  Aberdeen, famine of 1622, 30, 68, 102, described by Willis, 772 cholera water-borne, 832 837-8, 840 Footnotes: [1] James Lind, M.D., Two Papers on Fevers and Infection. Lond. 1763, p. 79. [2] Observations on Fevers and Febrifuges. Made English from the French of M. Spon. London, 1682. [3] James Hutchinson, M.D., De Mutatione Febrium e tempore Sydenhami, etc. Edin. 1782. Thesis. [4] Observationes Medicae, 3rd ed. 1676, I. 2. § 23. English by R. G. Latham, M.D. [5] Reports of Whitehaven Dispensary (Dixon) and of Nottingham General Hospital (Clarke), cited in the sequel. [6] Rilliet, De la FiÈvre TyphoÏde chez les Enfants, ThÈse, Paris, 2 Janv. 1840, based on 61 cases; West, Diseases of Infancy and Childhood, 3rd ed. Lond. 1854. [7] “Febris epidemicae cerebro et nervoso generi potissimum infestae, anno 1661 increbescentis descriptio,” in Pathologia Cerebri, Cap. VIII, “De Spasmis universalibus qui in febribus malignis” etc., Eng. transl. p. 51. [8] “Itaque ventrem inferiorem primo aperiens, viscera omnia in eo contenta satis sana et sarte tecta inveni”—the small intestine being telescoped in several places. [9] Elsewhere he says the first case of the series was “circa solstitium hyemale anno 1655.” [10] De Febribus, chapter “De febribus pestilentibus.” [11] Treatise on the Infantile Remittent Fever. London, 1782. [12] Pyretologia, 2 vols. Lond. 1692-94, i. 68, at the end of “Synopsis Febrium”:—“Febris verminosa, quae nulli e specibus memoratis praecisÉ determinari potest.” [13] HÄser gives a reference to an essay in which Willis’s fever of 1661 is compared to enteric fever: C. M. W. Rietschel, Epidemia anni 1661 a Willisio et febris nervosa lenta ab Huxhamio descriptae, etc. cum typho abdominali nostro tempore obvio comparantur. Lips. 1861. Not having found this essay, I cannot say on what grounds the comparison is made. [14] Lives of the Norths. New ed. by Jessopp. 3 vols. 1890, iii. 8, 21. [15] Diary of John Evelyn, Esq., F.R.S., 1641-1706, under the date of 18 Sept. [16] Diary of Samuel Pepys, Esq., F.R.S., 1659-69. [17] An analysis of the four Hippocratic constitutions, with modern illustrative cases, is given by Alfred Haviland, Climate, Weather, and Disease. London, 1855. [18] Epist. I. Respons. § 57. Greenhill’s ed. p. 298. [19] Tillison to Sancroft, 14 Sept. 1665. Cited in former volume, p. 677: “One week full of spots and tokens, and perhaps the succeeding bill none at all.” [20] H. Clutterbuck, M.D., Obs. on the Epidemic Fevers prevailing in the Metropolis. Lond. 1819, pp. 58-60. [21] Horace Walpole’s Letters give two instances: he himself had never set foot in Southwark; a small tradesman in the City had never heard of Sir Robert Walpole. [22] Transactions of the College of Physicians, iii. 366. [23] Willis, Op. ed. 1682, Amstelod. p. 110. “De febribus pestilentibus”: “Etenim vulgo notum est febres interdum populariter regnare, quae pro symptomatum vehementia, summa aegrorum strage, et magna vi contagii, pestilentiae vix cedant; quae tamen, quia putridarum typos innotantur, nec adeo certo affectos interemunt aut alios inficiunt haud pestis sed diminutiori appellatione febris pestilens nomen merentur. Praeter has dantur alterius generis febres, quarum et pernicies et contagium se remissius habent, quia tamen supra putridarum vires infestae sunt, et in se aliquatenus t? ?e??? Hippocratis continere videntur, tenuiori adhuc vocabulo febres malignae appellantur.” The war-typhus of 1643, which was sometimes bubonic, and was succeeded by plague in 1644, is given as an example of febris pestilens; the epidemic of 1661 as an example of maligna. [24] Pyretologia, i. 68. [25] C. L. Morley, De morbo epidemico, in 1678-9, narratio. Lond. 1680. [26] Guido Fanois, De morbo epidemico hactenus inaudito, praeterita aestate anni 1669 Lugduni Batavorum vicinisque locis grassante. Lugd. Bat. 1671. [27] Brownrigg cites the Leyden epidemic of 1669, which he calls an intermitting fever, as an instance of the effects of changes in the ground water; it was “powerfully aggravated by the mixture of salt water with the stagnant water of the canals and ditches. This fever happened in the month of August, 1669, and continued to the end of January, 1670.” “Observations on the Means of Preventing Epidemic Fevers.” Printed in the Literary Life of W. Brownrigg, M.D., F.R.S. By Joshua Dixon, Whitehaven, 1801. [28] Obs. Med. 3rd ed., v. 2. [29] Epist. I. Respons. §§ 56, 57. [30] Pyretologie, i. 429. [31] John Lamport alias Lampard, A direct Method of ordering and curing People of that loathsome disease the Smallpox. Lond. 1685, p. 28. [32] Hist. MSS. Com. v. 186. Duke of Sutherland’s historical papers. [33] Schedula Monitoria I. “De novae febris ingressu.” §§ 2, 3. [34] Ibid. § 46. [35] In the Belvoir Letters (Hist. MSS. Com. Calendar) Charles Bertie writes from London to the Countess of Rutland, 26 January, 1685, that “many are sick of pestilential fevers.” Evelyn says that the winter of 1685-6 was extraordinarily wet and mild, but does not mention sickness until June, 1686, when the weather was hot and the camp at Hounslow Heath was broken up owing to sickness. [36] Evelyn’s Diary, which gives other particulars, including a description of the ice-carnival on the Thames. [37] Thomas Short, M.D. of Sheffield, New Observations on City, Town and Country Bills of Mortality. London, 1750. [38] Freind (Nine Commentaries upon Fever, &c., engl. by Dale, Lond. 1730, p. 4) has the following general criticism upon Sydenham’s varying constitutions of fevers: “I believe also I may truly affirm that those very fevers which Sydenham explains as distinct species, according to the various temperature of the seasons, do not differ much from one another. For, if perhaps you should except the Petechiae, they differ rather in degree than in kind. There hardly ever appeared a fever in any season where the signs so constantly answered one another, that those which you found collected in one person should unite after the same manner in another; however upon this account you would not deny their labouring under the same distemper.” [39] Tractatus de Podagra, § 35. Greenhill’s edition, p. 428. [40] Chronicle of Perth (Maitland Club) under date 14 Oct. 1621. [41] Thorold Rogers, Hist. of Agric. and Prices, sub anno. [42] Extracts from Kirk Session Records. Spalding Club, 1846. [43] Chronicle of Perth. [44] History of the Burgh of Dumfries. By W. MacDowall. 2nd ed. Edin. 1873, p. 381. [45] Court and Times of James I., ii. 331. [46] Ibid., under date 25 Oct. 1423. [47] Ibid., ii. 439. [48] Cal. Coke MSS. (Hist. MSS. Com.) i. 158. [49] C. and T. James I., ii. 469. [50] Mayerne, Opera Medica, Lond. 1700. [51] Ibid., ii. 473. [52] Janus Chunradus Rhumelius, Historia morbi, qui etc. Norimb. 1625. [53] W. D. Cooper, ArchÆologia, XXXVII. (1857) p. 1. I had overlooked this important paper on English plagues in my former volume. The chief additional facts that it contains are the very severe plague at Cambridge in the summer of 1666, the deaths of 417 by plague at Peterborough in 1666, and of 8 more in the first quarter of 1667, and the slightness of the Nottingham outbreak, which was in August, 1666 (p. 22). [54] London Gazette, 17-21 June, 1675, repeated in the number for 28 June-1 July. [55] Brand, Hist. of Newcastle, II. 509. Report contradicted on 18 Dec. [56] “The habitations of the poor within or adjoining to the City,” says Willan, “have suffered greatly; and some, I am informed, have been almost depopulated, the infection having extended to every inmate. The rumour of a plague was totally devoid of foundation.” [57] Rudder, A New History of Gloucestershire, 1779, P. 737. [58] Spelman, De Sepultura. English ed. 1641, p. 28. He cites the burial fees paid to the parson as twice as much for coffined as for uncoffined corpses. This agrees on the whole with the evidence adduced in the former volume of this history, p. 335. [59] 18 and 19 Car. II. cap. 4; 30 Car. II. (1), cap. 3. These Acts were repealed by 54 Geo. III., cap. 108. [60] History of England, I. 359. [61] He has one or two relevant remarks: “But while we suppose common worms in graves, ’tis not easy to find any there; few in churchyards above a foot deep, fewer or none in churches, though in fresh-decayed bodies. Teeth, bones, and hair give the most lasting defiance to corruption. In an hydropsical body, ten years buried in the churchyard, we met with a fat concretion [adipocere] where the nitre of the earth and the salt and lixivious liquor of the body had coagulated large lumps of fat into the consistence of the hardest Castille soap, whereof part remaineth with us. The body of the Marquis of Dorset seemed sound and handsomely cereclothed, that after seventy-eight years was found uncorrupted. Common tombs preserve not beyond powder: a firmer consistence and compage of parts might be expected from arefaction, deep burial, or charcoal.” [62] One may allege poverty on general grounds, as well as on particular. Thus, in 1636, the mayor was unpopular: “He was a stout man and had not the love of the commons. He was cruel, and not pitying the poor, he caused many dunghills to be carried away; but the cost was on the poor—it being so hard times might well have been spared.” Ormerod, I. 203. [63] Printed plague-bill, with MS. additions, Harl. MS. 1929. [64] Haygarth, Phil. Trans., LXVIII. 139. [65] Cotton Mather’s Magnalia. Ed. of 1853, I. 227. [66] History of England &c., IV. 707. Evelyn (Diary, 21 May, 1696) says the city was “very healthy,” although the summer was exceeding rainy, cold and unseasonable. [67] Thomas Dover, M.B., The Ancient Physician’s Legacy. London, 1732, p. 98. [68] Broadsheet in the British Museum Library. [69] Tooke, Hist. of Prices, Introd. [70] Scotia Illustrata. Edin. 1684. Lib. II. p. 52. [71] Fynes Morryson, Itinerary, 1614. Pt. III. p. 156. [72] Edinburgh, 1691, p. 67. [73] The Epilogue to the Five Papers, etc. Edin. 1699, p. 22. This title refers to a controversy on the use of antimonial emetics in fevers. See Dr John Brown’s essay on Dr Andrew Brown, in his Locke and Sydenham, new ed. Edinb., 1866. [74] He adds that “the fever has several times before been in my family and among my servants and children.” In mentioning the case of the Master of Forbes in August, 1691, whom he cured, he remarks that “the malicious said he was under no fever”; to disprove which Dr Brown refers to the symptoms of frequent pulse, watching and raving, continual vomiting, frequent fainting, and extreme weakness. [75] Andrew Fletcher, Two Discourses. 1699. [76] The English Government took off the Customs duty upon victual imported from England to Scotland, and placed a bounty of 20d. per boll upon it. [77] Patrick Walker, Some Remarkable Passages in the Life and Death of Mr Daniel Cargill, &c. Edinb. 1732. (Reprinted in Biographia Presbyteriana. Edinb. 1827, II. 25.) [78] Sir John Sinclair’s Statistical Account of Scotland. 1st ed. III. 62. [79] Ibid. II. 544. [80] Ibid. VI. 122. [81] In the remote parish of Kilmuir, Skye, the famine is referred to the year 1688, “when the poor actually perished on the highways for want of aliment.” (Ibid. II. 551.) In Duthil and Rothimurchus, Invernessshire, the famine is referred to 1680, “as nearly as can be recollected:” “A famine in this and the neighbouring counties, of the most fatal consequence. The poorer sort of people frequented the churchyard to pull a mess of nettles, and frequently struggled about the prey, being the earliest spring greens.... So many families perished from want that for six miles in a well-inhabited extent, within the year there was not a smoke remaining.” (Ibid. IV. 316.) In the Kirk session records of the parish of Kiltearn, Rossshire, which I have seen in MS., there are various entries in the year 1697 relating to badges of lead to be worn by those licensed to beg from door to door: on 12 April, 34 such persons are named, and on 19 April, Robert Douglas was reimbursed for the cost of 35 badges. On 2 Aug., the number of poor who were to receive each from the heritors ten shillings Scots reads like “nighentie foure.” [82] John Freind, M.D., Nine Commentaries on Fevers, transl. by T. Dale. London, 1730. [83] Cal. Coke MSS. II. 405. [84] Joannes Turner, De Febre Britannica Anni 1712. Lond. 1713, p. 3. “Vere proximÈ elapso, per Gallias passim ingravescere coeperunt febres mali moris in nobiles domos, et regiam praecipue infestae; quÒ Ludovicum Magnum ipsa infortunia ostenderent Majorem, et patientia Christianissima Maximum.” [85] From London, on 25 February, 1701, we hear of the illness from a violent fever of Mr Brotherton, at his house in Chancery Lane; he was member for Newton, and Mr Coke was advised to look after his seat. A letter of 18 April, 1701, from Chilcote, in Derbyshire, says that it has been a sickly time in these parts and that a certain lady and her daughter were both dead and to be buried the same day. In the same correspondence, cases of fever in London are mentioned on 18 June and 4 December the same year (1701). Cal. Coke MSS. II. 421, 424, 429, 441. [86] Tractatus Duplex. Lond. 1710. Engl. transl. 1737, p. 253. [87] W. Butter, M.D., A Treatise on the Infantile Remittent Fever. Lond. 1782. [88] Philip Guide, M.D., A Kind Warning to a Multitude of Patients daily afflicted with different sorts of Fevers. Lond. 1710. [89] One death from “malignant fever,” two from scarlet fever. [90] Hunter’s Hallamshire, ed. Gatty. [91] Brand, Hist. of Newcastle, II. 308. Swift writes to Stella on 8 December, 1710: “We are terribly afraid of the plague; they say it is at Newcastle. I begged Mr Harley [the Lord President] for the love of God to take some care about it, or we are all ruined. There have been orders for all ships from the Baltic to pass their quarantine before they land; but they neglect it. You remember I have been afraid these two years.” The orders referred to were probably the Order of Council of 9 Nov. 1710. Parliament met on the 25th Nov. and passed the first Quarantine Act (9 Anne, cap. II.). Swift had a good deal to say with Ministers on many subjects, and it is not impossible, however absurd, that his had been the first suggestion to Harley of a quarantine law. I had purposed including a history of quarantine in Britain, but can find no convenient context for it. I shall therefore refer the reader to the historical sketch which I have appended to the Article “Quarantine” in the Encyclopaedia Britannica, 9th ed. [92] Essay on Epidemic Diseases. Dublin, 1734, p. 34. [93] Dr Guide, a Frenchman, who had been in practice in London for many years, says in his Kind Warning to a Multitude of Patients daily afflicted with different sorts of Fevers (1710) “the British physicians and surgeons are lately fallen into an unhappy and terrible confusion and mixture of honest and fraudulent pretenders.” Another writer of 1710, Dr Lynn, quoted in the chapter on Smallpox, implies that physicians were taking an unusually cynical view of their business. The most interesting essay of the time on fevers is by J. White, M.D. (De recta Sanguinis Missione &c. Lond. 1712), a Scot who had been in the Navy and afterwards in practice at Lisbon; but it throws no light upon the London fevers. [94] Elizabeth, Lady Otway, to Benj. Browne, Dec. 1st and 15th, 1715, and Feb. 16, 1716. Hist. MSS. Com. X. pt. 4, p. 352; Hemingway’s Hist. of Chester, II. 244. [95] Letters, ed. Cunningham, I. 72. [96] Lecky, History of England in the Eighteenth Century, VI. 204:—“All the evidence we possess concurs in showing that during the first three-quarters of the century the position of the poorer agricultural classes in England was singularly favourable. The price of wheat was both low and steady. Wages, if they advanced slowly, appear to have commanded an increased proportion of the necessaries of life, and there were all the signs of growing material well-being. It was noticed that wheat bread, and that made of the finest flour, which at the beginning of the period had been confined to the upper and middle classes, had become before the close of it over the greater part of England the universal food, and that the consumption of cheese and butter in proportion to the population in many districts almost trebled. Beef and mutton were eaten almost daily in villages.” [97] Six Centuries of Work and Wages, pp. 398-415. [98] Gentleman’s Magazine, 1766. [99] Short. [100] Clifton Wintringham, M.D., Commentarium nosologicum, morbos epidemicos et aeris variationes in urbe Eboracensi locisque vicinis ab anno 1715 usque ad finem anni 1725 grassantes, complectens. Londini, 1727. [101] W. White, M.D., Phil. Trans. LXXII. (1782), p. 35. The annual deaths under the old rÉgime exceeded by a good deal the annual births: in the seven years 1728-35, according to the figures from the parish registers in Drake’s Eboracum, the burials from all causes were 3488, and the baptisms 2803, an annual excess of 98 deaths over the births in an estimated population of 10,800 (birth-rate 37 per 1000, death-rate 46 per 1000). But in the