statuary sanction in 1604. Described by Paul Slack as ‘innovative, far-reaching and permanent’, the regulations remained relatively unchanged in subsequent reissues until they were ‘radically revised’ in 1666.Footnote 5 The Plague Orders established the officials and frontline workers who were to be appointed to manage plague, public health measures related to sanitation and housing and the practicalities of isolating the sick and their household contacts. The regulations required that the entire household be quarantined when plague was identified as the cause of death or illness. These measures were based on contemporary beliefs about contagion and the spread of plague by miasma (corrupted air), and were influenced by continental practice.Footnote 6
Our preconceptions about the contemporary response to plague have been shaped by whether what early modern Europeans called ‘plague’ was identical to modern bubonic plague.Footnote 7 The latter is dependent on rats and fleas for transmission, although human fleas and lice have also been shown to transmit the disease.Footnote 8 The recent discovery of the bacteria's ancient DNA (aDNA) in skeletons excavated from a London burial pit dated to the 1665 epidemic has resolved aspects of the debate.Footnote 9 The continuing work with aDNA, as Slack highlighted, has important implications for the judgments we can make about the ‘perceptions of contemporaries’ and their response to plague.Footnote 10 This includes the use of the pesthouse.
On account of its size, London devised special plague regulations in 1583, but they made no specific provision for a pesthouse. This followed a period in which plague was endemic in the capital, particularly in the suburbs.Footnote 11 Despite controversy, the belief that plague was contagious meant that quarantine was considered a ‘key element’ in the City's plague strategy throughout the seventeenth century. The view that parish authorities were best placed to respond to plague was also a central feature of the regulations.Footnote 12 The Plague Orders imposed great responsibility and an increasing burden on parish vestries, which tended to be select in structure in the suburbs – a narrow, co-opting and socially exclusive group that governed the parish – by the early seventeenth century.Footnote 13 Their focus was on the search for efficiency amidst limited resources, which also lay behind hardening perceptions of the right to residency and relief. The Plague Orders presented independence and flexibility to parishes, which was essential given that the interventions of national and civic authorities were inconsistent in the suburbs after 1600.
The ‘suburbs’ as discussed in this article broadly include the extramural and out-parishes included in the Bills of Mortality by 1636, the latter including Westminster (Figures 1 and 2). There is some flexibility of definition exercised, particularly as the area under the Bills was not fixed until 1636 and some suburban parishes were not included in earlier returns. It is important to note the difference in local government for the suburban parishes under the jurisdiction of the lord mayor, which were also part of the City's wardmote system that carried military, judicial and administrative responsibilities, and those outside that jurisdiction.
Figure 1. Map of the metropolitan London parishes, c. 1636–60.
Source: M. Davies, C. Ferguson, V. Harding, E. Parkinson and A. Wareham (eds.), London and Middlesex Hearth Tax Returns (London: BA & BRS Hearth Tax Series IX, 2014). I would like to thank Andrew Wareham at the Centre for Hearth Tax Research (University of Roehampton) for permission to use this map.
Figure 2. Map of the metropolitan London parishes in Middlesex and Surrey, c. 1636–60. Source: Davies et al., London and Middlesex Hearth Tax Returns. I would like to thank Andrew Wareham at the Centre for Hearth Tax Research for permission to use this map.
The English plague regulations were influenced by developments in Italy, where large plague hospitals, or Lazaretti, were an essential feature of plague management in some city-states from the fifteenth century. It has been argued by Crawshaw that the two state-funded hospitals in Venice were central to its public health strategy, and were a ‘powerful’ weapon in the ‘fight’ against plague. She argued for the ‘genuine’ intention of the hospitals to treat the plague sick and prevent the spread of the disease, and aligned them with the Republic's other medical and charitable institutions.Footnote 14 The historian of early modern Italian plague, John Henderson, pointed to the ‘public expression’ of Christian charity that was behind the Italian plague hospitals. While acknowledging the terrifying conditions and marginalization of the poor in Florence, Henderson also argued for the ‘deliberate’ purpose of Lazaretti to treat and, where possible, attempt to cure the plague sick.Footnote 15 Plague hospitals spread to various cities in France, Spain, the Swiss Confederation, Germany and the Low Countries in the fifteenth and sixteenth centuries.Footnote 16
The centralization of government was important to the development of plague measures in continental Europe. The situation was different in the British Isles where local government continued to be dominated by the parish in England and Wales and the burgh in Scotland, and there was a reluctance to invest in permanent pesthouse facilities. From the early sixteenth century, civic authorities in Scotland sometimes built temporary segregation camps. Karen Jillings, for example, found that pesthouses were erected hastily and cheaply in Aberdeen and were ‘relatively’ devoid of healthcare. Jillings contrasts the Scottish focus on segregation with the comfort that was ‘embedded in care’ in the Italian plague hospitals, which tended to be permanent facilities.Footnote 17 The attitude in England was somewhere between these two approaches, and the period up to 1665–66 is best described as one of local experimentation.
