Queen Elizabeth I’s reign is often celebrated for its cultural flourish and the establishment of Protestant England, but few episodes reveal the precariousness of her early rule as vividly as her brush with smallpox in 1562. This life-threatening illness not only imperiled the young monarch’s life but also ignited a political crisis that underscored the fragile nature of Tudor succession and the volatile religious factionalism of the era. This article explores the harrowing smallpox epidemic during Elizabeth’s early reign, the dramatic details of her illness and recovery, the political turmoil her near-death triggered, and the lasting implications for Elizabethan England.

The Menace of Smallpox in Sixteenth-Century England

Smallpox was among the most feared diseases of the early modern world, notorious for its high mortality rate and the disfiguring scars it left on survivors. In the early 1560s, England was gripped by an intense epidemic of smallpox, which had escalated into a virulent pandemic that swept through all levels of society. The disease did not discriminate, afflicting the nobility alongside the common people. Even the Bedford Countess and hundreds of other nobles fell ill during this time.

Medical knowledge was rudimentary, and treatments often reflected a blend of ancient practices and folk remedies. Symptoms were severe and frightening; Thomas Randolph, an English diplomat, described the early signs as including “severe headaches, gastrointestinal distress, and violent coughing.” The illness was swift and merciless, with many victims succumbing within days.

Elizabeth’s Sudden Illness: October 1562

On October 10, 1562, Queen Elizabeth I began to feel unwell while residing at Hampton Court Palace. Like many of her contemporaries, she initially believed that a hot bath followed by fresh air would alleviate her symptoms. Unfortunately, this only worsened her condition, leading to a debilitating fever that confined her to bed within hours.

The queen’s physicians were summoned urgently, including Dr. Burcot, a respected but notoriously ill-tempered German physician. Burcot immediately diagnosed smallpox, despite the absence of any visible rash on Elizabeth’s body at the time. The queen, skeptical of his diagnosis and offended by his demeanor, dismissed him from her presence, convinced he was incompetent. This initial rashless phase was a known but dangerous precursor to the full eruption of smallpox, signaling an impending outbreak of pustules.

The Crisis Deepens: The Court on Edge

By October 16, Elizabeth’s condition had deteriorated significantly. She lost the ability to speak and soon slipped into a nearly 24-hour period of unconsciousness. The royal physicians feared the worst, and the atmosphere at court grew grim. The Privy Council convened an emergency meeting to discuss the succession in the event of the queen’s death—a matter that had long been a source of anxiety given Elizabeth’s unmarried status and the complex religious divisions in England.

The prospect of Elizabeth’s demise threw the kingdom into political turmoil. Reports from the English ambassador, Sir Thomas Quarles, indicated that the Privy Council was deeply divided. The radical Protestant faction favored Lady Catherine Grey, a cousin of the queen, as the rightful heir. Moderate Protestants leaned toward the Earl of Huntingdon, a more distantly related nobleman. Others suggested that the matter should be settled by the Lord Chief Justice. Notably, Mary, Queen of Scots, Elizabeth’s Catholic cousin and rival claimant, was not mentioned in these early deliberations, reflecting the contentious and fractious nature of the succession debate.

A Desperate Plea and a Controversial Appointment

As Elizabeth hovered between life and death, her loyal advisors struggled to maintain order and prepare for a potential transition of power. Meanwhile, Lord Hunsdon managed to persuade Dr. Burcot to return and continue treating the queen—reportedly under threat of violence, as some historians suggest Hunsdon brandished a sharp dagger to compel the doctor’s cooperation.

Following medieval medical traditions influenced by Arabic practices and English physician John of Gaddesden, Burcot wrapped Elizabeth in red flannel and placed her on a straw mattress near a heated stove. He also administered a potent medicinal concoction. Miraculously, within two hours, Elizabeth regained consciousness and was able to speak—an astounding recovery that lifted the spirits of her attendants.

Knowing her condition was grave, Elizabeth expressed her concerns about the continuity of government after her death. She entrusted Robert Dudley, her close confidant and rumored lover, with the role of Protector of the Realm, granting him a generous annual pension of £20,000. She also secured a pension of £500 per year for Dudley’s servant, Tamworth, who was believed to have been a trusted confidant and possibly involved in the queen’s private affairs. Elizabeth vehemently denied any scandalous relationship with Dudley, invoking the presence of God as witness to their innocence. Her statements conveyed a monarch confronting mortality with dignity and pragmatism.

Political Reactions and the Fragility of Elizabeth’s Rule

Despite the queen’s wishes, the Privy Council and other political leaders were wary of appointing Dudley Protector, fearing it would provoke factional strife. The ambassador Quarles remarked that such a plan “could never come to pass,” illustrating the inherent instability of Elizabeth’s position and the dangers of concentrating power in a single individual.

Elizabeth’s survival averted an immediate succession crisis, but the episode exposed the fragility of Tudor rule and the simmering tensions within the English court. It also underscored the limited medical understanding of the time and the precariousness of royal health as a political matter.

The Appearance of the Rash: A Turning Point

Soon after her miraculous recovery, Dr. Burcot returned with additional medicines. It was at this moment that the first wave of smallpox pustules appeared on Elizabeth’s hands. The emergence of the rash was a critical turning point; Burcot assured the queen and her attendants that the appearance of pustules was a hopeful sign, indicating that the worst phase of the illness had passed.

He famously asked whether it was preferable for the rash to appear on the hands rather than on the face or chest—areas more likely to cause fatal complications or permanent disfigurement. The presence of pustules meant the disease was progressing as expected, moving toward resolution rather than sudden death.

Smallpox’s Cultural and Political Legacy in Elizabethan England

Elizabeth’s smallpox episode had enduring consequences beyond the immediate health scare. The disease’s disfiguring effects were well-known, and the queen’s eventual survival allowed her to maintain her iconic image, though some historians speculate whether she bore any visible scars.

More importantly, the crisis revealed the precariousness of Tudor succession and the high stakes of Elizabeth’s reign. The political factions that debated succession during her illness foreshadowed future conflicts, including those involving Mary, Queen of Scots, and later, the Stuart succession.

The event also highlighted the evolving relationship between medicine, politics, and royal authority. Elizabeth’s insistence on appointing Dudley Protector demonstrated her acute awareness of the political machinations at play and her attempt to control the posthumous governance of England, even as she faced death.

Conclusion: Survival Against the Odds

Queen Elizabeth I’s near-fatal encounter with smallpox in 1562 was a pivotal moment in English history. It was not merely a medical crisis but a political and cultural turning point that tested the resilience of the Tudor dynasty and shaped the future of the English throne. Elizabeth’s remarkable recovery—through a combination of medieval medical practices, personal determination, and perhaps sheer luck—allowed her to continue her reign, which would become one of the most celebrated periods in British history.

Her illness exposed the vulnerabilities of monarchic rule in a time before modern medicine and revealed the intricate interplay between health, power, and politics. Elizabeth’s survival was nothing short of miraculous, and it solidified her image as a strong and enduring ruler who overcame both disease and political intrigue to lead England into an era of unprecedented cultural and political achievement.