seven years, 1770-76, the balance was the other way: the population had increased by two thousand (to 12,800), and the births were on an average 20 in the year more than the deaths (474 births, 454 deaths), the birth-rate being still 37 per 1000, and the death-rate fallen to 35 per 1000. But the correctness of these rates depends on the population being exactly given. [102] “There has been very great mobbing by the weavers of this town, as they pretend, because they are starved for want of trade; and they pull the calico cloaths off women’s backs wherever they see them. The Trainbands have been up since last Friday, and they were forced to fire at the mobb in Moor Fields before they would disperse, and four or five were shott and as many wounded.” (Benjamin Browne to his father, 16 June, 1719: Mr Browne’s MSS. Hist. MSS. Com. X. pt. 4, p. 351.) The calicoes which the London weavers tore from the backs of women were doubtless the Indian fabrics brought home by the ships of the East India Company. These imports were so injurious to home manufactures that an Act had been passed in 1700 prohibiting (with some exceptions) the use in England of printed or dyed calicoes or any other printed or dyed cotton goods. This prohibition was re-enacted in 1721, two years after the rioting at Moorfields. (7 Geo. I. cap. 7). Blomefield (Hist. of Norfolk, III. 437) says that at Norwich also there was tearing of calicoes, “as pernicious to the trade” of that city. On the 20th of September, 1720, a great riot arose there, the rabble cutting several gowns in pieces on women’s backs, entering shops to seize all calicoes found there, beating the constables, and opposing the sheriff’s power to such a degree that the company of artillery had to be called out. [103] Ambrose Warren to Sir P. Gell, 16 Sept. 1718, Hist. MSS. Com. IX. pt. 2, p. 400 b. [104] The sudden rise was due to influenza; but the fever mortality was high for weeks before and after. [105] John Arbuthnot, M.D., Essay concerning the Effects of Air on Human Bodies. Lond. 1733, p. 187. [106] Edward Strother, M.D., Practical Observations on the Epidemical Fever which hath reigned so violently these two years past and still rages at the present time, with some incidental remarks shewing wherein this fatal Distemper differs from Common fevers; and more particularly why the Bark has so often failed: and methods prescribed to render its use more effectual. In which is contained a very remarkable History of a Spotted Fever. London, 1729. This book was written before the influenza of the end of 1729. At p. 126 the author was writing on the 24th of May, 1728. The preface is undated. [107] Bernard de Mandeville, M.D., A Treatise of the Hypochondriack and Hysteric Diseases, 3rd ed. 1730, 1st ed. 1711. It contains nothing about the “little fever.” [108] Richard Blackmore, M.D., A Discourse upon the Plague, with a prefatory account of Malignant Fever. London, 1721, p. 17. [109] W. Cockburn, M.D., Danger of improving Physick, with a brief account of the present Epidemick Fever. London, 1730. [110] I am the more persuaded of the identity with relapsing fever of much that was called remittent in Britain, and even intermittent, after reading the highly original treatise by R. T. Lyons on Relapsing or Famine Fever, London, 1872, relating to the epidemics of it in India. [111] Huxham, On Fevers, chap. VIII. [112] Murchison, Continued Fevers of Great Britain, 2nd ed. Lond. 1873, p. 423. [113] Sir Richard Manningham, Kt., M.D. Febricula or Little Fever, commonly called the Nervous or Hysteric Fever, the Fever on the Spirits, Vapours, Hypo, or Spleen. 1746. [114] It is clear that the nervous fever established itself as a distinct type in England in the earlier part of the 18th century, both in medical opinion and in common acceptation: thus Horace Walpole, writing from Arlington Street on 28 January, 1760, says: “I have had a nervous fever these six or seven weeks every night, and have taken bark enough to have made a rind for Daphne: nay, have even stayed at home two days.” Letters of Horace Walpole, ed. Cunningham, iii. 281. [115] Commentar. Nosol. u. s. [116] William Hillary, M.D., “An Account of the principal variations of the Weather and the concomitant Epidemical Diseases from 1726 to 1734 at Ripon.” App. to Essay on the Smallpox, Lond. 1740. [117] Brand, History of Newcastle, ii. 517, says that the magistrates of that town made a collection for the relief of poor housekeepers in the remarkably severe winter of 1728-29, the sum raised being £362. 18s. [118] Tooke, History of Prices from 1793 to 1837. Introd. chap. p. 40. [119] Ancient Physician’s Legacy. Lond. 1733, p. 144. [120] “In the year 1727,” says Hillary, “I ordered several persons to lose 120 to 140 ounces of blood at several times in these inflammatory distempers, with great relief and success; whereas, in this winter [1728] I met with few, and even the strong and robust, who could bear the loss of above 40 or 50 ounces of blood, at three or four times; but, in general, most of the sick could not bear bleeding oftener than twice, and then not to exceed 30 or 34 oz. at most, at two or three times; and especially those who had been afflicted with, and debilitated by, the intermitting fever in the autumn before,—these could not bear blooding oftener than once, or twice at most, and in very small quantities too, though the acuteness of the pain, and the other symptoms in all, seemed at first to indicate much larger evacuations that way; but the first bleeding often sunk the pulse and strength of the patient so much that I durst not repeat it more than once, and in some not at all.” Hillary, u. s. p. 26. [121] Edin. Med. Essays and Obs. I-VI. This annual publication was the original of the Transactions of the Royal Society of Edinburgh. [122] Ibid. I. 40; II. 27; II. 287 (St Clair’s case); IV. [123] Huxham, De aere et morbis. [124] Ebenezer Gilchrist, M.D., “Essay on Nervous Fevers.” Edin. Med. Essays and Obs. IV. 347, and VI. (or V. pt. 2), p. 505. [125] Ibid. V. pt. 1, p. 30. [126] Obs. de aere et morbis; also his essay On Fevers. [127] Hillary, App. to Smallpox, 1740, pp. 57, 66. [128] Mr Lecky (History of England in the 18th Century), II., says that the famine and fever of 1740-41, which he describes as an important event in the history of Ireland, “hardly excited any attention in England.” It was severely felt, however, in England; and if it excited hardly any attention, that must have been because there were so many superior interests which were more engrossing than the state of the poor. [129] Gent. Magaz. X. (1740), 32, 35. Blomefield, for Norwich, says that many there would have perished in the winter of 1739-40 but for help from their richer neighbours. [130] W. Allen, Landholder’s Companion, 1734. Cited by Tooke. [131] An Inquiry into the Nature, Cause and Cure of the present Epidemic Fever ... with the difference betwixt Nervous and Inflammatory Fevers, and the Method of treating each, 1742, p. 54. [132] John Altree, Gent. Magaz. Dec. 1741, p. 655. [133] White, ibid. 1742, p. 43. [134] Dunsford, Historical Memorials of Tiverton. The accounts of the great weaving towns of the South-west are not unpleasing until we come to the time when they were overtaken by decay of work and distress, from about 1720 onwards. The district, says Defoe, was “a rich enclosed country, full of rivers and towns, and infinitely populous, in so much that some of the market towns are equal to cities in bigness, and superior to many of them in numbers of people.” Taunton had 1100 looms. Tiverton in the seven years 1700-1706 had 331 marriages, 1116 baptisms, 1175 burials (a slight excess), and an estimated population of 8693, which kept nearly at that level for about twenty years longer (from 1720 to 1726 the marriages were 284, the baptisms 1070 and the burials 1175). [135] Gent. Magaz. XI. (1742), p. 704. [136] Blomefield, History of Norfolk III. 449. [137] Arnot, History of Edinburgh, 1779, p. 211. [138] Gent. Magaz. 1741, p. 705. [139] Edin. Med. Essays and Obs. I. Art. 1. [140] Gent. Magaz. 1742, p. 186. [141] John Wall, M.D., Medical Tracts, Oxford, 1780, p. 337. See also Obs. on the Epid. Fever of 1741, 3rd ed., by Daniel Cox, apothecary, with cases. [142] Edin. Med. Essays and Obs. VI. 539. [143] “And here I cannot but observe how many ignorant conceited coxcombs ride out, under a shew of business, with their lancet in their pocket, and make diseases instead of curing them, drawing their weapon upon every occasion, right or wrong, and upon every complaint cry out, ‘Egad! I must have some of your blood,’ give the poor wretches a disease they never might have had, drawing the blood and the purse, torment them in this world,” etc.—An Essay on the present Epidemic Fever, Sherborne, 1741. The practice of blood-letting in continued fevers received a check in the second half of the 18th century, but it was still kept up in inflammatory diseases or injuries. Even in the latter it was freely satirized by the laity. When the surgeon in Tom Jones complained bitterly that the wounded hero would not be blooded though he was in a fever, the landlady of the inn answered: “It is an eating fever, then, for he hath devoured two swingeing buttered toasts this morning for breakfast.” “Very likely,” says the doctor, “I have known people eat in a fever; and it is very easily accounted for; because the acidity occasioned by the febrile matter may stimulate the nerves of the diaphragm, and thereby occasion a craving which will not be easily distinguishable from a natural appetite.... Indeed I think the gentleman in a very dangerous way, and, if he is not blooded, I am afraid will die.” [144] Munk, Roll of the College of Physicians, II. 53. [145] Gentleman’s Magaz. III. 1733, Sept., p. 492. [146] Effects of Air on Human Bodies, 1733, pp. 11, 17. His excellent remarks on the need of fresh air in the treatment of fevers, two generations before Lettsom carried out the practice, are at p. 54. The curious calculation above cited was copied by Langrish, and usually passes as his. [147] “Also without the bars both sides of the street be pestered with cottages and alleys even up to Whitechapel Church, and almost half a mile beyond it, into the common field: all which ought to be open and free for all men. But this common field, I say, being sometime the beauty of this city on that part, is so encroached upon by building of filthy cottages, and with other purprestures, enclosures and laystalls (notwithstanding all proclamations and Acts of Parliament made to the contrary) that in some places it scarce remaineth a sufficient highway for the meeting of carriages and droves of cattle. Much less is there any fair, pleasant or wholesome way for people to walk on foot, which is no small blemish to so famous a city to have so unsavoury and unseemly an entrance or passage thereunto.” Stow’s Survey of London, section on “Suburbs without the Walls.” [148] The line of an old field walk can still be followed from Aldermanbury Postern to Hackney, Goldsmiths’ Row being one of the wider sections of it. [149] Luttrell’s Diary 10 June, 1684. [150] Roger North’s “Autobiography,” in Lives of the Norths, new ed. 3 vols., 1890, III. 54. [151] Willan, 1801: “The passage filled with putrid excremental or other abominable effluvia from a vault at the bottom of the staircase.” See also Clutterbuck, Epid. Fever at present prevailing. Lond. 1819, p. 60. Ferriar, of Manchester, writing of the class of houses most apt to harbour the contagion of typhus, says, “Of the new buildings I have found those most apt to nurse it which are added in a slight manner to the back part of a row, and exposed to the effluvia of the privies.” [152] C. Davenant to T. Coke, London, 14 Dec. 1700. Cal. Coke MSS., II. 411, “I heartily commiserate your sad condition to be in the country these bad weeks; but I fancy you will find Derbyshire more pleasant even in winter than the House of Commons will be in a summer season. For, though it be now sixteen years ago [1685], I still bear in memory the evil smells descending from the small apartments adjoining to the Speaker’s Chamber, which came down into the House with irresistible force when the weather is hot.” [153] Report on the Diseases in London, 1796-1800. Lond. 1801. [154] John Ferriar, M.D., Medical Histories and Reflections. London 1810, II. 217. [155] Heysham, Jail Fever at Carlisle in 1781. Lond. 1782, p. 33. [156] John Howard, State of the Prisons. [157] Notes and Queries, 4th ser. XII. 346. Jenkinson, who was a Minister under George II., was reputed to have set an example of stopping up windows in his mansion near Croydon: You e’en shut out the light of day Others had boards painted to look like brickwork, which could be used to cover up windows at pleasure. [158] Petition, undated, but placed in a collection in the British Museum among broadsides of the years 1696-1700. In 1725 the imprisoned debtors at Liverpool petitioned Parliament for relief, alleging that they were reduced to a starving condition, having only straw and water at the courtesy of the serjeant. Commons’ Journals, XX. 375. [159] Commons’ Journals, 20 March, 1728/29, 14 May, 1729, 24 March, 1729/30. “Mrs Mary Trapps was prisoner in the Marshalsea and was put to lie in the same bed with two other women, each of which paid 2s. 6d. per week chamber rent; she fell ill and languished for a considerable time; and the last three weeks grew so offensive that the others were hardly able to bear the room; they frequently complained to the turnkeys and officers, and desired to be removed; but all in vain. At last she smelt so strong that the turnkey himself could not bear to come into the room to hear the complaints of her bedfellows; and they were forced to lie with her on the boards, till she died.” [160] Political State of Great Britain, XXXIX. April, 1730, pp. 430-431, 448. [161] Gent. Magaz., XX. 235. This authority is twenty years after the event, the incident having been recalled in 1750, on the occasion of the Old Bailey catastrophe. [162] Huxham. [163] See the former volume of this History, pp. 375-386. [164] A Report &c. and of other Crown Cases. By Sir Michael Foster, Knt., some time one of the Judges of the Court of King’s Bench. 2nd ed. London, 1776, p. 74. [165] The Gentleman’s Magazine however says (1750, p. 235): “There being a very cold and piercing east wind to attack the sweating persons when they came out of court.” [166] See Bancroft, Essay on the Yellow Fever, with observations concerning febrile contagion etc. Lond. 1811. [167] Gent. Magaz. 1750, p. 274: “Many families are retired into the country, and near 12,000 houses empty”—an impossible number. [168] Sir John Pringle, Observations on the Nature and Cure of the Hospital and Jayl Fever. Letter to Mead, May 24. London, 1750. [169] One of the cases was that of an apprentice: “Some of the journeymen working in Newgate had forced him to go down into the great trunk of the ventilator in order to bring up a wig which one of them had thrown into it. As the machine was then working, he had been almost suffocated with the stench before they could get him up.” Pringle, “Ventilation of Newgate,” Phil. Trans. 1753, p. 42. [170] Thomas Stibbs to Sir John Pringle, Jan. 25, 1753. Ibid. p. 54. [171] “Ventilators some years since when first introduced, it was thought, would prove an effectual remedy for and preservative against this infection in jails; great expectations were formed of their benefit, but several years’ experience must now have fully shewn that ventilators will not remove infection from a jail.” Lind, Means of Preserving the Health of Seamen in the Royal Navy. New ed. Lond. 1774, p. 29. [172] J. C. Lettsom, M.D., Medical Memoirs of the General Dispensary in London, 1773-4. Lond. 1774. [173] Gent. Magaz. 1776, April 22. p. 187. [174] Lind, Two Papers on Fevers and Infection. Lond. 1763. pp. 90, 106. Many cases had buboes both in the groins and the armpits. [175] Carmichael Smyth, Description of the Jail Distemper among Spanish Prisoners at Winchester in 1780. Lond. 1795. [176] Cal. Coke MSS. Hist. MSS. Commiss. i. 218. [177] Med. Hist. and Reflect. ut infra. [178] The following case, which happened five or six years ago, shows disparity of conditions in a twofold aspect. A lady from a city in the north of Scotland travelled direct to Switzerland to reside for a few weeks at one of the hotels in the High Alps. Within an hour or two of the end of her journey she began to feel ill, and was confined to her room from the time she entered the hotel. An English physician diagnosed the effects of the sun; the German doctor of the place, from his reading only, diagnosed typhus fever, which proved to be right, the patient dying with the most pronounced signs of malignant typhus. An explanation of the mystery was soon forthcoming. The lady had been a district visitor in an old and poor part of the Scotch city; she had, in particular, visited in a certain tenement-house in a court, from which half-a-dozen persons had been admitted to the Infirmary with typhus (an unusual event) at the very time when she was ill of it on the Swiss mountain. [179] Blane, Select Dissertations. London, 1822, p. 1. [180] Mather’s Magnalia. 