Attempts to segregate the plague sick in sheds and houses outside the walls of several English provincial cities from the 1530s have been identified by Slack. He suggested that there was an increasing preference for the pesthouse to manage plague in the seventeenth century.Footnote 18 The mayor of Dartmouth in Devon informed the privy council in July 1627 that 15 houses were infected and that all inhabitants had been sent to a pesthouse remote from the town.Footnote 19 This strategy may have been aimed at containing a localized outbreak but it was also clearly motivated by bias against the poor. Entire families of ‘certain’ houses in Chapel Street in Liverpool were removed to newly built cabins beyond the town in April 1648. The ‘8 or 9’ persons that subsequently died of plague were apparently of ‘mean quality’.Footnote 20 As the example in Dartmouth suggests, there was confidence that the pesthouse could control the spread of plague when deployed quickly to segregate the sick. Six pesthouses were erected and enclosed near the Black Tower in the city walls of Norwich in April 1630. The city's ‘great caution’ apparently had the ‘desired effect’ as plague was contained. The structures were taken down in July when the need had passed.Footnote 21
There is evidence of a shift towards public health and improved care in some localities after 1630. In 1602, the City Corporation in Hull established a pesthouse in Myton Carr, an agricultural area to the west of the town. In 1604, they discussed the ‘great danger’ the infected posed to their neighbours if they were not removed there, where agricultural buildings were acquired and made ‘fit’ for use as a pesthouse. The owners of the buildings were to be paid ‘restitution’ for any damages. These must have been very basic facilities, but the location away from the town served the purpose of segregation. More pesthouses were built there in 1637. They were altered for better cleansing and an improved water supply in early 1638, which suggests a greater focus on public health.Footnote 22 Interesting experimentation is evident in Manchester, where survivors were moved from an initial stay at Collyhurst outside the town, to another ‘Pest-house’ in the town, before being discharged. This was no doubt intended to ensure that the inmates were fully recovered before their release. A repurposed house was used, for which the owner was paid rent.Footnote 23 It is difficult to know why a particular building might have been taken over by authorities, but doing so was probably cheaper than erecting new structures for a temporary need.
Despite these experiments, house-based isolation remained the primary mode of managing plague in provincial England. Of the 1,372 quarantined individuals receiving relief plague payments in Preston in 1630–31, just 63 were inmates in the pesthouse.Footnote 24 Slack found that cabins or ‘hovels’ housed only a minority of the plague sick in outbreaks in Bristol in the 1640s. A quarter of all plague deaths occurred in the pesthouse in Worcester in 1637, which was ‘exceptional’. The 10 per cent that died in the pesthouse in Norwich in 1665–66 was ‘more usual’.Footnote 25
The earlier developments most certainly influenced the recommendation in the new 1666 national Plague Orders that each parish should establish a pesthouse. Slack found ‘remarkable investment' in pesthouses in several provincial cities after the publication of the new regulations.Footnote 26 He suggested that they were a revival of Theodore de Mayerne's (physician to Charles I) 1630/31 policy, which promoted the building of large European-style plague hospitals, and reflected the influence of Lord Craven, who argued in 1666 that household quarantine was difficult to enforce and did little to prevent further ‘contagion’ when it was.Footnote 27 The practice of shutting up infected houses had also attracted vehement criticism by writers and pamphleteers in London's major epidemics. A notable 1665 pamphlet argued that house-based quarantine was ‘little better’ than the inmates being ‘Murther'd, or buryed alive’.Footnote 28 Romola Davenport, Max Satchell and Leigh Shaw-Taylor have argued that the earlier developments influenced the use of the pesthouse for the treatment of smallpox beyond the disappearance of plague, particularly the focus on treating the poor.Footnote 29 While the discussion in this section provides some comparison to the pesthouse in London, it is important to acknowledge the unique demographic context in which the study of plague in the capital is situated.
The development of the City of London's pesthouse
During the early modern period, the population of London grew enormously, driven by domestic migration. From 60,000–70,000 people in 1550, the capital grew to 200,000 by 1600 and 400,000 in 1650.Footnote 30 The spatial and human focus was increasingly in the suburbs beyond the City's walls, where many parishes contained populations greater than England's provincial cities by the 1630s. To understand the plague experience in London, the focus needs to be on the suburbs, where the disease was a long-term problem and intersected forcefully with poverty. Around 20 per cent of the capital's population died in each of the major epidemics in 1563, 1603, 1625 and 1665, and 14 and 10 per cent in 1592/93 and 1636 respectively. The disease was endemic in London in the 1570s and early 1580s, the 8 and 13 years following the 1603 and 1636 epidemics, and there were minor localized outbreaks in 1630 and 1631.Footnote 31 Roger Finlay found that the impact of plague was unequally distributed between different areas of the growing metropolis and that the ‘greatest’ distress and the highest death rates were experienced in the extramural parishes in 1593, 1603 and 1625.Footnote 32 Suburban populations tended to be balanced toward the poor, a largely self-sufficient and mobile group with the potential to seek, receive or be excluded from parish relief. They were particularly vulnerable to the socio-economic dislocation that plague might cause, which is important when considering whom the pesthouse catered for.
