Book 1 The Origins
I Scrofula The two words 'ecrouelles', or more often 'scrofula', which is only a learned form of the first (both of them coming from the Latin scrofula), are used by doctors today to signify tuberculous adenitis, that is to say inflammation of the lymph nodes due to the bacillus of tuberculosis. It is obvious that before the advent of bacteriology, such specialization of these two names, which go back to the medicine of antiquity, was quite impossible. It was not possible to distinguish between the various infections of the ganglia; or at any rate the tentative scientific efforts at classification -which were bound to be abortive-did not leave any traces in current medical language. All these infections were uniformly called 'ecrouelles' in French and scrofula or strumae in Latin; these last two words were generally synonymous. It should be added that by far the greater number of inflammations of the ganglia are tuberculous in origin; so that the majority of cases classed as scrofula by the doctors in the Middle Ages would also be diagnosed as such by our doctors today. But popular language was less precise than technical language. The ganglia most easily attacked by tuberculosis are those of the neck; and when the disease goes untreated, and suppurations occur, the face may easily appear to be affected. Hence a confusion, apparent in many of the documents, between scrofula and various other affections of the face or even the eyes.l Tubercular adenitis is very widespread, even nowadays; so what must it have been like in conditions of hygiene notably inferior to our own? If we mentally add the other kinds of adenitis, and all the vague crop of miscellaneous diseases popularly confused with them, we shall have some idea of the ravages attributable to what Europe of old used to include under the name of 'scrofula'. In certain regions, as both mediaeval and modern doctors testify, these diseases were virtually endemic.2 This is hardly ever a fatal disease; but especially where there is a failure to give the appropriate treatment, it
is very trying and disfiguring. The frequent suppurations had something repulsive about them, and the horror they engendered is naively expressed in more than one ancient account. The face became 'putrid' and the sores gave forth a 'foetid odour'. The background picture, then, which the historian of the royal miracle should keep in mind, is that of countless sufferers longing for healing, and ready to have recourse to any remedies they might hear of through common report.