2 vols. Hartford, 1853, i. 226 “Life of Sir William Phipps.” “Whereof there died, ere they could reach Boston, as I was told by Sir Francis Wheeler himself [‘but a few months ago’], no less than 1300 sailors out of 21, and no less than 1800 soldiers out of 24.” He had brought 1800 troops with him from England to Barbados in transports. [181] Churchill’s Collection, VI. 173. [182] W. Cockburn, M.D. An Account of the Nature, Causes, Symptoms and Cure of the Distempers that are incident to Seafaring People. 3 Parts. London, 1696-97. [183] J. White, M.D. De recta Sanguinis Missione, or, New and Exact Observations of Fevers, in which Letting of Blood is shew’d to be the true and solid Basis of their Cure, &c. London, 1712. His chief point, that the strongest and lustiest were most obnoxious to malignant fevers, had been urged by Cockburn in 1696. [184] Lind (Two Papers on Fevers and Infection, London, 1763, p. 113) gives an instance where the poisonous effluvia of the ship’s well did not spread through the ’tween decks: “The following accident happened lately [written in 1761] in the Bay of Biscay. In a ship of 60 guns, by the carpenter’s neglecting to turn the cock that freshens the bilge-water, which had not been pumped out for some time, a large scum, as is usual, or a thick tough film was collected a-top of it. The first man who went down to break this scum in order to pump out the bilge-water was immediately suffocated. The second suffered an instantaneous death in like manner. And three others, who successively attempted the same business, narrowly escaped with life: one of whom has never since perfectly recovered his health. Yet that ship was at all times, both before and after this accident, remarkably healthy.” It was the contention of Renwick, a naval surgeon who wrote in 1794, that it was the stirring of the bilge-water in being discharged from the ship’s well, or the adding of fresh water to the foul, that caused the offensive emanations. “Hence the first cause of febrile sickness in all ships recently commissioned.” Renwick made so much of the foul bilge-water as a cause that he thought the fevers ought to be termed “bilge-fevers.” Letter to the Critical Reviewer, p. 42. [185] These particulars are not given in Freind’s special work on Peterborough’s campaign, which deals only with the military and political history, but in his Nine Commentaries on Fever (Engl. ed. by Dale, London, 1730), and in a Latin letter to Cockburn, dated Barcelona, 9 Sept. 1706, which was first printed in Several Cases in Physic. By Pierce Dod, M.D. London, 1746. [186] Smollett joined the ‘Cumberland’ as surgeon’s mate in 1740, before she sailed with the fleet sent out under Vernon and others to Carthagena. His account in Roderick Random of the sick-bay of the ‘Thunder’ as she lay at the Nore is doubtless veracious: “When I observed the situation of the patients, I was much less surprised that people should die on board, than that any sick person should recover. Here I saw about fifty miserable distempered wretches, suspended in rows, so huddled one upon another that not more than fourteen inches space was allowed for each with his bed and bedding; and deprived of the light of the day, as well as of fresh air; breathing nothing but a noisome atmosphere of the morbid steams exhaling from their own excrements and diseased bodies, devoured with vermin hatched in the filth that surrounded them, and destitute of every convenience necessary for people in that helpless condition.” Chap. XXV. He wrote a separate account of the fatal Carthagena expedition in a compendium of voyages. [187] Coxe’s Life of Marlborough. Bohn’s ed. I. 183. [188] Grainger’s essay, Historia febris anomalae Bataviae annorum, 1746, 1747, 1748, etc. Edin. 1753, is chiefly occupied with an anomalous “intermittent” or “remittent” fever with miliary eruption, and with dysentery. [189] For a full discussion of the relation of dysentery to typhus, see Virchow, “Kriegstypus und Ruhr.” Virchow’s Archiv, Bd. LII. (1871), p. 1. [190] Sir John Pringle, Obs. on the Nature and Cure of Hospital and Jayl Fever, Lond. 1750 (Letter to Mead); and his Obs. on Diseases of the Army, Lond. 1752 (fullest account). [191] Pringle, Diseases of the Army, pp. 40-45. [192] Ibid. p. 68. [193] Donald Monro, M.D. Diseases of British Military Hospitals in Germany, from Jan. 1761 to the Return of the Troops to England in 1763. Lond. 1764. The same campaign called forth also Dr Richard Brocklesby’s Œconomical and Medical Observations from 1758 to 1763 on Military Hospitals and Camp Diseases etc. London, 1764. [194] Essay on Preserving the Health of Seamen, Lond. 1757; Two papers etc. u. s. [195] In 1755 a pestilential sickness raged in the North American fleet, the ‘Torbay’ and ‘Munich’ being obliged to land their sick at Halifax. [196] The Gentleman’s Magazine for December, 1772 (p. 589), records the following: “The bodies of two Dutchmen who were thrown overboard from a Dutch East Indiaman, where a malignant fever raged, were cast up near the Sally Port at Portsmouth; they were so offensive that it was with difficulty that anyone could be got to bury them.” [197] W. Brownrigg, M.D. Considerations on preventing Pestilential Contagion. London, 1771, p. 36. [198] Lind writes in his book on the Health of Seamen, “The sources of infection to our armies and fleets are undoubtedly the jails: we can often trace the importers of it directly from them. It often proves fatal in impressing men on the hasty equipment of a fleet. The first English fleet sent last war to America lost by it alone two thousand men.” [199] R. Robertson, M.D. Observations on Jail, Hospital or Ship Fever from the 4th April, 1776, to the 30th April, 1789, made in various parts of Europe and America and on the Intermediate Seas. London, 1789. New edition. [200] Given by Blane in a Postscript to his paper “On the Comparative Health of the British Navy, 1779-1814” in Select Dissertations, London, 1822, p. 62. [201] Blane, u. s. p. 47, from information supplied by Dr John Lind, of Haslar Hospital. [202] Diseases incident to Seamen, p. 18. [203] Ibid. p. 34. [204] Trotter, Medicina Nautica, I. 61. His general abstracts of the health of the fleet in the first years of the French War, 1794-96, give many instances of ship-typhus. [205] John Clark, M.D. Observations on the Diseases which prevail in Long Voyages to Hot Countries, &c. London, 1773. 2nd ed. 2 vols., 1792. John Lorimer, M.D., published in Med. Facts and Observations, VI. 211, a “Return of the ships’ companies and military on board the ships of the H. E. I. C. for the years 1792 and 1793.”
[206] Reflections and Resolutions for the Gentlemen of Ireland, p. 28. Cited by Lecky. [207] Sutton, “Changing Air in Ships,” Phil. Trans. XLII. 42; W. Watson, M.D. ibid. p. 62; H. Ellis, ibid. XLVII. 211. [208] Ibid. XLIX. 332, “Ventilation of a Transport.” [209] Ibid. pp. 333, 339. [210] Lind, Essay on the Most Effectual Means of Preserving the Health of Seamen in the Royal Navy. New Ed. London, 1774, p. 29. [211] Blane, Diseases incident to Seamen, 1785, p. 243. [212] Id. “On the Comparative Health of the British Navy from the year 1799 to the year 1814, with Proposals for its farther Improvement.” Select Dissertations, 1822, p. 1. [213] Le Cat, Phil. Trans. XLIX. 49. [214] “Its cause seemed to be something contagious mixed with the contents of the stomach and intestines, especially the bile and alvine faeces, which absorbed thence contaminates the whole body and affects especially the cerebral functions.” Gent. Magaz., Article signed “S,” 1755, p. 151. [215] James Johnstone, M.D., senior, Malignant Epidemic Fever of 1756. London, 1758. [216] Nash, Hist. of Worcestershire, II. 39, found evidence in the Kidderminster registers that the fevers of 1727, 1728 and 1729 had “very much thinned the people, and terrified the inhabitants.” Watson, “On the Medical Topography of Stourport,” Trans. Proc. Med. Assoc., II., had heard or read somewhere that fever was so bad in Kidderminster in the first part of the 18th century that farmers were afraid to come to market. [217] Huxham, Dissertation on the Malignant Ulcerous Sore-Throat. Lond. 1757, p. 60. [218] Tooke, History of Prices. Introduction. [219] In Shrewsbury gaol, in 1756, thirty-seven colliers were confined for rioting during the dearth. Four of them died in gaol, ten were condemned to death, of whom two were executed. Phillips, History of Shrewsbury, 1779, p. 213. [220] Johnstone, u. s. Short says: “a slow, malignant, putrid fever in some parts of Yorkshire, Cheshire, Worcestershire and the low parts of Leicestershire, which carried off very many.” In October, 1757, it set in at Sheffield and raged all the winter. [221] Short, Increase and Decrease of Mankind in England, etc. London, 1767, p. 109. [222] Charles Bisset, Essay on the Medical Constitution of Great Britain, 1 Jan. 1758, to Midsummer, 1760. Together with a narrative of the Throat-Distemper and the Miliary Fever which were epidemical in the Duchy of Cleveland in 1760. London, 1762, pp. 265, 270, &c. [223] James Sims, M.D., Obs. on Epid. Disorders. Lond. 1773, p. 181. [224] W. Hillary, M.D., Changes of the Air and Concomitant Epid. Disorders in Barbadoes. 2nd ed., Lond. 1766. [225] Tractatus duplex de Praxeos Regulis et de Febre Miliari, Lond. 1710. Engl. transl. of the latter, Lond. 1737. [226] Ormerod, Clin. Obs. on Continued Fever. London, 1848. [227] Historia Febris Miliaris, et de Hemicrania Dissertatio. Auctore Joanne Fordyce, M.D., Londini, 1758. Symptoms at p. 16. In an Appendix Dr Balguy makes the following curious division of the miliary vesicles: the white in malignant continued fever, the dull red in remittent fever, the “almost efflorescent” in intermittent. Fordyce makes them to appear as early as the third day, and to begin to disappear in four or six days in favourable cases. [228] London, 1773, p. 9. See also Sir W. Fordyce’s essay of the same year. [229] John Moore, M.D., Medical Sketches, Lond. 1786. Part II. “On Fevers.” Referring to the “putrid” fever in particular, he says that certain unbelievers, of whom he was probably one, “assert that mankind are tenacious of opinions, when once adopted, in proportion as they are extraordinary, disagreeable and incredible.” Dr Moore is best known as the author of Zeluco. [230] Haygarth, Phil. Trans. LXIV. 73. [231] Percival, ibid. LXIV. 59. [232] Hutchinson, u. s. [233] Annual Register, 1766, p. 220. The King’s Speech on 11 Nov. was chiefly occupied with the dearth. The use of wheat for distilling was prohibited by an order of Council of 16 Sept. 1766. Gent. Magaz. p. 399. To show the hardships of the rural population at this time, Mr Gladstone, in a speech at Hawarden in 1891, read the following words copied from a stone set up in the park of Hawarden to commemorate the rebuilding of a mill: “Trust in God for bread, and to the king for protection and justice. This mill was built in the year 1767. Wheat was within this year at 9s., and barley at 5s. 6d. a bushel. Luxury was at a great height, and charity extensive, but the poor were starved, riotous, and hanged.” [234] Lecky, III. 115. [235] Gent. Magaz., series of letters by various hands in 1766. See also a long essay in the Annual Register for 1767 (then edited by Edmund Burke), “On the Causes and Consequences of the present High Price of Provisions,” p. 165. The evidence of a rise in the standard of living, in the matter of dress and luxuries as well as of food, is equally clear from Scotland in the articles written by the parish ministers for the ‘Statistical Account.’ [236] For a judicious estimate of the value of the Parish Clerks’ bills of mortality see the elaborate paper by Dr William Ogle, Journ. Statist. Soc. LV. (1892), 437. [237] Diseases of the Army. New ed. 1775, pp. 334-5. Pringle admitted, however, that “in some of the lowest, moistest and closest parts of the town, and among the poorer people, spotted fevers and dysenteries are still to be seen, which are seldom heard of among those of better rank living in more airy situations.” [238] Medical Sketches, Lond. 1786, p. 464. [239] Lecky, History of England in the Eighteenth Century, II. 636, generalizes the facts as follows: “The wealthy employer ceased to live among his people; the quarters of the rich and of the poor became more distant, and every great city soon presented those sharp divisions of classes and districts in which the political observer discovers one of the most dangerous symptoms of revolution.” [240] “This disease, as it appears in jails and hospitals, has been well described by Sir John Pringle; and other authors have given accounts of it on board of ships, especially crowded transports and prison-ships, but I do not find that its originating in the families of the poor in great cities during the winter has been taken notice of.” Med. Trans. Coll. Phys. III. 345. [241] He has been immortalised by Johnson’s verses: “Well tried through many a varying year [242] John Coakley Lettsom, M.D., Medical Memoirs of the General Dispensary in London, April 1773 to March 1774. London, 1774. [243] Nothing could be clearer than Dr John Arbuthnot’s reasoning and advice on this matter half a century before. [244] London, 1775. [245] Med. Trans. of the Coll. Phys. Lond. III. (1785), 345: “Observations on the Disease commonly called the Jail or Hospital Fever.” By John Hunter, M.D., physician to the army. [246] James Sims, M.D., “Scarlatina anginosa as it appeared in London in 1786,” Mem. Med. Soc. Lond. I. 414. Willan, who saw the same epidemic of scarlatinal sore-throat in London in 1786, believed that the angina was also “connected with a different species of contagion, namely, that of the typhus or malignant fever originating in the habitations of the poor, where no attention is paid to cleanliness and ventilation.” Cutaneous Diseases, 1808, p. 333. [247] The rumour of London fevers seems to have reached Barker, who kept an epidemiological record at Coleshill. Referring to the winter of 1788-89, he says: “At this time there were dreadful fevers in London, fatal to many, and a very infectious one in Coventry, of which many among the poor died, most of them being delirious, and many phrenetical.” [248] Robert Willan, M.D., Reports on the Diseases of London, particularly during the years 1796-97-98-99 and 1800. London, 1801. [249] He names specially some streets of St Giles’s parish, the courts and alleys adjoining Liquorpond Street, Hog-Island, Turnmill Street, Saffron Hill, Old Street, Whitecross Street, Golden Lane, the two Bricklanes, Rosemary Lane, Petticoat Lane, Lower East Smithfield, some parts of Upper Westminster, and several streets of Southwark, Rotherhithe, etc. “I recollect a house in Wood’s Close, Clerkenwell, wherein the fomites of fever were thus preserved for a series of years; at length an accidental fire cleared away the nuisance. A house, notorious for dirt and infection, near Clare-market, afforded a farther proof of negligence: it was obstinately tenanted till the wall and floors, giving way in the night, crushed to death the miserable inhabitants.” [250] Medical Reports on the Effects of Water, Cold and Warm, as a Remedy in Fever and other Diseases. 2nd ed., 1798. It need hardly be explained that Dr Currie was competent on fevers, his use of the clinical thermometer marking him as a man of precision. He is best known to the laity as the biographer of Robert Burns and the generous helper of the poet’s widow and family. [251] “If it be supposed,” says Currie, “that some cases may be denominated typhus by mistake, let it be considered how many cases of this disease do not appear in the books of the Dispensary, though occurring among the poor, being attended by the surgeons and apothecaries of the Benefit Clubs to which they belong.” [252] Moss (A Familiar Medical Survey of Liverpool, 1784), who had not the same means of knowing the prevalence of typhus in Liverpool as Currie, declares that “there has been but one instance of a truly malignant fever happening in the town for many years; it was in the autumn of 1781, and appeared in Chorley Street, which is one of the narrowest and most populous streets in the town, and nine died of it in one week; it was only of short duration, and did not spread in any other part of the town.” He admits that the habitations of the poorer class were confined, being chiefly in cellars; yet the diet of the sober and industrious is wholesome and sufficient, the comfortable artizans being ship-carpenters, coopers, ropers and the like. [253] John Clark, M.D., Observations on the Diseases which prevail in Long Voyages, &c. 2nd ed., Lond. 1792; Account of the Newcastle Dispensary from its Commencement in 1777 to March 1789, Newcastle, 1789; and subsequent Annual Reports. [254] Haygarth, Phil. Trans. LXIV. 67; Hemingway, History of Chester, I. 344 seq. [255] Arnold Toynbee, Lectures on the Industrial Revolution of the 18th Century, etc. London, 1884. [256] Toynbee (u. s.) says of the time before the mills were built: “The manufacturing population still lived to a very great extent in the country. The artisan often had his small piece of land, which supplied him with wholesome food and healthy recreation. His wages and employments too were more regular. He was not subject to the uncertainties and knew nothing of the fearful sufferings which his descendants were to endure from commercial fluctuations, especially before the introduction of free trade.” [257] Percival, “Population of Manchester.” Phil. Trans. LXIV. 54. [258] James Lucas, “Remarks on Febrile Contagion.” London Medical Journal, X. 260. [259] In Appendix to Hutchinson’s Cumberland, 1794. Reprinted in Appendix to Joshua Milne’s Valuation of Annuities, Lond. 1815. [260] John Heysham, M.D., Account of the Jail Fever, or Typhus Carcerum, as it appeared at Carlisle in 1781. London, 1782. [261] Aikin, Phil. Trans. LXIV. 473. [262] John Aikin, M.D., The Country from 30 to 40 miles round Manchester. Lond. 1795, p. 584. [263] John Ferriar, M.D., Medical Histories and Reflections. 