The crown increasingly viewed the pesthouse as part of the response to plague and pushed for the city to build one in the years after the 1563 epidemic.Footnote 33 Following a failed scheme in 1583, a pesthouse was eventually established in St Giles Cripplegate in 1594.Footnote 34 The Cripplegate register does not identify any burials from the City's pesthouse, which probably had a burial ground, for which records do not survive. St Luke's Old Street was created in the Middlesex area of Cripplegate in 1733, and the vestry minutes refer to the ‘Pesthouse burial ground’ that had been appropriated for pauper burials.Footnote 35 The Bills of Mortality also reported burials ‘at the Pest-house’.Footnote 36 However, the pesthouse never became a major feature of the capital's plague experience. Slack estimated that the City's facility accommodated no more than 50 people in its first decade of operation. Despite the establishment of ‘at least’ two new pesthouses in 1630, the network of five metropolitan facilities that existed in 1665 accommodated just 600 people at any one time.Footnote 37 These included two new structures in the western out-parish of St Giles in the Fields and neighbouring St Martin in the Fields, an older pesthouse in St Margaret Westminster and a smaller structure to the east in Stepney. No pesthouse was built south of the river in Southwark.Footnote 38
The crown's complaints about the inadequacy of London's pesthouse provision were a familiar trope throughout the period.Footnote 39 The more general discord between the crown and the City about government in the suburbs, which increased during the 1630s, focused on whether the City should incorporate the suburbs or whether the suburbs should incorporate independently.Footnote 40 This contributed to the inertia that beset any plan to expand the pesthouse network. Anxiety about plague was behind the crown's renewed push to expand the network in 1630. The privy council proposed that four to five pesthouses should ring the metropolis, and sourced directions from St Louis and St Marcel hospitals in Paris for a hospital or workhouse for ‘receiving, nourishing, and dressing plague infected’. This was based on the advice of the aforementioned Theodore de Mayerne, who, along with the College of Physicians, drew attention to London's public health problems that related to overcrowded housing and the general lack of cleanliness.Footnote 41 Until this scheme could be achieved, the privy council were increasingly keen to see the City's pesthouse used more effectively. Alongside the City's reluctance, individual interests appear to have also hindered the building of additional metropolitan facilities. The privy council discussed the allocation of £206 for a new pesthouse in the north-western out-parish of Clerkenwell in May 1637. Complaints, however, were received from several noble residents about the closeness of the proposed facility to their houses, and the plan was scuppered.Footnote 42
Despite the limited capacity and narrow jurisdictional responsibility of the City's pesthouse, its operation was a feature of the Court of Aldermen's response to plague. This was primarily in years when the disease was a more tangible presence within the walls. In May 1603, they ordered the City chamberlain to ‘defraye’ the charges needed for ‘dyett and otherwise’ in preparing the pesthouse. The financial burden of the City's pesthouse was an ongoing preoccupation at Guildhall, reflected in the aldermen's anxiety about how the money would be repaid. In July, they decreed that any person removed to the pesthouse would be ‘mayneteyned & relieved’ at the charge of the householder, or the parish, if they could not pay. Care to minimize outlay is also evident in 1609, an endemic plague year in which some intramural parishes were affected. In August, the aldermen ordered the chamberlain to make payment for ‘Phisicke surgery and diet and other charges’ disbursed by the keeper of the pesthouse for the ‘poore visited’ persons sent by City authorities.Footnote 43 This is the only reference to the pesthouse, however, in the period of endemic plague between 1604 and 1611.
Although the Court of Aldermen discussed the City's pesthouse when epidemics emerged in 1625 and 1636, they made no reference to its operation in the period of endemic plague between 1637 and 1648.Footnote 44 Orders issued by the House of Lords about plague in 1641 and 1647 refer to the City's pesthouse, but it has to be assumed that it largely functioned without any extraordinary intervention at that time.Footnote 45 The City's Cash Books show payments to the appointed individual responsible for acquiring provisions for the pesthouse and to William Upton, the aforementioned ‘Keeper’. These are listed as a standard ‘outward fee’ each year, even in 1649, when the period of endemic plague had ended. The Cash Books show the lengthy service of William, during which he received annual payments of £13 6s 8d. This was based on an order by the Court of Aldermen going back to July 1611. The last reference traced for this article was in the year ending September 1649, when Upton received his usual annuity and was closing in on 40 years’ service.Footnote 46
Other references to the City's pesthouse mention one Nathaniel Upton, who is usually marked as the surgeon, and was the son of William. The baptism of Nathaniel is recorded in the St Giles Cripplegate register on 29 June 1609. William's non-medical background is evident in his listed occupation of ‘Weaver’. The marriage allegation of Nathaniel, ‘Surgeon of Cripplegate’, to Dorothy Sutton is recorded in December 1639.Footnote 47 Nathaniel's pesthouse service was also lengthy and his experience with plague extensive. Samuel Pepys refers to his work in 1665, and he is recorded as the householder of the 42 hearths ‘Posthouse’ in ‘ould street south’ in the 1665 Lady Day Hearth Tax assessment.Footnote 48 Nathaniel died of consumption in Cripplegate in May 1666, and his connection to the parish is evident in the £10 he bequeathed to the local poor.Footnote 49 While the operation of the City's pesthouse contrasts with that of the wider hospital system in London, particularly their government by a committee or council, the experience of the senior staff is notable. This balances F.P. Wilson's negative comments about the pesthouse's staff and the care given to inmates, which he based on the pessimistic narrative of literary sources.Footnote 50
