A WEAK and ill stranger called Andrew Hodgson arrived in Penrith, then a small collection of hovels around a massive castle, only to promptly die. Tragic, it seemed, but not unusual. Three weeks later people began to die in the same way, fainting, then sickness and body swellings, vomiting blood,and after two or three days they, too, joined Hodgson.

It was 1538 and the plague, the Black Death, had arrived in England.

In less than five years, 60% of the population of Europe was to perish, upwards of 75 million people. Rats have taken the blame for spreading it, but just as Jimmy Cagney never actually said “you dirty rat”, it may be that the rodent has been given a bad rep and it was more likely passed on by travellers like Hodgson.

In disease-ravaged Britain, there are accounts of parents who abandoned their children once they realised they were ill. The tell-tale sign was the appearance on the skin of “God’s tokens” – the red rings which were a sign that the blood vessels were leaking blood into tissue.

In Italy, in The Decameron, Giovanni Boccaccio wrote of Florence at the time: “Many died by day or by night in the public streets; the departure of many others, who died at home, was hardly observed by their neighbours until the stench of their putrefying bodies carried the tidings; and what with their corpses and the corpses of others who died on every hand, the whole place was a sepulchre.’”

The way to have stopped the spread would have been what we are doing today, or trying to, had they then known, although that is not to say it would have been successful – a long quarantine, wearing of masks and contact tracing, which we may even get round to shortly. Instead there was what amounted to medieval herd immunity. It took its course to exhaustion.

The weak and frail may have perished through natural selection but for the survivors the plague modified their genes and made them more resistant to disease, so that this generation and succeeding ones lived longer.

There were several by-products. The perfume industry was created because, while doctors then believed the plane was caused by poisonous vapours, aromatic herbs were used to purify the air, and to cover body odour. Hospitals became, not places for the doomed, stricken, it was believed, because they had sinned, but places where doctors and nurses, rather than monks and nuns, tried to heal people.

And, of course, sex comedies emerged, like The Decameron, together with the rise of English as the predominant language, as well as the end of feudalism, because there were simply so few left to till and labour that they could demand, and receive, higher wages and fairer conditions.

When David Home was born on this day, April 26, 1711, in a tenement in Edinburgh’s Lawnmarket, Scotland was in an abject state. The Darien Disaster, less than two decades previously, had effectively beggared the country, with approximately 20% of all the money circulating in Scotland lost. It bequeathed what Burns called the parcel of rogues, who forged the Act of Union and which dissolved a Scottish Parliament for three centuries.

Home changed his name to Hume when he was 23 because his surname, pronounced Hume in Scotland, was understood as the place where you lived, or as the prefix to counties.

By then he had gone to the University of Edinburgh at 12, or possibly 10, failing to graduate because he had no respect for his professors and believed that all he needed to learn he could acquire from books.

From the age of 18 and for more than 10 years he did just that, read, until he became so ill and depressed his doctors prescribed “a course of bitters and anti-hysteric pills”, whatever they were. And a pint of claret each day, so it had its compensations.

At the age of 29, his literary debut, the seminal A Treatise Of Human Nature, was published and Hume was on his way. A job as a librarian at Edinburgh University provided access to research material and to The History Of England, which was published in six volumes between 1754 and 1761.

England at the time had around five times the population and almost 40 times the wealth, but Scotland had a network of parish schools and four universities to England’s two.

Hume, the philosopher, joined with a wealth of other eminent scholars, mathematicians, scientists, thinkers and poets in what has become known as the Scottish Enlightenment. In 1776, Adam Smith published The Wealth Of Nations, the bedrock of modern economics.

Pandemics are dotted throughout our history. In 1918, what is now called the Spanish Flu infected around 500 million worldwide, killing upwards of 50 million, although the exact figure is something of a guesstimate as proper medical records were not kept.

One thing we do know is the flu did not originate in Spain, although coverage of it did. Spain had been neutral in the Great War whereas bad news, like this outbreak, was covered up by the allies to preserve morale. It spread fast because there were no effective vaccines or antivirals, like today with Covid-19, and the first effective one wasn’t produced until the 1940s.

By summer 1919, the flu pandemic came to an end, the unwitting herd approach had triumphed, as those who were infected either died or developed immunity. It was almost 90 years later, in 2008, that researchers discovered what made the 1918 flu so deadly – a group of three genes enabled the virus to weaken a victim’s bronchial tubes and lungs and clear the way for bacterial pneumonia. Not a lot different to coronavirus.

Its long-term effects were brutal. Children born or conceived then achieved lower educational attainment, experienced increased rates of physical disability, enjoyed lower lifetime income and a lower socioeconomic status than those born immediately before and after it. A decade later, after the economic carnage of the war and the pandemic, the Great Depression ravaged Western economies.

Another, and even more serious, effect of the First World War, the harsh measures imposed on Germany, incubated widespread grievance and hostility, breeding the conditions for Hitler and the Nazi party which led to the Second World War. Around 75 million people died, 20 million of them combatants, more than 20 million more soldiers and civilians in the Soviet Union, the remainder the collateral damage through genocide, bombings, massacres, disease and starvation.

The most positive outcome, for this country at least, was the creation of the welfare state and the National Health Service we honour, and not just once a week on our doorsteps. It was the cornerstone of Clement Attlee’s policy which saw Labour defeat the Conservatives under the wartime leader Winston Churchill in 1945. It was launched in the form we know today in 1948 by Health Secretary Aneurin Bevan. It was free for all, paid for by general taxation, and based on need rather than the ability to pay.

As Bevan put it: “No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”