4 vols., 1810-13, I. 172. [264] Ferriar, I. 261. [265] Ibid. I. 234. [266] Ibid. II. 213-20. [267] Ibid. I. 153-6; and II. 57. [268] Ferriar, I. 166-8. [269] This is perhaps the first numerical evidence of the slight fatality of typhus in children. A more elaborate proof of the same was given long after by Geary for Limerick. An early age-table for Whitehaven is given under Smallpox, infra. [270] David Campbell, M.D., Observations on the Typhus or Low Contagious Fever. Lancaster, 1785. [271] Joshua Dixon, M.D., Annual Reports of the Whitehaven Dispensary, 1795 to 1805. Details for 1773-4 in his note in Memoirs of Lettsom, III. 353. [272] Dixon, Literary Life of Dr Brownrigg, pp. 238-9. [273] Aikin, Country round Manchester. Lond. 1795, p. 616. [274] Nature and Origin of the Contagion of Fevers. Hull, 1788. [275] Account of a Contagious Fever at Aylesbury. Aylesbury, 1785. [276] Thomas Day, Some Considerations ... on the Contagion in Maidstone Jail, 1785. [277] See Barnes, in Mem. Lit. Phil. Soc. Manchester, II. 85. Dr Samuel Parr wrote his epitaph in the Cathedral. Also Johnstone sen. to Lettsom, Memoirs, III. 241. [278] Martin Wall, M.D., Clin. Obs. on the Use of Opium in Low Fevers and in the Synochus. Oxford, 1786. [279] J. C. Jenner, in Lond. Med. Journal, VII. 163. [280] Gent. Magaz. 1785, I. 231, March 1. [281] This is the period and the district to which Robert Burns refers, under date of 21 June, 1783, in a letter to his cousin, James Burness, of Montrose: “I shall only trouble you with a few particulars relative to the wretched state of this country. Our markets are exceedingly high, oatmeal 17d. and 18d. per boll, and not to be got even at that price. We have, indeed, been pretty well supplied with quantities of white peas from England and elsewhere; but that resource is likely to fail us, and what will become of us then, particularly the very poorest sort, heaven only knows.” The lately flourishing silk and carpet weaving had declined during the American War, and the seasons had been adverse to farmers. The lines in Burns’ poem, “Death and Dr Hornbook”: ‘This while ye hae been mony a gate are explained by a note, “An epidemical fever was then raging in the country.” [282] Account by Rev. Geo. Skene Keith, Statist. Act. II. 544. [283] Also Banff, ibid. XX. 347. “Not twenty years ago, but you I think Trotter, Medicina Nautica, I. 182, 1797, gives these real cases:—“During the short time that I attended the dispensary at Newcastle, just at the beginning of the [French] war, I was sent for to a poor man in a miserable and low part of the town called Sandgate. He was ill with what is called a spotted fever.” Six children were standing round his bed, the oldest not more than nine. They had been ill first, then his wife, who was recovered and had gone out to pawn the last article they had to buy meal for the children. The man worked on the quay at 1s. 2d. per diem. Again, “When I practised as a surgeon and apothecary at the end of the late [American] war in a small town in Northumberland, with an extensive country business, some similar scenes came under my view. Two servants of two opulent farmers applied to me for relief. The first had seven children, who took the fever one by one till the whole became sick. His wages were 1s. per diem. His master, a rich man, thought himself charitable by allowing them to pull turnips from his field for food. The other servant was a shepherd; but his herding, as the saying is, was a poor one. The first and second of six children were able to work a little, till they got a fever in a severe winter, and down they fell, one after another, the father and mother at last.” They wanted to sell the cow; but some charitable ladies raised a small subscription, by which means the comforts of wine and diet came within their reach; their master, for his part, sent them the carcase of a sheep, which had been found dead in a furrow, with a request that the skin should be returned. [285] Jenner to Shrapnell, Baron’s Life of Jenner, I. 106-7. [286] John Barker, Epidemicks, pp. 201-6. [287] The dearth of 1794-95 called forth one notable piece, the ‘Thoughts and Details on Scarcity,’ drawn up by Mr Burke, from his experience in Buckinghamshire, originally for the use of Mr Pitt, in November, 1795. Burke takes an optimist line, and preaches the economic doctrine of laissez faire: “After all,” he asks, “have we not reason to be thankful to the Giver of all good? In our history, and when ‘the labourer of England is said to have been once happy,’ we find constantly, after certain intervals, a period of real famine; by which a melancholy havock was made among the human race. The price of provisions fluctuated dreadfully, demonstrating a deficiency very different from the worst failures of the present moment. Never, since I have known England, have I known more than a comparative scarcity. The price of wheat, taking a number of years together, has had no very considerable fluctuation, nor has it risen exceedingly within this twelvemonth. Even now, I do not know of one man, woman, or child, that has perished from famine; fewer, if any, I believe, than in years of plenty, when such a thing may happen by accident. This is owing to a care and superintendence of the poor, far greater than any I remember.... Not only very few (I have observed that I know of none though I live in a place [Beaconsfield] as poor as most) have actually died of want, but we have seen no traces of those dreadful exterminating epidemicks, which, in consequence of scanty and unwholesome food, in former times not unfrequently wasted whole nations. Let us be saved from too much wisdom of our own, and we shall do tolerably well.” The last sentence is his favourite principle of “a wise and salutary neglect” on the part of Government. [288] A labourer at Bury St Edmunds, receiving a weekly wage of five shillings, was able to buy therewith at the old prices:
[289] Loidis and Elmete, 1816, p. 85. [290] Thorp, Tract of 1802, cited by Hunter, Ed. Med. Surg. Journ. April, 1819, p. 239. [291] Currie, Med. Phys. Journ. X. 213. [292] Beddoes. [293] Goodwin, Med. Phys. Journ. IX. 509. Cf. Gervis, Med. Chir. Trans. II. 236. [294] Elizabeth Hamilton, The Cottagers of Glenburnie, Edin. 1808: “The only precaution which the good people, who came to see him [the farmer] appeared now to think necessary, was carefully to shut the door, which usually stood open.... The prejudice against fresh air appeared to be universal.... The doctor did not think it probable that he would live above three days; but said, the only chance he had was in removing him from that close box in which he was shut up, and admitting as much air as possible into the apartment.... While the farmer yet hovered on the brink of death, his wife and Robert, his second son, were both taken ill.... Peter MacGlashan had taken to his bed on going home and was now dangerously ill of the fever.... All the village indeed offered their services; and Mrs Mason, though she blamed the thoughtless custom of crowding into a sick room, could not but admire the kindness and good nature with which all the neighbours seemed to participate in the distress of this afflicted family.” [295] Charlotte BrontË’s story of Shirley falls in this period and turns upon the industrial crisis in Yorkshire; but it is on the whole a happy idyllic picture. Harriet Martineau wrote in Household Words, vol. I. 1850, Nos. 9-12, a story entitled “The Sickness and Health of the People of Bleaburn,” a Yorkshire village supposed to have been Osmotherly. It is, in substance, an account of a terrible epidemic of fever in the year 1811, the story opening with the news of the victory of Albuera and the rejoicings thereon. It appears to have been constructed very closely from the real events of the plague of 1665-66 in the village of Eyam, in the North Peak of Derbyshire, and had probably a very slender foundation in any facts of fever in Yorkshire or elsewhere in the year 1811. “Ten or eleven corpses,” says the novelist, “were actually lying unburied, infecting half-a-dozen cottages from this cause.” Cf. infra, Leyburn, p. 167. [296] T. Bateman, M.D., Reports on the Diseases of London ... from 1804 to 1816. Lond. 1819. [297] Parl. Committee’s Report on Contag. Fev. 1818, p. 33. Table by P. M. Roget. [298] Adam Hunter, Ed. Med. Surg. Journ., April, 1819. [299] Cleland, Glasgow and Clydesdale Statist. Soc. Transactions, Pt. I. Nov. 2, 1836. [300] Sutton, Account of a Remittent Fever among the Troops in this Climate. Canterbury, 1806. [301] In the first three months of 1811 a singular fever occurred among working people in part of a suburb of Paisley, one practitioner having 32 cases in 13 families. It was marked by rigors at the onset, pain in the back, headache, dry skin, loaded very red tongue, quick fluttering pulse, watchfulness, delirium-like fatuity, abdominal pain in many, foetid stools, great prostration, gradual recovery after fifteen or sixteen days without manifest crisis, and relapses in some. In this fever Murchison discovers enteric or typhoid. Its limitation to a part of one of the suburbs of Paisley is, of course, in the manner of enteric fever; on the other hand, only one of those 32 cases died, which is a rate of fatality perhaps not unparalleled in typhoid but much more often matched in typhus or relapsing fever of young and old together; while the length of the fever, fifteen or sixteen days or sometimes more, is too great for the abortive kind of enteric and too little for enteric fever completing both its first and second stages. James Muir, Edin. Med. and Surg. Journ. VIII. 134. Murchison, Continued Fevers, p. 428. [302] James Clarke, M.D., “Medical Report for Nottingham from March 1807 to March 1808,” Edin. Med. and Surg. Journ. IV. 422. His account of the unwholesome state of the weavers’ houses is as bad as any of those already given. [303] McGrigor, “Med. Hist. of British Armies in Peninsula,” Med. Chir. Trans. VI. 381. [304] Richard Hooper, “Account of the Sick landed from Corunna,” Edin. Med. and Surg. Journ. V. (1809), p. 398. See also Sir James McGrigor, ibid. VI. 19. [305] James Johnson, Influence of Tropical Climates, p. 20. [306] J. Terry, in Ed. Med. and Surg. Journ., Jan. 1820, p. 247. [307] Bateman, Account of the Contagious Fever of this Country. Lond. 1818. [308] The following from the “Observations on Prevailing Diseases,” Oct.-Nov., 1818 (perhaps by Dr Copland), in the London Medical Repository, X. 525, shows that the relapses in the earlier part of this epidemic had been commonly remarked in London: “Fevers are still prevalent.... Relapses have been noticed as of frequent occurrence in the instances of the late epidemic. To what are these to be attributed? Are we to ascribe them to the influence of the atmosphere, to anything in the nature of the disorders themselves, or to the vigorous plans of treatment which are adopted for their removal? These relapses are more common in hospital than in private practice.... It has recently become the fashion to consider the state of recovery from fever as one which will do better without than with the interposition of the cinchona bark. Has the prevalence of this negative practice anything to do with the admitted fact of frequent relapse?” [309] Report of the Select Committee of the House of Commons on Contagious Fever, Parl. Papers, 1818. [310] On the Epidemic Fever at present prevailing. Lond. 1819, p. 40. [311] J. B. Sheppard, “Remarks on the prevailing Epidemic.” Edin. Med. Surg. Journ., July 1819, p. 346. Also for Taplow, Roberts, Lond. Med. Repos. XIV. 186. [312] W. Hamilton, M.D., Med. and Phys. Journ., June 1817, p. 451. [313] Laws and Phenomena of Pestilence, Lond. 1821, p. 39. Christison says: “All great towns, with the exception it is said of Birmingham.” [314] Adam Hunter, Edin. Med. Surg. Journ., Apr. 1819, p. 234, and Apr. 1820. [315] Wood, “Cases of Typhus.” Edin. Med. Surg. Journ., April, 1819. [316] Adam Hunter, u. s. [317] T. Barnes, Edin. Med. Surg. Journ., April, 1819. [318] H. Edmonston, ibid. XIV. (1818), p. 71. [319] T. McWhirter, ibid. April, 1819, p. 317. [320] J. C. Prichard, M.D., History of the Epidemic Fever which prevailed in Bristol, 1817-19. Lond. 1820. [321] Obs. on the Cure and Prevention of the Contagious Fever now in Edinburgh. Edin. 1818. [322] Edin. Med. Surg. Journ. XVI. 146. [323] Benj. Welsh, Efficacy of Bloodletting in the Epidemic Fever of Edinburgh. Edin. 1819. [324] Life of Sir Robert Christison, Edin. 1885, I. 142:—“I had been scarcely three weeks at my post in the fever hospital when I was attacked suddenly—so suddenly, that in half-an-hour I was utterly helpless from prostration. I had nearly six days of the primary attack, then a week of comfort, repose and feebleness, and next the secondary attack, or relapse, for three days more. My pulse rose to 160, and continued hard and incompressible even at that rate. My temperature under the tongue was 107° &c.” He was bled to 30 oz. and next day to 20 oz. more. Before the end of the epidemic, in August, 1819, he had another attack of relapsing fever, for which he was bled to 24 oz. and a third, after exposure to chill, the same autumn, which last was a simple five-days’ fever without relapse, also treated by the abstraction of 24 oz. of blood. In 1832 he had two attacks of the same synocha without relapses, and throughout the rest of his life many more: e.g. 16 June, 1861, “I have had something like the relapsing fever of my youth”—a five-days’ fever with a relapse on the 18th day; and again, on 19 March, 1868, “Incomprehensible return of mine ancient enemy.” These experiences coloured Christison’s view of relapsing fever, the so-called relapses being, in his opinion, comparable to the returning paroxysms of ague. [325] Cleland. [326] Report signed A. Brebner, provost, printed in Harty, Historic Sketch of the Contagious Fever in Ireland, 1817-19. Dublin, 1820, Appendix, p. 110. [327] Memoir concerning the Typhus Fever in Aberdeen, 1818-19. By George Kerr, Aberdeen, 1820. [328] William Gourlay, “History of the Epidemic Fever as it appeared in a Country Parish in the North of Scotland.” Edin. Med. and Surg. Journ., July, 1819, p. 329, dated 20 Nov. 1818. [329] Trans. K. and Q. Cal. Phys. Ireland, V. 527. [330] Dub. Q. J. Med. Sc. VIII. 297. [331] A succession of thirty-one cases of relapsing typhoid at Charing Cross Hospital in 1877-78 were made the subject of an able essay by J. Pearson Irvine, M.D., Relapse of Typhoid Fever, London, 1880. [332] Cited in Aberdeen Report, 17 Dec. 1818, in Harty, App. p. 110. [333] Report of Select Committee, u. s. p. 6, and minutes of evidence. [334] Prichard, pp. 74, 88. [335] Christison, Month. J. Med. Sc. X.; Bennett, Princip. and Pract. of Med. 944-5. [336] See above, p. 110-11. [337] A complementary measure, namely, notification of contagious sickness to the authorities, was put in practice at Leeds in 1804 on the opening of the House of Recovery there. The Leeds House of Recovery, with fifty beds, was opened on 1 November, 1804, the epidemic of fever being then about over. One of its officers was an inspector, whose duty was “to detect the first appearance of infection, to cause the removal of the patient to the House of Recovery, and to superintend the fumigating and whitewashing of the apartment from which he is removed. So great is the solicitude of the physicians to promote early removal that rewards are offered to such as shall first give information of an infectious fever in their neighbourhoods.” It was claimed that this had been a great success, Leeds having been for twelve years previous to the epidemic of 1817 nearly exempted from two of the most infectious and fatal diseases, namely, typhus