The pesthouse was situated in the extended network of buildings and infrastructure maintained by the City. The Cash Books show repairs and improvements being made to the pesthouse during a period when the crown was urging them to make better use of it. A plumber was paid to lay 336 yards of lead pipes for the ‘conveyance of the New river water from Old Street into the Pesthouse’ in the year to September 1636.Footnote 51 This was listed under ‘Extraordinary workes buildings and repairs’ and would have occurred before the epidemic, which points to long-term investment in the facility and public health improvements. The focus on care is evident in the preparations made in 1636 for the people sent ‘out of this Citty’ to the pesthouse. This was listed under ‘fforen charges’ in the Cash Book and includes payment for 20 ‘fflock Bedds and Bolsters’ and 20 ‘paire of Blanketts', straw and mats, and 22 cauldrons of sea coals.Footnote 52 Ongoing investment in the pesthouse is also evident in William Upton being reimbursed for ‘repayring some decayed places in and about’ the pesthouse. This entry was listed in the Cash Book covering the year up to September 1637, between the repair of two stables that they leased in Finsbury (presumably the fields and manor) and the repair of the common sewers in the Old Bailey and Dukes Place.Footnote 53 The logistical and financial challenges of the pesthouse's maintenance, amidst the wider buildings and facilities they managed, likely played a part in the City's reluctance to expand the pesthouse network.
In contrast to their attitude during major epidemics, the aldermen were concerned about additional outlay in an endemic plague year, particularly when there was little impact from plague within the walls. Nathaniel Upton was paid £5 in early July 1636, for his ‘greate care and paines’ in ‘curing’ people in the pesthouse. The barber-surgeon who assisted him was paid in September for ‘curing certaine poore people’. In the year ending September 1638, however, a year in which there were very minor localized outbreaks in the suburbs, Nathaniel was paid £10 above his agreed salary, on account of the ‘great charges besides his owne paines’ in attending poor people sent to the pesthouse. This was provided with the understanding that he should expect only the allowance paid by the individuals sent there or their parish.Footnote 54 Guildhall was consistent in their policy that the visited sick, or their parishes, were expected to cover the costs of their stay. This and the reference to the barber-surgeon's payment, hint at the social group that the pesthouse catered for, which is also evident when looking at how some suburban parishes used the facility.
Use of the City's pesthouse by suburban parishes
Despite the experienced senior staff and the public health improvements, the suburban parishes lying wholly or partially within the City's jurisdiction made very limited use of the metropolitan pesthouse. The problem was that the narrow jurisdiction of the City's pesthouse did not take account of London's rapidly growing suburbs and the plague needs therein. The plague records of the western extramural parish of St Bride Fleet Street for the 1640s and a combined poor and plague account booklet in neighbouring St Sepulchre Newgate for 1647, for example, do not refer to the use of the pesthouse in these endemic plague years. Rather, house-based quarantine was used exclusively to isolate the infected.Footnote 55
To the east, the extramural parish of St Botolph Aldgate made only sporadic use of the City's pesthouse, and usually for individuals without a fixed address or of dubious status. In 1625, the churchwardens paid £1 19s for sending the wife of Gilbert Haylis to the pesthouse, and in 1630, paid £2 1s 6d to send a woman from the cage (parish lock-up) there, and £2 2s for another unnamed individual.Footnote 56 The churchwardens’ accounts list 27 households who were supported in their quarantine in 1630 and expenditure of £42 3s 13d in relieving the occupants. Plague was limited to a very small number of local outbreaks in 1630, particularly in Aldgate, yet the pesthouse was still not used to any great extent by the parish.Footnote 57 Alongside its limited capacity, the cheaper cost of maintaining quarantine in dwelling units likely deterred the parish from using the pesthouse more extensively.Footnote 58 There are no references in the Aldgate records to the use of the City's pesthouse beyond 1630. The parish cage may have been used as a cheaper alternative to the City's pesthouse for the segregation of those whose right to belong was questionable, which is suggested by plague deaths there in 1636 and 1638.Footnote 59
The incidental references to the pesthouse in the churchwardens’ accounts of the western extramural parish of St Dunstan in the West present a similar theme to those in Aldgate but helpfully reveal some detail about those sent there. St Dunstan's paid 2s for carrying a woman to the pesthouse ‘from the Constables dore’ in 1603. This is the only reference to the pesthouse in the accounts in that epidemic, amidst 27 specified payments to the poor visited.Footnote 60 The woman found at the constable's door may have been destitute or possibly a servant or lodger turned out of a house, as other examples in the records show sometimes occurred.Footnote 61
The well-maintained records of St Dunstan's do not refer to the use of the pesthouse in the period of endemic plague between 1604 and 1611 or in the 1625 epidemic.Footnote 62 There was some use of the facility in the 1630s and early 1640s and the burial register gives context for those references. In early November 1630, the ‘master’ of the pesthouse was paid for taking in Alice Evans, ‘that came out of Katherins house’ and lay sick in the street for a week. The register records 192 burials in 1630, of which 49 were of plague. The parish paid the master for a further week on 13 November and spent another 5s to ‘sende her away into the Country’, presumably on her recovery. The reference suggests that she was not settled in the parish.Footnote 63 The household of Rowland Katherin was located in Fetter Lane and he and his daughters Margaret and Mary were buried of plague in late September.Footnote 64 Alice Evans may have been their servant or lodger. She seems to have survived quarantine and been turned out of the house when it was reopened around the first week of November. In this instance, the parish used the pesthouse to accommodate a sick servant or a lodger made homeless.
All other plague references in the accounts in 1630 are to shutting up houses and supporting visited families. The parish preferred house-based quarantine, even in a minor endemic plague year, despite the crown's urging for greater use of the pesthouse. Around the time of Alice Evans’ stay in the pesthouse, the churchwardens paid for nails and staples ‘used aboute the houses’ in Fetter Lane and for padlocks for other quarantined houses.Footnote 65 Even though 1630 was not a particularly severe plague year, the pesthouse would have been quickly overwhelmed had parishes generally resorted to its use. This gives some context to St Dunstan's only making use of the pesthouse for certain individuals in extraordinary circumstances.
The other principal means of using the pesthouse in St Dunstan's was by calling on the expertise of the pesthouse ‘master’ as a public health official. Both William and Nathaniel Upton were called on in this capacity, although Nathaniel tends to be denoted as ‘surgeon’.Footnote 66 On 6 November 1631, the churchwardens paid the ‘master’ for searching a gentleman who died in Chancery Lane of the Plague.Footnote 67 One plague burial is marked in the St Dunstan's register, that of a ‘Country man dying in the street of the Plague’ on 6 November. This may not have been the gentleman referenced, but it does indicate the relative absence of plague in the parish in that year.Footnote 68 In this instance, the master was called on as a public health official to confirm an isolated case of plague. A reference in the records of the central city parish of St Anne and Agnes in 1636 makes this explicit: the churchwarden paid 6s 3d for the pesthouse surgeon to view a body after ‘our searchers had beene there, for better satisfaction’.Footnote 69
St Dunstan's recorded 238 burials in 1636, of which 61 were recorded as plague.Footnote 70 In June, the parish appointed two widows to view those suspected to ‘dye of plague’. Both women were pensioners and described as ‘Ancient searchers’ and were chosen based on their ‘long experience’.Footnote 71 The master of the pesthouse was still used to view some suspected plague deaths and illnesses, including ‘Mr Foye's maid’ on 3 December.Footnote 72 Elizabeth and Mary, daughters of George ‘Foye’, were buried on 8 and 19 November, and George Foye on 23 November. None of the burials was marked as plague. Elizabeth Dalavell, ‘servant unto George Foye’, and presumably the maid viewed in December, was buried on 16 December and not recorded as plague.Footnote 73 The master of the pesthouse was sought when the maid fell sick in a household where several deaths had already occurred. He was also called for ‘searching’ one Miller's daughter around the time of Elizabeth Dalavell's death.Footnote 74 The value placed on the expertise of Upton is reflected in the 4s 6d fee paid on these two occasions, which was double that usually paid to a pair of searchers.
St Dunstan's made limited use of the senior staff at the pesthouse in the period of endemic plague that followed the 1636 epidemic. On 2 September 1641, the ‘surgeon’ of the pesthouse was paid for viewing two bodies at the ‘howse of Pybus’ and also the body of William Staines, a minister who had died in ‘Beriffords house’ in Fetter Lane.Footnote 75 In total, St Dunstan's reported 36 plague burials in 1641, of 358 burial events.Footnote 76 These, and the calling of the ‘master’ to view the body of one dying of plague in widow Goodpeed's house in Ram's Alley on 16 May 1641, are the only references to the pesthouse in the 1640s, despite the persistent presence of plague in the parish.Footnote 77 This, taken with the absence of references to the pesthouse in the records of St Botolph Aldgate after 1630, suggests that the sporadic use of the pesthouse by some extramural parishes had faded to no use by the 1640s. The use of the pesthouse in the parishes that sat outside the City's jurisdiction, however, was different, particularly in those to the west, where a local pesthouse might be established.
The establishment of the local pesthouse
Kira Newman argued that the parish pesthouse was a second ‘key feature’ of plague control in London and Westminster, behind house-based quarantine.Footnote 78 This was the case in some of the western out-parishes, but less so in other areas. Whether a pesthouse was built or not, house-based quarantine remained the most common approach to plague control, due, as Newman points out, to a ‘scarcity’ of resources and lack of ‘overarching organisation’. The lack of overarching organization was less of a problem in the suburban parishes, where the select vestry closely managed local affairs. The interconnected problems of population growth, poverty and plague, however, created unique challenges.