and scarlet fever. (It happened, however, that the whole of England, Scotland and even Ireland were exempted to the same remarkable, and of course gratifying degree.) Whitaker, Loidis and Elmete, 1816, p. 85. [338] A strange epidemic of the early summer of 1824 in a semi-charitable girls’ school at Cowan Bridge, between Leeds and Kendal, which is the subject of a moving chapter in ‘Jane Eyre,’ was inquired into by Mrs Gaskell, the biographer of Charlotte BrontË. Forty girls were attacked with fever. A woman who was sent to nurse the sick, saw when she entered the school-room from twelve to fifteen girls lying about, some resting their heads on the table, others on the ground; all heavy-eyed and flushed, indifferent and weary, with pains in every limb, the atmosphere of the room having a peculiar odour. The symptoms, so far as known, and the circumstances of the school, point more to relapsing fever than to typhus, which is the name given to it by Charlotte BrontË. None died of the fever (it is otherwise in the tale), but one girl died at home of its after-effects. Dr Batty, of Kirby, who was called in, did not consider the type of fever to be alarming or dangerous. The dietary of the school had undoubtedly been most meagre for growing girls, and its discipline severe. The house was old and unsuited for the purposes of a boarding-school. [339] Cowan, Journ. Statist. Soc. III. (1840) p. 271; Glas. Med. Journ. III. 437. [340] Some of these were treated at the extra fever-hospital in Spring Gardens. [341] From the table by Christison, Edin. Med. Journ., Jan. 1858, p. 581. [342] Life of Christison, “Autobiography.” [343] John Burne, M.D., Pract. Treatise on the Typhus or Adynamic Fever. London, 1828. [344] To show the effect of emotion in causing a relapse, he gives an instance, almost the only concrete illustration in all his book: An Irishwoman, Ann McCarthy, aged 26, was admitted to Guy’s Hospital on 20 June, 1827, with “adynamic fever of the second degree,” having been already ill for two weeks: the course of her fever was favourable and she was “soon convalescent.” While still in the ward mending her strength, she lent her bonnet to another female patient to go out with; finding that her kindness had been abused by the woman forgetting to return the bonnet, she became exceedingly angry, relapsed into the fever on the 10th of July, was wildly delirious for several days, and died on the 19th of July. At this time it was the practice at Guy’s to examine the bodies after death; but permission was refused in the case in question, so that Burne was unable to say “whether the bowels were affected.” The case, therefore, may have been one of relapsing enteric fever. A similar ambiguity is discussed by Hughes Bennett in his Principles and Practice of Physic (p. 923), and decided in favour of relapsing fever proper, or relapsing synocha. [345] Sir William Jenner, M.D., Lectures and Essays on Fevers and Diphtheria, 1849 to 1879. London, 1893. [346] Christison, Life, u. s. I. 341. [347] “Cases showing the frequency of the occurrence of Follicular Ulceration in the Mucous Membrane of the Intestine during the progress of Idiopathic Fever, with Dissections, and Observations on its Pathology.” Lond. Med. and Physical Journ., Aug. 1826, p. 97. [348] Ibid. p. 351. [349] Burne, u. s. [350] Richard Bright, M.D., Reports of Medical Cases. Part I., 1827. [351] Life of Sir Robert Christison, I. 144. Also in Trans. Soc. Sc. Assn. 1863, p. 104. [352] Edin. Med. Journ., Jan. 1858, p. 588. Cf. infra, under Dysentery, 1828. [353] Reid, Trans. K. and Q. Coll. of Phys. in Ireland, V.; O’Brien, ibid. [354] Writing in 1839, Dr Stokes, of Dublin, made the following remarkable assertion (Dub. Journ. Med. and Chem. Sc. XV. p. 3, note): “In the epidemic of 1826 and 1827 we observed the follicular ulceration (dothienenteritis of the French) in the greater number of cases.” As the epidemic of 1826-27 was almost wholly one of relapsing fever, the statement is at least puzzling. It was made twelve years after the epidemic, at a time when the discrepancies between British and French observers, as to the occurrence of ulceration of the ileum in continued fever, were much discussed. Dr Lombard, of Geneva, having visited Glasgow, Dublin and other places, and confirmed the fact that the characteristic lesion of enteric fever was at that time only occasional, went on to say that Irish typhus was a species of disease by itself, a morbus miseriae. Whereupon the editor of the ‘Dublin Journal of Medical Science’ (XII. 503, in a review of Cowan’s Glasgow Statistics) gave the following truly Irish reply: “Had Dr Lombard made more inquiries, he would have found that Ireland is not so sunk in misery and debasement but that she can produce occasionally a fever which, in abdominal ulcerations, can compete with the sporadic diseases of her wealthier and more enlightened neighbours.” It may have been in the same patriotic spirit that Stokes declared “the greater number of cases” in the epidemic of 1826 and 1827 to have had follicular ulceration. [355] G. L. Roupell, M.D., Some Account of a Fever prevalent in 1831. Lond. 1837. [356] In addition to what has been said on this point already, for particular epidemics, I shall give a statement for ordinary years by Dr Carrick, of Bristol, in his ‘Medical Topography’ of that city: Trans. Prov. Med. Assocn. II. (1834), p. 176. “Continued fever is common enough, but nine-tenths of the cases are of a simple character, terminating for the most part within seven days, and unaccompanied with anything more serious than slight catarrhal or rheumatic disorder. Typhus gravior is rare—much more so than might be expected.” [357] Charles West, M.D., “Historical Notices designed to illustrate the question whether Typhus ought to be classed among the Exanthematous Fevers.” Edin. Med. and Surg. Journ. 1840, April, p. 279. [358] Alexander Kilgour, M.D., ibid. Oct. 1841, p. 381. [359] Cowan, “Vital Statistics of Glasgow,” Journ. Statist. Soc. III. [360] Cases at Mile-End Fever Hospital. [361] Including 906 male fever-patients at Albion Street temporary hospital. [362] Blackwood’s Magazine, March, 1838, p. 289. [363] In 1819 the Irish in Glasgow had been estimated at 1 in 9·67: in 1831 the Irish part of the population had risen to 1 in 5·69. Dr Cowan, however, said of them: “From ample opportunities of observation, they appear to me to exhibit much less of that squalid misery and habitual addiction to the use of ardent spirits than the Scotch of the same grade.” [364] Robert Cowan, M.D., “Statistics of Fever in Glasgow for 1837.” Lancet, April 10, 1839. [365] James Arrott, M.D., Edin. Med. and Surg. Journ., Jan. 1839, p. 121. [366] Craigie ibid. April, 1837. [367] Christison, Monthly Journ. Med. Sc. X. 1850, p. 262. [368] Kilgour, u. s. [369] Cowan, Journ. Statist. Soc. III. 1841. [370] Arrott, u. s. [371] Craigie, u. s. [372] Edin. Med. and Surg. Journ. July, 1838. [373] Principles and Practice of Physic, 3rd ed. 1848, II. 742, 732. [374] First Report of the Registrar-General, London, 1839. [375] The district registrars had hardly organised their work in the first two or three years of registration. Some gave much more complete returns than others. There was a reluctance to register births, and the marriages were not all registered. But the totals of deaths came out very nearly as the actuaries had expected. [376] The Third Report of the Registrar-General gives the mortality in all parts of England from typhus in 1839 (as well as from scarlatina) in an elaborate table of the registration districts and sub-districts. [377] W. Budd, M.D., Lancet, 27 Dec. 1856, and 2 July, 1859. Dr Budd, who had been studying in Paris and seeing much typhoid fever, but little or no typhus, in the service of Louis at La PitiÉ hospital, took the whole of these cases for enteric or typhoid, and insisted, in his later life, on the ground of his North Tawton experiences in 1839, that typhoid fever spread by contagion. He published numerous papers on this theme (Lancet, 27 Dec. 1856, another series in the same journal from 2 July to Nov. 1859, Brit. Med. Journ. Nov.-Dec. 1861, and, finally, a volume of reprints with additions, Typhoid Fever, its Nature, Mode of Spreading and Prevention, London, 1873). But he published no clinical cases nor post-mortem notes, to make good his 1839 diagnosis, on which the whole matter turned, contenting himself with an assurance that he knew typhoid well from studying it under Louis (who, at that time, believed that the typhus of armies, gaols, &c. and of the British writers, was the same as the fever which he, and others after him, named typhoid). He also made the following six statements, as if he were making affidavit: (1) that the great majority of the cases had early diarrhoea, (2) that three had profuse intestinal haemorrhage, (3) that more or less of tympanitis was almost universal in the epidemic, (4) that in nearly every case he found the rose-coloured lenticular spots, (5) that one case, which was the only one examined post-mortem, had the characteristic ulceration of the intestine, and (6) that one fatal case had the symptoms of perforation of the gut. This summary manner, asking in effect to be taken on trust, is not usually accepted from innovators, none of the great discoverers having resorted to it. Hitherto, however, no one has thought proper to question Budd’s diagnosis of the epidemic fever in his North Tawton practice, nor even to remark upon his strange error of treating the epidemic of 1838-39 all over Britain as purely one of typhoid (Lancet, 27 Dec. 1856). But everyone knew that typhoid fever did not spread in the way that he described (doubtless correctly for the above cases). After the publication of his book in 1873 an attempt was made by an influential layman in the Times (9 Nov. 1874) to popularize Budd’s fallacies or paradoxes on the contagiousness of typhoid. “How,” it was asked, after a summary of the North Tawton epidemic in 1839, “could a disease whose characters are so severely demonstrable, have ever been imagined to be non-contagious? How could such a doctrine be followed, as it has been, to the destruction of human life?” [378] “For three years past trade had been getting worse and worse, and the price of provisions higher and higher. This disparity between the amount of the earnings of the working classes and the price of their food occasioned, in more cases than could well be imagined, disease and death. Whole families went through a gradual starvation. They only wanted a Dante to record their sufferings. And yet even his words would fall short of the awful truth; they could only present an outline of the tremendous facts of the destitution that surrounded thousands upon thousands in the terrible years 1839, 1840, and 1841. Even philanthropists who had studied the subject were forced to own themselves perplexed in their endeavour to ascertain the real causes of the misery; the whole matter was of so complicated a nature that it became next to impossible to understand it thoroughly.... The most deplorable and enduring evil that arose out of the period of commercial depression to which I refer, was this feeling of alienation between the different classes of society. It is so impossible to describe, or even faintly to picture, the state of distress which prevailed in the town [Manchester] at that time, that I will not attempt it; and yet I think again that surely, in a Christian land, it was not known even so feebly as words could tell it, or the more happy and fortunate would have thronged with their sympathy and their aid. In many instances the sufferers wept first, and then they cursed. Their vindictive feelings exhibited themselves in rabid politics. And when I hear, as I have heard, of the sufferings and privations of the poor, of provision shops, where ha’porths of tea, sugar, butter, and even flour, were sold to accommodate the indigent—of parents sitting in their clothes by the fireside during the whole night for seven weeks together, in order that their only bed and bedding might be reserved for the use of their large family—of others sleeping upon the cold hearthstone for weeks in succession, without adequate means of providing themselves with food or fuel—and this in the depth of winter—of others being compelled to fast for days together, uncheered by any hope of better fortune, living, moreover, or rather starving, in a crowded garret, or damp cellar, and gradually sinking under the pressure of want and despair into a premature grave; and when this has been confirmed by the evidence of their careworn looks, their excited feelings, and their desolate homes—can I wonder that many of them, in such times of misery and destitution, spoke and acted with ferocious precipitation?” Mrs Gaskell, Mary Barton. [379] John Goodsir, “On a Diseased Condition of the Intestinal Glands,” Lond. and Edin. Monthly Journ. of Med. Science, April, 1842. He does not enter on the question “as to whether the subject of the present paper constitutes a distinct species of disease, or be merely a form of the ordinary continued fever”; but he appears to recognize that a certain district may have a form of fever special to it, as Reid had probably told him. [380] John Reid, M.D., “Analysis and Details of Forty-seven Inspections after Death,” Edin. Med. and Surg. Journ., Oct. 1839, p. 456. [381] Reid, u. s., from Home’s records. [382] Murchison, Continued Fevers, 2nd ed. 1873, p. 444. [383] Lombard, in Dublin Journal of Med. Sc. X. (1836), p. 17. He bore witness, also, to the rarity of the bowel-lesion in the Glasgow fevers. This was confirmed by Dr Perry, of that city, Ibid. X. 381. See also Julius Staberoh, M.D., “Researches on the Occurrence of Typhus in the Manufacturing Cities of Great Britain,” Ibid. XIII. 426. [384] Trans. Prov. Med. Assoc. II. (1834), p. 176. [385] Continued Fevers, 2nd ed. 1873, p. 443. [386] Christison, “On the Changes which have taken place in the Constitution of Fevers and Inflammations in Edinburgh during the last forty years.” Paper read at Med. Chir. Soc. Edin. 4 March, 1857. Edin. Med. Journ. Jan. 1858, p. 577. [387] Continued Fevers, under the head of “Typhus,” p. 47. [388] See especially John Rose Cormack, M.D., Natural History, Pathology and Treatment of the Epidemic Fever at present prevailing in Edinburgh and other towns. Lond. 1843; and the papers by Wardell, Lond. Med. Gaz. N. S. II-V. [389] Dr Betty, of Lowtherstown, Fermanagh, Dubl. Quart. Journ. Med. Sc. VII. 125. [390] Murchison says that the enteric fever of the end of 1846 was prevalent at many places in England where the epidemic of typhus never made its appearance, and that in Edinburgh (according to an unpublished essay by Waters) most of the enteric cases not only occurred prior to the outbreak of the epidemic of Irish fever, but came from localities in the neighbouring country and from the best houses of the New Town—not from the crowded courts of the Old Town, to which the later epidemic of typhus and relapsing fever was restricted. Murchison, u. s. p. 49. The following papers relate to the autumnal typhoid of 1846 in England: Sibson, “Fever at Nottingham and neighbourhood in Summer and Autumn of 1846,” Med. Gaz. XXXIX.; Taylor, “Fever at Old and New Lenton in 1846,” Med. Times, XV. 159 and Med. Gaz. XXXVIII. 127; Turner, “Fever at Minchinhampton in Autumn 1846,” Med. Gaz. XLII. 157; Brenchley, “Fever in Berkshire in 1846,” Med. Gaz. XXXVIII. 1082; Bree, “Epidemic Fever at Great Finborough in Autumn of 1846,” Prov. Med. and Surg. Journ. 1847, p. 676. [391] In the Report of the Registrar-General for the year 1847. [392] This was the occasion which furnished Father Newman with a famous argument for the bona fides of his co-religionists: “The Irish fever cut off between Liverpool and Leeds thirty priests and more young men in the flower of their days, old men who seemed entitled to some quiet time after their long toil. There was a bishop cut off in the North; but what had a man of his ecclesiastical rank to do with the drudgery and danger of sick calls, except that Christian faith and charity constrained him?” John Henry Newman, D.D., History of My Religious Opinions, London, 1865, p. 272. [393] Leigh, in Report Reg.-Gen. for 1847, X. p. xx. [394] H. M. Hughes, “On the Continued Fever at present existing in the southern districts of the metropolis,” Lond. Med. Gaz. Nov. 1847; Laycock, “Unusual prevalence of Fever at York,” Lond. Med. Gaz. Nov. 1847; Bottomley, “Notes on the Famine Fever at Croydon in 1847,” Prov. Med. and Surg. Journ. 1847; Ormerod, Clinical Observations on Continued Fever at Bartholomew’s Hospital, Lond. 1848; Art. in Brit. and For. Med. Chir. Rev. 1848, I. 285; Duncan, Journ. Pub. Health, I. 200 (Liverpool); Paxton, Prov. Med. Journ. 