There is some evidence that a local pesthouse was used in the large eastern out-parish of Stepney before 1665. In December 1651, the vestry agreed to let the ground and a house ‘comonly called the Pest-house & field’.Footnote 79 This was a parish initiative, which the vestry saw no need to maintain when plague declined. This differed from the small pesthouse built there in 1665, which was the result of external intervention.Footnote 80 Parishes to the east lacked the taxpaying base of those to the west. It is not surprising, therefore, that the vestry looked to increase revenue by leasing out the resource when there was no immediate plague need.
There is little evidence that a pesthouse was established in Southwark in the seventeenth century. A facility was in operation in Lambeth, at least in 1636, 1639 and 1641, in the peripheral area of Lambeth Marsh. It seems to have been a single structure of very limited capacity. Two families were removed there in 1636, and one reference is made to a family in September 1641, amidst 55 other payments to visited houses.Footnote 81 Across the Thames from Lambeth, St Margaret Westminster established a pesthouse in Tothill Fields as early as 1606.Footnote 82 The proximity of the crown and the presence of the wealthy national elite in Westminster, who might be a source of pressure and funding, may have influenced the establishment of the local pesthouse, and others that followed in the area.
The vestry in the western out-parish of St Giles in the Fields sought a lease for a pesthouse and ground for as ‘long time as it can be gotten’ in 1639. The facility was intended for the poor, as is evident in workmen being asked to give the cost to ‘make it fit for the poor people to dwell in’. The pesthouse was in use by 1640, when the parish paid ground rent for one year, gave relief to the poor inmates and paid one Powell for ‘looking’ to the pesthouse for a year. It was either maintained or rebuilt as the need arose through to 1648. A carpenter was paid to mend the pesthouse in 1641 and another for ‘building the pesthouse’ in 1648.Footnote 83 The expense and focus of the plague regulations, however, made it impracticable for the pesthouse to do any more than support the wider policy of house-based quarantine in a fast-growing and poor parish like St Giles.Footnote 84
The decision to establish a pesthouse in St Giles may have been influenced by the experiments in neighbouring St Martin in the Fields from 1630, when a tenement was converted to a pesthouse in the peripheral space of Coleman Close in Soho (Figure 3). Considering the operation of quarantine in St Martin's in 1636 and 1637, Kira Newman argued that the parish pesthouse was a place to put the sick for the full period of quarantine and where they might receive care. The discussion that follows expands that focus to consider the quality of the pesthouse structures and whom they catered for, how they were operated, and change and continuity in the parish's approach to the resource between 1630 and 1648.
Figure 3. Map showing the approximate location of the parish pesthouse in Soho in St Martin in the Fields.
Source: Faithorne and Newcourt map (1658). The map was surveyed in the 1640s. http://tudigit.ulb.tu-darmstadt.de/show/Sp_London1658/0003/scroll (accessed 14 Aug. 2022).
The St Martin's pesthouse is first mentioned in the vestry minutes in January 1631, when the parish paid rent to one Mr Gisby, ‘Landlord of the Pesthouse’, for the previous Christmas quarter.Footnote 85 The building was one of a dozen that had been erected in Coleman Close in 1623. The parish leased it from Edward Gisby for £40 at an annual rent of £8 16s.Footnote 86 Just 28 plague burials were marked in the register in 1630.Footnote 87 Nonetheless, this may have been sufficient to make the vestry anxious, particularly when set alongside the fear at Whitehall about plague and the crown's urging for an expansion of the pesthouse network. The establishment of the pesthouse fits with the range of other responses and associated infrastructure initiatives that were taken to manage the poor and plague in a rapidly growing and socially diverse parish. St Martin's population grew from around 3,000 in 1600 to 18,000 by the outbreak of the civil wars and the parish was acutely affected by poverty from the 1620s.Footnote 88 The infrastructure initiatives included almshouses, a house of correction and the acquisition of a burial ground.Footnote 89 These projects required forward-thinking, funding and ongoing management, amidst limited resources and growing needs.
While the parish's pesthouse was not in constant use, the regular presence of plague meant that the vestry often discussed it as part of its response to the disease after 1630. Although just 24 plague burials occurred between January and June in 1631, with 13 in March, the vestry continued to experiment with the pesthouse.Footnote 90 In mid-April, the parish paid to gather witnesses to attend the ‘tendring of the Rent for the Pesthouse’. The facility was in use until mid-June.Footnote 91 Household quarantine was still implemented despite the low level of plague incidence and availability of the pesthouse. It may have been of limited capacity in its initial form, with just three individuals kept at various points in 1631. St Martin's seems to have initially used the pesthouse to segregate individuals, servants or people who may not have had accommodation appropriate for house-based quarantine.Footnote 92
The vestry sought to maintain access to the local pesthouse in 1632, aiming for flexibility to help cover its cost when plague was not present but ensuring that it was available when the parish had need. In mid-June, the two churchwardens were directed to approach Sir Edward Wardour and offer him the right of refusal to a lease for a pesthouse in an existing building not used for that purpose, from which an agreement was struck.Footnote 93 The vestry directed the churchwardens to make the house ‘tenable’ and draw income to support their work with the poor, and importantly, ensure access to the building ‘uppon a daies warning, or more’. The vestry situated the pesthouse alongside other infrastructure that was focused on the poor. This is evident in late October, when the parish overseers were ordered to maintain the condition of the almshouse and pesthouse from which they would receive the rents for the use of the poor.Footnote 94 The pesthouse was presumably leased at this point, until the parish required it for plague management.
The vestry minutes do not record any decision to reinstate the local pesthouse in 1636. However, the removal to the pesthouse of people from two separate households in Spur Alley at the beginning of June shows that it was quickly repossessed in response to plague.Footnote 95 The parish shut up 360 households and 1,752 individuals between June 1636 and December 1637.Footnote 96 The pesthouse was used to manage close to a third (107) of the quarantined households, both as the first and secondary platform of response. Removals at the beginning of isolation comprised 80 per cent (85) of admissions. However, as the scale of quarantine increased in 1636, house-based quarantine greatly exceeded the use of the pesthouse and was still being used when plague declined in early 1637 (Figure 4).Footnote 97
Figure 4. Use of the pesthouse by month in St Martin in the Fields, July 1636 – July 1637. Source: WAC F4514.
The extraordinary plague payments show the expense and effort taken to expand capacity through July 1636. The parish spent £163 building and fitting out temporary structures, a significant outlay and ramping up of capacity, which indicated the important role the pesthouse was to play in managing plague, alongside an increased focus on care and public health. The sum of £82 18s was paid for 139 deal boards and timbers for the intended building of 22 pesthouses. A carpenter was paid to dismantle three ‘pesthouses' in the churchyard and build nine in the ‘Pestfeild’, which suggests that there might have been three existing structures already in use, separate from the repurposed tenement leased from Wardour. Twelve additional structures and a watch house were also built in the ‘Pestfeild’, the latter probably intended to ensure compliance and security.Footnote 98 The new structures were purpose-built multiple units and most likely under a single administration, and a different kind of physical structure from the repurposed tenement. They were basic but not necessarily thrown up without sufficient care to render them uncomfortable.
Newman commented that the development of the infrastructure for the new pesthouse units was slow to come, due to the vestry's reluctance to ‘scale up’.Footnote 99 This lag is understandable in the context of the wider management of the poor and other parish business that was not displaced by the arrival of plague. The situation was not helped by the departure from the parish of 214 ratepayers at the beginning of the epidemic.Footnote 100 It is fairer to judge the subsequent effort and expense taken to ensure durability, comfort and the facilitation of cleansing of the pesthouses, the latter being achieved by the digging of a well on 24 July. As the project neared completion, a bricklayer was paid £14 16s 5d to erect a chimney in each of the new structures. Final preparations involved the purchase of 19 chaldrons of sea coals and ‘panns platters potts’ and ‘like necessaries’.Footnote 101 Plague officers may have maintained fewer persons within each pesthouse to facilitate conditions more conducive for care and treatment. The evidence suggests that the new structures may have accommodated three people each. This and the focus on care and public health could be taken to have played a part in the high survival rates in the pesthouses in 1636 and 1637, whereby 86 per cent of those removed there were later discharged.Footnote 102 However, this may also have been due to random variation, inaccuracies in the recording of deaths, or because some individuals admitted to the pesthouse were not infected with plague.
Of those households where the pesthouse was used, 92 per cent (98) were chargeable by some degree to the parish.Footnote 103 Newman was correct in her observation that plague pushed otherwise self-sufficient people to apply for parish relief and this is evident in the rising proportion of quarantined individuals who were ‘chargeable to the parish’ through the epidemic. Newman focused on the middling sort and linked this group to the 30 per cent of quarantined households that were located on main streets, the assumption being that these spaces were primarily home to middling and substantial residents.Footnote 104 However, returns for building in defiance of Royal Proclamations also show tenements were being built in the main streets of the parish and these were erected cheaply to accommodate the migrant poor.Footnote 105 A return for 1638 shows 27 tenements erected illegally in the main street of Long Acre.Footnote 106 This is important when set alongside parish sources, which show that the poor were more severely affected by plague than other social groups. The parish grave maker was paid for making 364 graves for the ‘poore visited’ from early June 1636 to April 1637. This accounts for the great majority of plague burials in that period of time but also exceeds the number of recorded plague burials in the parish register and may reflect under-registration of plague deaths, possibly in the pesthouse.Footnote 107 The purchase of a chair to carry and a common prayer book to be read to the poor, and the purchase of ‘plaisters & salues for the Poore visited’ by the searcher and pesthouse matron Thomazine Ellis also hints to the social group the pesthouse was intended for.Footnote 108
The poor presented the potential for significant expense during a plague event and the use of the parish pesthouse provided flexibility and the opportunity to minimize the cost and the logistical burden of house-based quarantine. This was also a way to mitigate national policy that directed parties to confine the healthy with the sick. The building in which John Eastridge, for example, is marked as the ‘householder’ in Spur Alley was comprised of four families of 17 people and was shut up on 29 June and reopened just over four weeks later. This was probably a sub-divided tenement and cost the parish close to £11 to support. Three members of one family were sent to the pesthouse after the initial house-based isolation.Footnote 109 The parish chose not to maintain the quarantine of the healthy with the sick in a house that had already incurred a significant charge.