1847, pp. 533, 596 (Rugby). [395] The following papers relate to the epidemic in Scotland in 1847: Orr, “Historical and Statistical Sketch of the progress of Epidemic Fever in Glasgow during 1847,” Edin. Med. and Surg. Journ. LXIX.; Stark, “On the Mortality of Edinburgh and Leith for 1847,” Ibid. and LXXI.; R. Paterson, “Account of the Epidemic Fever of 1847-8” in Edinburgh, Ibid. LXX.; W. Robertson, “Notes on the Epidemic Fever of 1847-8,” Month. Journ. of Med. Sc. IX. 368; J. C. Steele, “View of the Sickness and Mortality in the Glasgow Royal Infirmary during 1847,” Edin. Med. and Surg. Journ. LXX.; J. C. Steele, “Statistics of the Glasgow Infirmary for 1848,” Ibid. LXXII. 241; J. Paterson, “Statistics of the Barony Parish Fever Hospital of Glasgow in 1847-8,” Ibid. LXX. 357. [396] Buchanan, Report Med. Officer Privy Council for 1864, and Trans. Epid. Soc. 1865, II. 17; Hamilton, Lancet, II. 1867, p. 608 (Liverpool); Martyn, Brit. Med. Journ. July, 1863; Davies, Med. Times and Gaz. II. 1867, p. 427 (Bristol); Thompson, St George’s Hosp. Reports, I. (1866), p. 47 (London); Allbutt, ibid. p. 61 (Leeds). [397] Buchanan, Report Med. Off. Privy Council for 1865, p. 210. [398] James Stark, M.D., “Remarks on the Epidemic Fever of Scotland during 1863-64-65” etc., Trans. Epidem. Soc. N. S. II. 312. See also Russell, Glasg. Med. Journ. July, 1864, and R. Beveridge (for Aberdeen), Lancet, I. 1868, p. 630. [399] Weber, Lancet, I. 1869, pp. 221, 255; Murchison, ibid. II. 1869, pp. 503, 647; Gee (Liverpool), Brit. Med. Journ. II. 1870, p. 246; Robinson (Leeds), Lancet, I. 1871, p. 644; Muirhead (Edinburgh), Edin. Med. Journ. July, 1870, p. 1; Rabagliati (Bradford), ibid. Dec. 1873; Tennant (Glasgow), Glasgow Med. Journ. May, 1871, p. 354; Armstrong (Newcastle), Lancet, I. 1873, p. 48. [400] Muirhead (l. c.) says: “In no single instance which came under my observation could starvation be said to be the immediate cause of the disease. Not one of those individuals could be said to be emaciated.... On strict and repeated inquiry, not one of them would confess to having been in destitute circumstances.” During the winter of 1870-71 I attended from the Edinburgh New Dispensary several relapsing-fever patients at their homes, and can clearly remember having been surprised at the condition of decency and comfort in which I found them. The appearance of comfort was certainly due in part to the district visitors, who were numerous and active during the epidemic. [401] Spear, “Typhus Fever in various parts of England, 1886-87.” Rep. Med. Off. Loc. Gov. Bd. N. S. XVI. p. 169. [402] 2303 of these fever deaths in 1864 occurred in the eight principal towns of Scotland, classified as follows: typhus, 1450, relapsing fever, 371, gastric, enteric, or typhoid, 382. [403] G. B. Longstaff, M.D., Trans. Epid. Soc. 1884-5, p. 72, reprinted in his Studies in Statistics, Lond. 1891, p. 402. The seasonal curve for the typhoid admissions to the London Fever Hospital over a longer period is nearly the same, as well as that of the registered deaths by typhoid in all London, 1869-84. [404] The following large registration districts besides those in the Table, had enteric-fever death rates of ·5 and upwards per 1000 persons living, in the ten years 1871-80; in nearly all of them there has been a marked decline in the ten years 1881-90:—Durham, Hartlepool, Easington, Houghton-le-Spring, Darlington, Gateshead (county Durham); Morpeth (Northumberland); Aysgarth, Todmorden, Dewsbury, Pontefract, Barnsley, Rotherham (Yorkshire); Dudley, Leigh, Ormskirk (Lancashire); Crickhowell (Wales); Worksop, Radford (Nottingham); Shrewsbury; Peterborough; Portsea Island (Hants). Of the London districts, Hackney had the highest enteric fever, 0·46 per 1000 in a general death-rate of 20·78. The high rate of a decennium is not unfrequently brought up by one great explosion. In many of the Lancashire, Yorkshire and Midland towns, with rates about ·4 per 1000 persons, the rate has been somewhat steady from year to year. In the decennium 1871-80, many special outbreaks, some of them in villages, were reported on by the inspectors of the Medical Department, and traced for the most part to water-supplies tainted by the percolation of excrement. [405] The Registration District of Middlesborough was carved out of Stockton and Guisborough in 1875. [406] Registration District containing a population of 72,707 on a mean between the census of 1871 and that of 1881. In 1891 the population was 146,812. [407] F. W. Barry, M.D., in Rep. Med. Off. Loc. Gov. Board for 1882, p. 72. The contention of the inspector was that the water-supply had been tainted by enteric-fever evacuations from a case which began on 22 May in a cottage some half-mile distant from the reservoir but in communication with it through ditches and brooks. The area of the water-supply did not correspond with the area of the fever. [408] The report for the Medical Department by F. W. Barry, M.D. (Enteric Fever in the Tees Valley, 1890-91, Parl. papers, Nov. 1893), is an elaborate argument to prove that the flooded state of the Tees was indeed the relevant antecedent, not as indexing the rise of the ground-water in the respective towns, but as dislodging and sweeping down the slops, sewage and dry refuse of the market town of Barnard Castle, in upper Teesdale, whereby the water taken in from the Tees two miles above Darlington to the tanks, filters and reservoirs of the Darlington Corporation, and of the Stockton and Middlesborough Water Board, was tainted in some unusual degree—a hypothesis the more remarkable that the refuse, such as it was, had been suspended or dissolved in an unusual volume of water, that little refuse could have collected between the first floods and the second, and that no cases of enteric fever were known in the upper valley of the Tees. This judicial deliverance has not been accepted by the authorities of Darlington, Stockton and Middlesborough, nor by the Royal Commission on Water Supply, before whom it was laid. [409] Besides the epidemic at Worthing in 1893, which is still sub judice, the best known instance of typhoid following a certain water-supply is the explosion at Redhill and Caterham in Jan.-Feb. 1879, Rep. Med. Off. Loc. Gov. Board, for 1879, Parl. papers, 1880, p. 78. The first instance alleged of the distribution by milk was the Islington explosion in July-August 1870 (Ballard, Med. Times and Gaz. 1870, II. 611). It was soon followed by the Marylebone explosion in the summer of 1873 (Rep. Med. Off. L. G. B., N. S. II. 193); but such instances have become less common, while instances of scarlatina and diphtheria following a milk-supply have become more common. [410] Second Letter to Sir Hercules Langrishe, May, 1795. [411] Berkeley’s Querist, Q. 362. [412] Radulphus de Diceto, Imag. Histor. Eng. Hist. Soc. ed. I. 350. [413] “Topogr. Hiberniae” in Opera, Rolls ed. V. 67. This and the preceding reference had escaped the notice of Dr John O’Brien, in the historical introduction to his Observations on the Acute and Chronic Dysentery of Ireland. Dublin, 1822. [414] Polychronicon, Rolls ed. I. 332-3. [415] “Many of the English-Irish have by little and little been infected with the Irish filthinesse, and that in the very cities, excepting Dublin and some of the better sort in Waterford, where the English continually lodging in their houses, they more retain the English diet.” And again: “In like sort the degenerated citizens are somewhat infected with the Irish filthinesse, as well in lowsie beds, foule sheetes, and all linnen, as in many other particulars.... Touching the meere or wild Irish, it may truely be said of them, which was of old spoken of the Germans, namely, that they wander slovenly and naked, and lodge in the same house (if it may be called a house) with their beasts.” Fynes Moryson, Itinerary, Pt. IV. p. 180. [416] Ireland’s Natural History, &c. Written by Gerard Boate, late Doctor of Physick to the State in Ireland. And now published by Samuel Hartlib, Esquire. Lond. 1652. The author died at Dublin, shortly after his arrival there, on 9/19 January 1650/49. His information would seem to have come in part from his brother Arnold Boate, resident in Ireland. [417] Hardiman, History of Galway, p. 126 seq. The plague from July 1649 to Lady Day 1650 is said to have swept away 3700 of the inhabitants, including 210 of the most respectable burgesses and freemen, with their families. The capitulation on 5 April, 1652, was followed by famine throughout the country, and by a revival of plague for two years, “during which upwards of one-third of the population of the province was swept away.” [418] Cromwell’s Letters and Speeches, II. 55, 77. [419] Edmund Borlase, History of the Reduction of Ireland to the Crown of England. 1675, p. 172. [420] Boyle’s Works, fol. Lond. 1744, V. 92. [421] The war-pestilence at Londonderry in 1689 is the third recorded epidemic of the kind there, not including what may have happened in the capture of the town by the Catholics in O’Neill’s rebellion, when Derry was destroyed, to be rebuilt in 1613 by the London Companies with a new charter under the name of Londonderry. The first historical occasion of sickness was in 1566. The troops of Elizabeth were landed on Loch Foyle in October and built their huts on the site of the old monastery. In the course of the winter the greater part of a force of 1100 men perished by dysentery and the infection which it breeds (see former volume, p. 372). On 12 Dec. 1642, a year after the outbreak of the Rebellion of Confederate Catholics, a petition of the agents of the distressed city of Londonderry to the Commons represented that there were 6059 persons in the city, whereof 5123 were women and children, or sick, aged or impotent; only 2000 were inhabitants of the city, the rest having fled there for safety. Spotted fever had broken out. (Hist. MSS. Comis. V. “MSS. of the House of Lords.”) [422] With the exception of the last quoted piece of information, the most minute particulars of the siege of Londonderry are in an essay by an army chaplain, John Mackenzie, A Narrative of the Siege of Londonderry, London, 1690, which was written to correct and augment A True Account of the Siege of Londonderry by the Rev. Mr George Walker, rector of Donoghmoore in the county of Tyrone, and late Governor of Derry. London, 1689. [423] See former volume, pp. 634-43. [424] Minute particulars of it are given in An Impartial History of the Wars in Ireland [1689-1692]. By George Story, Chaplain to Sir Thomas Gower’s Regiment. London, 1693. Part I. [425] Gangrene of the extremities was one of the symptoms of the “plague of Athens” as described by Thucydides. There is no need to invoke ergotism for an explanation of it, as some have done. [426] At that time there was little systematic knowledge of military hygiene. Nearly two generations after, the experiences of Pringle, Donald Monro and Brocklesby in the campaigns of 1743-48 and 1758-63 in Germany and the Netherlands, yielded many valuable hints, some of which Virchow made use of in compiling his “Rules of Health for the Army in the Field,” in the Franco-Prussian War of 1870-71. See his Gesammelte Abhandlungen aus dem Gebiete der Öffentlichen Medicin und Seuchenlehre. [428] Joseph Rogers, M.D. Essay on Epidemic Diseases. Dublin, 1734. [429] In further illustration of the power of morbid effluvia, he says: “We see how small a portion of a putrid animal juice, taken into the blood by inoculation, like a most active leaven sets all in a ferment; and in a very short time brings the whole juices of a sound body into an equal state of corruption with itself,”—instancing war-typhus, plague from cadaveric corruption (according to ParÉ), the Oxford gaol fever, and “a later instance at Taunton not more than five or six years ago.” [430] Dr Rogan of Strabane, in his Condition of the Middle and Lower Classes in the North of Ireland, 1819, was of a different opinion (p. 90): “No police regulations exist in Strabane to prevent the slaughtering of cattle in any part of the town. The butchers, therefore, most of whom live in the narrow streets near the shambles, have their slaughter-houses immediately behind their dwellings. The garbage is thrown into a large pit, which is generally cleaned but once in the year, at the season when the manure is required for planting potatoes, and at this time an offensive smell pervades the whole town, and is perceptible for a considerable distance around. The families exposed constantly to the effluvia arising from these heaps of putrid offal might have been expected to suffer severely from fever; but on the contrary, they were found to be much less liable to it than others in the same rank of life. This was no doubt owing to their living chiefly on animal food, and thus escaping the debility induced by deficient nourishment, which certainly had the chief share in creating a predisposition to the disease.” [431] Bp. Nicholson to Archbp. of Canterbury, cited by Lecky (II. 216) from Brit. Mus. Add. MS. 6116. [432] Cited by O’Rourke, History of the Great Irish Famine of 1847. Dublin, 1875, from pamphlet in the Halliday Collection of the Royal Irish Academy. [433] See Boulter’s Letters to the English Ministers. [434] Wakefield’s Ireland, II. 6, cited by Barker and Cheyne. [435] John Rutty, M.D. Chronological History of the Weather and Seasons and prevailing Diseases in Dublin during Forty Years. London, 1770. [436] Maurice O’Connell, M.D. Morborum acutorum et chronicorum Observationes. Dublin, 1746. [437] Boulter’s Letters. Oxford, 1769, I. 226. [438] Lecky, II. 217. [439] Berkeley’s Works. Ed. Fraser, Oxford, 1871, III. 369. [440] Lord John Russell used these historical parallels from England and Scotland in his great speech in the House of Commons, during the debate on Ireland, 25th January, 1847. [441] Fraser, “Life and Letters of Berkeley,” in Works, IV. 262. [442] Berkeley to Prior, Feb. 8 and 15, 1740/1. [443] He published the receipt in a Dublin journal. [444] Berkeley to Thomas Prior, in “Life and Letters,” u. s., p. 265. Some attempts at relief-works had been made the year before, two of which are still to be seen in the obelisks on Killiney Hill near Dublin and on a hill near Maynooth (“Lady Conolly’s Folly.” O’Rourke, u. s.). [445] Rutty, p. 93. [446] (Dublin, 1741). [447] Cited by O’Rourke. Short, a contemporary, also says that the fever in Galway was like a plague. [448] Dutton, Statistical Survey of the County of Galway. Dublin, 1824, p. 313: “1741. A fever raged this year that occasioned the judges to hold the assizes in Tuam. Numbers of the merchants of Galway died this year, and multitudes of poor people, caused partly by fever and by the scarcity, as wheat was 28s. per cwt.” [449] The author of The Groans of Ireland (Dublin, 1741) says: “On my return to this country I found it the most miserable scene of distress that I ever read of in history: want and misery in every face; the rich unable to relieve the poor; the road spread with dead and dying bodies; mankind of the colour of the docks and nettles which they fed on; two or three, sometimes more, on a car going to the grave for want of bearers to carry them, and many buried only in the fields and ditches where they perished.” Skelton, a Protestant clergyman, says: “Whole parishes in some places were almost desolate; the dead have been eaten in the fields by dogs, for want of people to bury them.” Skelton’s Works, Vol. V. Cited by Lecky. [450] Report by Dr Phipps to Baron Wainwright, 10 March, 1741. Cited by F. C. Webb, Trans. Epidem. Soc. 1857, p. 67. [451] Smith’s Kerry, p. 77. He adds that many were excused the hearth-tax on account of their poverty, by certificate of the magistrates; so that the decrease in 1744 may mean a greater proportion excused the tax, as well as a depopulation. [452] How near the verge of want the people were is brought out by an experience in Galway county in 1745: a great fall of snow smothered vast numbers of cattle and sheep, which caused a great many farmers to surrender their lands. Wheat rose from six to eighteen shillings the hundredweight, while, after the distress, the best land in Connaught could be rented for five shillings an acre. Dutton’s Galway, p. 313. [453] For Kinsale, Cork and Bandon, see Marjoribanks, Med. Press and Circ. 1867, II., 8. [454] James Sims, M.D. Observations on Epidemic Disorders, with Remarks on Nervous and Malignant Fevers. London, 1773, p. 10. The preface is dated from London, whither Sims had removed from Tyrone. He rose to eminence in the London profession. [455] A Letter to a Member of the Irish Parliament relative to the present State of Ireland. By Philo-Irene. London, 20 May, 1755. The turning of hundreds of acres into one dairy-farm had caused the depopulation which Goldsmith described in the Deserted Village: “By this unhappy policy several villages have been deserted at different times by the inhabitants, and numbers of them set a-begging,” p. 6. [456] Sims, u. s. pp. 164-5. [457] F. Barker and J. Cheyne, Account of the Fever lately epidemical in Ireland, 2 vols. London, 1821. This work relates mainly to the epidemic of 1817-19, but there is a short retrospect, the valuable