The longer periods of quarantine tended to be in the pesthouse in 1636/37, rather than in dwelling units, which reflects the sustained care that might be given to inmates.Footnote 110 This was facilitated by experienced senior staff, including Thomazine Ellis who was one of two pesthouse matrons and had worked as a parish searcher in 1625 and 1630/31. Nurses also attended the sick at the pesthouse and often accompanied an individual there following an initial period of house-based isolation.Footnote 111 When taken together with the basic but comfortable new structures, and the provision for cleansing, the existence of an enhanced focus on care, rather than basic segregation, is a reasonable conclusion to draw.
Despite the increasing plague incidence through the early summer of 1637, the vestry ordered the new pesthouse structures to be pulled down in the first week of July.Footnote 112 This might have seemed premature given that 11 households had been newly shut up, of which the pesthouse was associated with two.Footnote 113 But given that the parish had spent £800 on quarantine and experienced problems in bringing in all due plague and poor rates, the decision was probably financially motivated.Footnote 114 It was not until late November that the vestry ordered that the boards and timber were to be taken down and brought into the new churchyard for decontamination, while the bricks were to be sold. Forward planning is evident in the vestry's order that the materials were to be locked in a shed for future use.Footnote 115
The pesthouse continued to play a role in the parish's repertoire of response to plague in the period of endemic plague that followed. Access was maintained for when it was needed, and income was taken when it was not. In June 1638, the repurposed tenement in Soho was rented out for the remainder of the lease's term and in 1639, rent was paid to Wardour.Footnote 116 The tenement was probably tenanted until May 1640, when the vestry decided to scale up capacity, for which the experience of 1636 informed their approach. Just over £154, financed by a special rate, was spent securing ground, buying materials and paying carpenters and a bricklayer to build seven or eight new structures. These appear similar to those in 1636. This estimate is based on the comparison of the sums spent on materials and construction between the two plague events.Footnote 117
It is not clear whether the new structures were in use beyond 1640, but the pesthouse probably fell in and out of use as it was needed, much the same as in neighbouring St Giles in the Fields. For example, in September 1643, the parish became ‘tenants’ to William Oxindon for the ‘feilds called the Pesthouse feilds’. The vestry may have considered a new scale-up in 1645 as in early June they asked the churchwardens to give an account of the pesthouse boards and materials. The parish was hit particularly hard by plague in 1647 and new space was sought between the ‘Forte in Tyburne and the Crab Tredd’ (crab-tree fields).Footnote 118 The records do not contain any references to its establishment, operation or dissembling. Soho had presumably been selected in the 1630s due to the availability of space and as the parish continued to develop, the vestry looked to a location that was then on the new periphery of the settlement. The stated intention to find new ground and the references to the pesthouse earlier in the decade show continuity in the parish's approach to the resource as a flexible and optional tool in their repertoire of measures to manage plague.
Conclusion
Despite the aspirations of the crown for the pesthouse to play a leading role in plague management in London, akin to the permanent plague hospitals in Italy, it did not become a major feature of the response to the disease in the suburbs. The unique demographic and social challenges faced by parishes, the focus of the plague regulations until 1666 and the complexities of government in the suburbs made this impossible. The narrative about the pesthouse, particularly the City's facility in Cripplegate, tends to be pessimistic. While it was not a priority for the City, was inadequate, and in any case out of reach for parishes beyond the City's jurisdiction, it was managed by experienced and well-regarded senior staff. Moreover, the repairs and works after 1630 show some change in attitude toward public health in the urban environment. The failure of the City to expand the network of metropolitan pesthouses and the conflict that this generated with the crown reflects the complexities of government in the suburbs and the leading role taken by select vestries to manage local affairs. This underscores the growing power of parochial government and their independent and pragmatic response to local problems. This included the different ways that they used the pesthouse, although a unifying feature was the focus on the poor. While the extramural parishes made limited use of the City's pesthouse and senior staff, financial and logistical considerations and the focus of plague regulations meant that house-based quarantine remained the primary mode of plague management. The building of a local pesthouse by some parishes beyond the City's jurisdiction was situated within a wider building programme to manage the poor. Their experimental approach and the subtle shift from basic segregation to an increased focus on care and public health were similar to other English provincial towns and cities. This point, and the conclusions above, are important ones to draw amidst the developments that led to the new Plague Orders in 1666, and our wider understanding of London's suburbs at a time of rapid growth and change.
Acknowledgments
This article was researched and written while undertaking a Ph.D. at Birkbeck College, University of London, Department of History, Classics and Archaeology, Russell Square, London, WC1B 5DQ.