part of which is for the years 1797-1802. [458] The history of the Limerick and Belfast fever-hospitals is carried back to a few years before the founding of the Waterford hospital; but the latter was the first that was formally organised as a fever-hospital. [459] “The fever in 1800 and 1801 very generally terminated on the fifth or seventh day by perspiration; the disease was then very liable to recur. The poor were the chief sufferers by it; and it was much more fatal amongst the middling and upper classes in proportion to the number attacked.” Barker and Cheyne, op. cit. p. 20. [460] Smith’s Kerry. Dublin, 1756, p. 77. [461] Smith’s Kerry, p. 88. [462] A Tour in Ireland ... in 1776-78. London, 1780. [463] The forty-shillings freeholder of Ireland was a life-renter whose farm was worth forty shillings annual rent more than the rent reserved in his lease. [464] Malthus, Essay on the Principle of Population. Bk. II. chap. 10, Bk. III. chap. 8, and Bk. IV. chap. 11. [465] Francis Rogan, M.D., Observations on the Condition of the Middle and Lower Classes in the North of Ireland, as it tends to promote the diffusion of Contagious Fever; with the History and Treatment of the late Epidemic Disorders. London, 1819. [466] William Carleton, the vates sacer of the Irish peasantry, was born, in 1798, in one of those Tyrone thatched cottages, in the parish of Clogher. His father had changed his holding three times before William, the youngest child, was fourteen years old; the last of the four was a farm of sixteen or eighteen acres in the north of Clogher parish, and “nearer the mountains.” Carleton says that he “lived among the people as one of themselves” until he was twenty-two, which would have been until the year 1820; so that he probably saw the famine and fever of 1817-18 among that very Tyrone peasantry whom Dr Rogan brings before us from the medical side. The scenes of famine and fever in the ‘Black Prophet’ are those “which he himself witnessed in 1817, 1822, and other subsequent years,” having been recalled by him in the form of a tale which was published in 1846, at the beginning of the Great Famine of that and the following year. His early recollections of famine and fever come into other tales, such as the ‘Clarionet,’ the ‘Poor Scholar’ and ‘Tubber Derg,’ in which last is related the almost inevitable reduction to poverty and at length to beggary of a most upright and industrious farmer owing to the fall of prices, without fall of rents, after the Peace of 1815. Carleton’s work has always the quality of fidelity, and he may be credited when he says that the scenes of famine and fever are not exaggerated. [467] Rogan, u. s. p. 95: “A farmer within my knowledge, who holds fifteen acres of arable land, with nearly an equal quantity of cut-out bog, for which he pays £28 per annum, has erected six cabins for labourers. They are built with mud, instead of lime, and are thatched, so that they cannot each have cost more than three or four pounds. For some time he received from three of his tenants six guineas per annum, and from the others two guineas each, the latter only holding a cottage and a small garden [the former three having also grazing for a milch cow, half a rood of land for flax, and half an acre for oats, with privileges of cutting turf and planting as many potatoes as they could each provide manure for]; but they have been all so reduced in circumstances by the late scarcity as to be now unable to keep a cow, and for the two last years have rented their cabins and potato gardens alone. All the straw raised on the farm would scarcely suffice to keep the houses water-fast if applied solely to this purpose.” One of the first things that the Marquis of Abercorn did in the epidemic of 1817 was to call upon the subletting farmers on his manors to repair the roofs of their cottiers’ cabins. [468] Carleton, in one of his tales, has given a vivid picture of the lurid or gloomy appearance of the country in the late autumn of 1816, as if it foreboded the distress of the following spring. [469] Probably their cattle had been impounded for rent and tithe. The author of the pamphlet Lachrymae Hiberniae (Dublin, 1822), a resident on the western coast, says (p. 8), with reference to the seizures for rent and tithe: “Oh what scenes of misery were exhibited in Ireland in this way during the years 1817, ’18 and ’19; by that time the people were left without cattle; after this their potatoes and corn were seized and sold, and in some cases their household furniture, even to their blankets.” The hardness of landlords in general is alleged by Dr Rogan, with an exception in favour of the Marquis of Abercorn in his own district. [470] There was dysentery also in the autumn of 1818. Cheyne, Dubl. Hosp. Rep. III. 1. [471] Rogan, p. 31. [472] The following is an instance, from Boyle, in Roscommon: “In the middle of June, 1817, or a little earlier, a soup-shop was established here by subscription, where soup was daily given out to one thousand persons, who, naturally anxious to procure it in time, crowded together during its distribution, though every pains was taken to keep order amongst them. From the 16th to the 23rd of that month the weather became suddenly and unusually hot, and the disease about that period spread rapidly among those persons, the greater number of whom attributed the origin of their complaint to attendance at the soup-shop; among that crowd, many of whom I have seen faint from absolute want during exposure to the sun, there were persons from houses where the disease existed.” Report by Dr Verdon of Boyle, 26 June, 1818, in Barker and Cheyne, I. 325. [473] Dr King of Tralee (Barker and Cheyne, I. p. 177) wrote as follows: “It is a custom in this country for very poor persons, living in the country parts, and possessing a miserable hovel with a small garden, after they have sowed their potatoes, to shut up their hut and carrying their families with them, to roam about the country, trusting to the known hospitality of the towns and villages for shelter and subsistence till the time for digging the potatoes shall have arrived.” [474] Barker and Cheyne, I. 60. [475] In Carleton’s tale of ‘The Poor Scholar,’ it is related how the hay-mowers stopped in their work to erect a hut for the fever-stricken youth, and a much larger hut not far from the first for the numerous persons who ministered to his wants under a kind of quarantine arrangement. The stealing of milk from rich men’s cows for the sick youth is the subject of a dialogue between the Roman Catholic bishop and the leader of the kindly party of mowers, in which the latter shows a skill in casuistry creditable to his religious instructors. [476] William Harty, M.D., Historic Sketch of the Contagious Fever Epidemic in Ireland during 1817-19. Dublin, 1820. This work contains information collected by a circular of queries addressed to practitioners in the several provinces. It was undertaken by Dr Harty at the instance of Sir John Newport, M.P. for Waterford. The work by Barker and Cheyne on the same epidemic took longer to prepare, having been published in 1821. See also Cheyne, Dubl. Hosp. Rep. II. 1-147. [477] Barker and Cheyne, p. 65. A similar incident comes into Carleton’s tale of ‘The Clarionet’: “At length, out of compassion, the few neighbours who feared not to attend a feverish death-bed, acting on the popular belief that children under a certain age are not liable to catch a fever, placed the boy in her arms.” This popular belief was well founded. [478] Accounts from various places in Barker and Cheyne, and in Harty. Rogan (u. s. p. 45) says: “The cases of typhus gravior were infinitely more numerous among the rich and well-fed than among the poor; and with them also the head was most frequently the seat of diseased action.” [479] Report on the Present State of the Distressed District in the South of Ireland: with an Enquiry into the Causes of the Distresses of the Peasantry and Farmers. Dublin, 1822. [480] Lachrymae Hiberniae, or the Grievances of the Peasantry of Ireland, especially in the Western Counties. By a Resident Native. Dublin, 1822 (September). The author, a resident of the west coast, was concerned in the distribution of relief, and positively asserts the saving of thousands “from his own personal knowledge.” [481] Robert James Graves, M.D., “Report on the Fever lately prevalent in Galway and the West of Ireland.” Trans. K. and Q. Col. Phys. IV. (1824), p. 408. [482] John O’Brien, M.D., “On the Epidemic Dysentery which prevailed in Dublin in the year 1825.” Trans. K. and Q. Col. Phys. V. (1828) p. 221; Burke, Ed. Med. Surg. Journ. July, 1826, p. 56; Speer, Med. Phys. Journ. N. S. VI. 199. [483] John O’Brien, “Med. Rep. of the H. of Recovery, Cork Street, Dublin, for the year ending 4 Jan. 1827.” Trans. K. and Q. Col. Phys. V. 512. [484] Graves, Clinical Medicine, 1843. Lect. XVIII. [485] O’Brien, u. s. [486] “Remarks on the Epidemic Dysentery of the Autumn of 1826 in the South of Ireland.” By Alexander McCarthy, M.D. Edin. Med. and Surg. Journ. April, 1827, p. 289. [487] “It is a melancholy picture of society to witness the increase of wealth and luxury on one side, and the greatest want and wretchedness on the other; to meet famine and exhaustion in the great body of the people, in a country that produces as much food as would afford a full supply for once and a half its present population; to see the granaries full of corn and flour, and the great body of the people scarcely existing on a half supply of bad potatoes. Such is the miserable situation of the Irish, a race of people distinguished for their intellect, and above all for their resignation and patience under afflictions the most trying.” [488] Dub. Quart. Journ. Med. Sc. XI. 385. [489] W. J. Geary, M.D., “Report of the St John’s Fever and Lock Hospitals.” Dub. Quart. Journ. Med. Sc. XI. 378: XII. 94. [490] Various descriptions of these exist, of which that by Carleton in the tale ‘Barney Branagan,’ is probably not overdone. [491] The Report of the Roscrea Fever Hospital for 1827 says: “In March, when the dung is being removed from the back yards for the purpose of planting the potatoes, the number of patients becomes double in the Fever Hospital.” Dublin Medical Press, Jan. 1846, p. 235. [492] Babington, “Epidemic Typhous Fever in Donoughmore.” Dub. Quart. Journ. X. 404. [493] G. A. Kennedy, “Report of Cork St. Fever Hosp. 1837-38.” Ibid. XIII. 311. Graves, Ibid. XIV. 363. [494] Lynch, Ibid. N. S. VII. 388, gives some particulars of it also at Loughrea, Galway, in 1840. [495] System of Clinical Medicine. Dublin, 1843, p. 57. The “change of type,” with special reference to treatment, is discussed more fully in Lecture XXXIV. pp. 492-500. See also Dub. Quart. Journ. Med. Sc. XIV. 502, where a letter on the changed character of fever at Sligo is cited. [496] The Census of Ireland, 1841, Parl. Papers, 1843. “Report on the Table of Deaths,” by W. R. Wilde. The deaths in the family, with their causes, &c., in each of the previous ten years were entered on the census paper by the head of the family, or by the parish priest for him. These returns were, of course, far from exhaustive or correct. [497] Graves, Clinical Medicine, 1843, p. 46. Remarking on the much greater frequency of fever in Ireland than in England, he says (p. 47): “Nothing can be more remarkable than the facility with which a simple cold (which in England would be perfectly devoid of danger), runs into maculated fever in Ireland, and that, too, under circumstances quite free from even the suspicion of contagion—in truth, except when fever is epidemic, catching cold is its most usual cause.” [498] The principal work on the general circumstances of the Irish famine of 1846-47 is The History of the Great Irish Famine of 1847, with notices of Earlier Irish Famines. By Rev. John O’Rourke, P.P., M.R.I.A. Dublin, 1875. [499] Joseph Lalor, M.D., Dub. Quart. Journ. Med. Sc. N. S. III. 38. [500] Cited by O’Rourke, p. 152. [501] The Census of Ireland, 1851. Part V. Table of deaths, vol. I. Dublin, 1856, p. 235. The following are a few instances of depopulation between 1841 and 1851.
[502] Essay on the Principle of Population. Bk. IV. chap. XI. Thorold Rogers has in many passages emphasized the advantages of the English practice from medieval times of living on the dearest kind of corn; but he seems to have overlooked the priority of Malthus throughout the whole of the eleventh chapter of his fourth book. In Six Centuries of Work and Wages (p. 62), Rogers says: “Hence a high standard of subsistence is a more important factor in the theory of population than any of those checks which Malthus has enumerated.” [503] Cited in Thomas Doubleday’s Political Life of Sir Robert Peel. London, 1856, II. 398 note. [504] It is a doctrine of economics that the higher standard of living checks population. Thus Marshall says of England: “The growth of population was checked by that rise in the standard of comfort which took effect in the general adoption of wheat as the staple food of Englishmen during the first half of the 18th century.” Economics, p. 230. [505] Vol. VII. (1849) pp. 64-126, 340-404, and Vol. VIII. pp. 1-86, 270-339 of the Dublin Quart. Journ. of Medical Science, N. S. contain numerous reports collected by the editors from all parts of Ireland, and published either in abstract or in full. These are the chief medical sources. Some particulars are given also in the Dublin Med. Press, 1846 to 1849 in several papers on dysentery. [506] John Popham, M.D., Dub. Quart. Journ. Med. Sc. N. S. VIII. 279. [507] Cited by Dr Jones Lamprey, Dub. Quart. Journ. VII. 101. [508] Lamprey, Dub. Quart. Journ. VII. 101. [509] O’Rourke. [510] Ormsbey, Dub. Quart. Journ. VII. 382. [511] Pemberton, ibid. VII. 369. [512] Lalor, u. s. [513] This epidemic called forth two pamphlets on the relation of famine to fever, one by Dominic Corrigan, M.D., On Famine and Fever as Cause and Effect in Ireland (“no famine, no fever”), and a reply to it by H. Kennedy, M.D., On the Connexion of Famine and Fever. [514] Pains resembling those of rheumatism were common in the fever of 1817-18 at Limerick. Barker and Cheyne, I. 432. [515] Lamprey, u. s. [516] Dr Kelly of Mullingar compared the smell of relapsing fever to that of burning musty straw. Dub. Quart. Journ. Med., Aug. 1863, p. 341. [517] Cusack and Stokes, ibid. IV. 134. [518] Barker and Cheyne, Harty, and Rogan have been cited to this effect for earlier epidemics. Graves (Clin. Med. pp. 59-60) says: “In the epidemics of 1816, 1817, 1818 and 1819, it was found by accurate computation that the rate of mortality was much higher among the rich than among the poor. This was a startling fact, and a thousand different explanations of it were given at the time.” He cites Fletcher (Pathology, p. 27) an Edinburgh observer, as follows: “The rich are less frequently affected with epidemic fevers than the poor, but more frequently die of them. Good fare keeps off diseases, but increases their mortality when they take place.” [519] Dub. Quart. Journ. Med. Sc. N. S. VII. 388. [520] Census of Ireland, 1851. [521] The Census of Ireland of 1851. Part V. Table of Deaths. 2 vols. Dublin, 1856. Upwards of two hundred pages are occupied with a chronological “Table of Cosmical Phenomena, Epizootics, Epiphitics, Famines and Pestilences in Ireland” from the earliest times. This retrospect, which is very replete but tedious and uncritical, is followed by a summary report of twenty pages on “The Last General Potato Failure, and the Great Famine and Pestilence of 1845-50,” and by a long series of tabulated extracts from contemporary writings on all matters relating to the famine. [522] Of this total, 18,430 deaths were from dysentery and 7,264 from diarrhoea. [523] The increase in 1849 was doubtless owing to choleraic diarrhoea during the epidemic of Asiatic cholera, the deaths from dysentery being one-half of the total. [524] R. Mayne, M.D., “Observations on the late Epidemic Dysentery in Dublin.” Dub. Quart. Journ. Med. Sc. VII. 294. See also papers in Dubl. Med. Press, 1849. [525] 17th and 26th Reports of the Regr.-Genl. Ireland. [526] Review of Murchison in Dub. Quart. Journ. Med. Sc., Aug. and Nov. 1863, pp. 169 and 339: “We are able, from extensive opportunities of observing the epidemic [of 1846-48] in Dublin, to verify the statement of Dr H. Kennedy as to the infrequency of enteric fever.” [527] Dub. Quart. Journ. Med. Sc. Nov. 1865, p. 285. [528] See p. 273, supra. [529] O’Connor, u. s. p. 286, “Typhoid has scarcely appeared in this locality, which cannot boast of the excellence of its sewerage.” [530] “On Atmospheric Conditions influencing the Prevalence of Typhus Fever.” Dub. Quart. Journ. Med. Sc., May, 1866, p. 309. [531] H. Kennedy, M.D., “Further Observations on Typhus and Typhoid Fevers as seen in Dublin.” Ibid., Aug. 1862, p. 50. [532] Nearly one-half of all the enteric fever deaths in Ulster and Leinster come respectively from Belfast and Dublin:
[533] Higden’s Polychronicon. Rolls Series, I. 332. [534] Dyall of Agues. London, [1564]. [535] Essay on Epidemic Diseases. Dublin, 1734. [536] Dissert. Epistol. § 93. Greenhill’s ed. p. 378. [537] One regrets to find the above mistake in the learned pages of Murchison (p. 8). The following by Dr Robert Williams (Morbid Poisons, II. 423) is absolutely erroneous: “In Sydenham’s time, intermittent fever and dysentery were constantly endemic in London; and the mortality from the former cause alone averaged, in a comparatively small population, from one to two thousand persons annually.” What Sydenham says is that dysentery was endemic in Ireland (on the authority of Boate, no doubt), that it was epidemic in London in the end of 1669 and in the three years following, and that for the space of ten years it had appeared quite sparingly (quae per decennium jam parcius comparuerat). As to intermittents, he says they were absent from London for thirteen years, from 1664 to 1677, except in sporadic or imported cases. In the London bills the deaths from “agues” are sometimes distinguished from “fevers,” and are then seen to be only some dozen or twenty in two thousand. [538] It is used in the Latin title of an Edinburgh graduation thesis, “De Catarrho epidemio, vel Influenza, prout in India occidentali sese ostendit,” by J. Huggar, which is assigned in HÄser’s bibliography to the year 1703. Having been unable to find the thesis, I have not verified the date. [539] Annales Monastici (St Albans), Rolls Series, No. 191, under the year 1427; Hist. MSS. Commiss. IX. pt. 1, p. 127, records of Canterbury Abbey.—An epidemic in Ireland a century before, in 1328, has been given by Sir W. R. Wilde, and by Dr Grimshaw following him, under the name of “murre,” as if that had been its name at the time. The explanation seems to be that the contemporary Irish name slaedan was rendered by Macgeoghegan, in his translation of the Annals of Clonmacnoise, by the 15th century English term “murre.” The “mure” of 1427 was a universal influenza; but the word was afterwards used for a common cold, along with poss, as in Gardiner’s Triall of Tabacco, 1610, fol. 12 and 15: “stuffings in the head, murres and pose, coughs”; and “the poze, murre, horsenesse, cough” etc. [540] Cal. Cecil. MSS. I. under the dates. [541] Munk, Roll of the College of Physicians, I. 32. [542] Cited in Southey’s Commonplace Book, from Fuller’s Pisgah Sight, p. 54. [543] Southey, Commonplace Book, from Strype’s Memorials of Cranmer, p. 284. [544] Thoresby, Ducatus Leodiensis, ed. Whitaker, App. p. 152. [545] Baines, Lancashire, II. 679: 39 deaths from 17 to 24 August, 1551, set down to “plague,” i.e. sweat. [546] Lest it may be supposed that there has been adequate discussion of the differences between epidemic agues and influenzas, I quote from Hirsch’s Handbuch der historisch-geographischen Pathologie the passage in which these epidemics or pandemics of “malarial fever” are referred to: “These epidemics of malaria, which extend not unfrequently over large tracts of country, and sometimes even over whole divisions of the globe, forming true pandemics, correspond always in time with a considerable increase in the amount of sickness at the endemic malarious foci, whether near or distant; they either die out after lasting a few months, or they continue—and this applies particularly to the great pandemic outbreaks—for several years, with regular fluctuations depending on seasonal influences. On the very verge of the period to which the history of malarial epidemics can be traced back, we meet with a pandemic of that sort, in the years 1557 and 1558, which is said to have overrun all Europe (Palmarius, De morbis contagiosis. Paris, 1578, p. 322).... It is not until the years 1678-82 that we again meet with definite facts relating to an epidemic extending over a great part of Europe....” (Eng. Transl. I. 229.) [547] Queen Elizabeth and her Times. Ed. Wright, 2 vols. Lond. 1838, I. 113. Sir W. Cecil writing from Westminster to Sir T. Smith on 29th December [1563] says: “The cold here hath so assayled us that the Queen’s majestie hath been much troubled, and is yet not free from the same that I had in November, which they call a pooss, and now this Christmas, to keep her Majestie company, I have been newly so possessed with it as I could not see, but with somewhat ado I wryte this. We have had perpetuall frosts here sence the 16th of this month. Men doo now ordinarily pass over the Thamiss, which I thynk they did not since the 8th yere of the reign of King Henry the VIII.” Ibid. I. 157. For “poss,” see note p. 305. [548] Ephemer. Meteorol. anni 1561 [for the latitude of Brabant]. Antwerp, 1561: “Tusses numero infinitae atque tanta contagionis vi praestabunt ut pauci immunes reliquant, praecipuÈ circa mensis finem.” The almanacks of those times must have been constructed on the same principle as the weather forecasts of our own time—namely, that of using the experience of one year for the next, just as the weather of one day is an indication for the next. In 1575 Dr Richard Foster (who became president of the College of Physicians in 1601) issued an almanack in which he foretold “sweating fevers” for the month of July (Ephemer. meteorol. ad ann. 1575. Lond. 1575). Cogan says that Francis Keene, an astronomer, also prophesied the return of the sweating sickness in 1575, “wherein he erred not much, as there were many strange fevers and nervous sickness.” [549] Johan Boekel, S?????? novi morbi quem plerique medicorum catarrhum febrilem, vel febrem catarrhosam vocant, qui non solum Germaniam, sed paene universam Europam graviss. adflixit. Helmstadtii, 1580. [550] Hoker’s “Irish historie ... to the present year 1587,” p. 165a in Holinshed’s Chronicles. [551] This very moderate increase of the deaths in London in 1580 may be compared with the probably fabulous figures which Webster (I. 163) gives for continental cities the same year: Rome, 4000 deaths, LÜbeck, 8000 deaths, Hamburg, 3000 deaths. I have given the weekly deaths and baptisms in London for five years, 1578-82, in my former volume, p. 341. [552] There is a curious reference to “the sweat” in Shakespeare’s Measure for Measure, Act I. scene 2, where the bawd, in an aside, says: “Thus, what with the war, what with the sweat, what with the gallows, and what with poverty, I am custom-shrunk.” It is known that Shakespeare adapted and condensed his play from Whetstone’s Promus and Cassandra, printed in 1578, who took it from an Italian romance. But Whetstone’s dialogue, which is pointless and verbose beside Shakespeare’s, gives an entirely different speech to the bawd at the same place in the action, making no reference to “the sweat.” The date of Measure for Measure is not certain; but it seems to belong to the earlier period of Shakespeare’s work, when he was adapting old plays most freely. Whatever its date, the war, the sweat, the gallows and poverty are evidently topical allusions pointed enough for the audience to have taken up. [553] The year 1610 is mentioned by Short as a season of universal catarrhal fever abroad; but that epidemic is not in the modern chronologies of influenza. [554] Chamberlain to Carleton in Court and Times of James I. I. [555] Same to same 4 Nov. 1612. Ibid. I. p. 201. [556] Court and Times of James I. I. p. 206. [557] Ibid. p. 208. [558] Court and Times of James I. p. 197. [559] Ibid. p. 237. [560] Ibid. Letter of 25 Nov. 1613. [561] Cal. Coke MSS. I. 83. [563] Graunt, Obs. upon the Bills of Mortality, 1662. [564] Robert Boyle did not attach much importance to the name of “new disease.” “The term new disease,” he says, “is much abused by the vulgar, who are wont to give that title to almost every fever that, in autumn especially, varies a little in its symptoms or other circumstances from the fever of the foregoing year or season.” (Boyle’s Works. 6 vols. 1772, V. 66.) But it was the name commonly given to the epidemics of catarrhal fever among others, and it does not appear, when the history is examined closely, that it was ever given except to some epidemic separated by several years from the last of the kind. [565] Sir R. Leveson’s Letters. Hist. MSS. Commiss. V. 146. [566] Pp. 568-577. [567] ???et?????a sive Gulielmi Dragei Hitchensis ?at??? ?a? F???s?f?? Observationes ab Experientia de Febribus Intermittentibus. Londini, 1665. [568] His tract is dated 1641. [569] By Nicholas Sudell, licentiate in physick and student in chimistry. London, 1669. [570] ???et?????a. A rational account of the Cause and Cure of Agues, with their signs, Diagnostick and Prognostick. Also some Specified Medicines prescribed for the Cure of all sorts of Agues, &c. Whereunto is added a short account of the Cause and Cure of Feavers and the Griping in the Guts. Authore Rto. Talbor, Pyretiatro. Londini, 1672. [571] Sir Thomas Watson (Practice of Physic, I. 725) has a story which shows how long these fancies, encouraged by quacks, may linger: “A coachman by whose side I sat while travelling from Broadstairs to Margate was speaking of the rarity of ague in that part of the Isle of Thanet. His father, he said, once had the complaint, and a fit came on while he was on a visit to him, the coachman, at Ramsgate. The son administered to his suffering parent a glass of brandy; whereupon ‘he threw the agy off his stomach; and it looked for all the world like a lump of jelly.’” [572] Philip Guide, M.D., A Kind Warning, &c. Lond. 1710. [573] The best summary of the “history of the use of Peruvian bark” is by Sir George Baker, in Trans. Col. Phys. III. (1785), 173. [574] Cited by Baker, l. c. p. 190. [575] Lives of the Norths. New ed. by Jessopp. Lond. 1890, III. 188. [576] He fell into a kind of decline and died at his country house on 5 September, Dr Radcliffe having been summoned from London without avail. [577] Baker, l. c., “Had not physicians been taught by a man whom they, both abroad and at home, vilified as an ignorant empiric, we might at this day have had a powerful instrument in our hands without knowing how to use it in the most effectual manner.” This was written at a time when physicians spoke of “throwing in the bark”—throwing it in “with a shovel,” as an Edinburgh professor used to say. [578] John Barker, M.D., of Sarum, and afterwards physician to the forces, says in 1742 (in his essay on the epidemic fever of 1741, u. s. p. 112) that he had Sydenham’s letter in manuscript before him, and that it was written in October, 1677. [579] Cited by Baker, Trans. Col. Phys. III. 208. [580] Beaufort MSS. Histor. MSS. Com. XII. App. 9, p. 85. [581] Evelyn’s Diary, under the date of 29 Nov. 1694. [582] Evelyn; Luttrell, I. 327. [583] Hist. MSS. Com. V. 186. Sutherland correspondence. [584] The Diary of John Evelyn, under the date 4 Feb. 1685. [585] The popular imagination at the time appears to have been most impressed by Dr King’s promptitude in whipping out his lancet. Roger North must have had it incorrectly in his mind when he wrote: “About the time of the death of Charles II., it grew a fashion to let blood frequently, out of an opinion that it would have saved his life if done in time.” [586] Obs. Med. 3rd ed. 1675, V. 5. [587] Ralph Thoresby, Ducatus Leodiensis, ed. Whitaker, App. p. 151. Brand, Hist. of Newcastle, under the year 1675, says that “the jolly rant” caused 724 deaths in that town, the authority given being Jabez Cay, M.D., who left his papers to Thoresby. The number given is probably the mortality from all causes. [588] Patrick Walker’s Life of Cargill, pp. 29, 30. [589] Synopsis Nosologiae. 3rd ed. Edin. 1780, II. 173. [590] Epist. respons. ad R. Brady, § 42. [591] Luttrell (Diary, I. 23) enters under Oct. 1629: “About the middle of this month vast great rains fell which have been very prejudiciall to many persons.” [592] Christopher Love Morley, M.D., De Morbo Epidemico tam hujus quam superioris Anni, id est 1678 et 1679 Narratio. Preface dated London, 31 Dec. 1679. [593] Lady Chaworth to Lord Roos, Calendar of the Belvoir MSS. II. 47. [594] Lives of the Norths. Ed. cit. III. 143. [595] Luttrell’s Historical Relation. Oxford, 1857, I. 19. [596] Luttrell, loc. cit. I. 20, 21, 44. [597] On 16 March, the illness of “little Frank ... hath made me suspect some kind of aguish distemper; but, if it be, it is so little that we neither perceive coming nor going.” On 7 July, another child is recovered of her feverish distemper. On 5 October, “all my little ones are very well, but some of my servants have quartan agues.” Lives of the Norths, Letters of Anne, Lady North. [598] An authentic case of these lingering epidemic agues was that of John Evelyn in the beginning of 1683. On 7th February, 1687, he writes: “Having had several violent fits of an ague, recourse was had to bathing my legs in milk up to the knees, made as hot as I could endure it; and sitting so in a deep churn or vessel, covered with blankets, and drinking carduus posset, then going to bed and sweating. I not only missed that expected fit, but had no more, only continued weak that I could not go to church till Ash Wednesday, which I had not missed, I think, so long in twenty years”—in fact, since his “double tertian” in 1660, which kept him in bed from 17th February to 5th April. [599] Ralph Thoresby caught it at Rotterdam, suffered from it, in the tertian form, for several weeks of October and November, 1678, and brought it home with him to Leeds. He gives a good account of the illness in his Diary (2 vols. Lond. 1830). [600] The History of this present Fever, with its two products, the Morbus Cholera and the Gripes. By W. Simpson, Doctor in Physick. London, 1678. [601] Cal. Belvoir MSS. II. 120. June, 1688. Bridget Noel to the Countess of Rutland. [602] Walter Harris, M.D., De morbis acutis infantum. Lond. 1689. English transl. by Cockburn, 1693, p. 88. [603] “Historical Account of the late General Coughs and Colds, with some Observations on other Epidemical Distempers.” Phil. Trans. XVIII. (1694), p. 109. [604] “’Twas very remarkable that in England as well as this kingdom a short time before the general fever, a slight disease, but very universal, seized the horses too: in them it showed itself by a great defluxion of rheum from their noses; and I was assured by a judicious man, an officer in the army of Ireland, which was then drawn out and encamped on the Curragh of Kildare, there were not ten horses in a regiment that had not this disease.” Molyneux, u. s. [605] Evelyn says nothing of a great epidemic cold in this season, but makes the following remarks on the weather: “Oct. 31. A very wet and uncomfortable season. Nov. 12. The season continued very wet, as it had nearly all the summer, if one might call it summer, in which there was no fruit, but corn was very plentiful.” [606] Molyneux, Phil. Trans. XVIII. (1694), p. 105. [607] “An universal cold that appeared in 1708, and was immediately preceded by a very sudden transition from heat to cold in Dublin and its vicinity.” Molyneux’s Memoirs. [608] La Grippe may, of course, be taken literally to mean seizure; but the common use of the word seems to have been figurative for some fancy that seized many at once and became the fashion. [609] Joannes Turner, M.D., De Febre Britannica Anni 1712. Lond. 1713, pp. 3, 4. [610] Mead, Short Discourse concerning Pestilential Contagion. Lond. 1720, p. 8. But Short, who wrote in 1749, places the “Dunkirk rant” under the year 1710: (Air, Weather, &c. I. 455).—“March 1, began and reigned two months an epidemic which missed few, and raged fatally like a plague in France and the Low Countries, and was brought by disbanded soldiers into England, namely a catarrhous fever called the Dunkirk rant or Dunkirk ague.... It lasted eight, ten, or twelve days. Its symptoms were a severe, short, dry cough, quick pulse, great pain of the head and over the whole body, moderate thirst, and sweating. Diuretics were the cure.” [611] “The effects and evidences of God’s displeasure appearing more and more against us since the incorporating union [1707], mingling ourselves with the people of these abominations, making ourselves liable to their judgments, of which we are deeply sharing; particularly in that sad stroke and great distress upon many families and persons, of the burning agues, fevers never heard of before in Scotland to be universal and mortal.” Life and Death of Alexander Peden. 3rd ed. 1728. Biog. Presb. I. 140. [612] Boyle’s Works. Ed. 1772, V. 725. [613] Ibid. V. 49. [614] Scotia Illustrata. Edin. 1684. Lib. II. “De Morbis,” p. 52. [615] Commentar. Nosolog. Lond. 1727. [616] The Method and Manner of curing the late raging Fevers, and of the danger, uncertainly and unwholesomeness of the Jesuit’s bark. Dated 6 Dec. 1728: “You see that intermitting fevers, when they come to be chronical (and you may see it almost everywhere) make room for a great many distempers, and those very difficult to cure.” p. 49. [617] An Enquiry into the Causes of the Present Epidemical Diseases, viz. Fevers, Coughs, Asthmas, Rheumatisms, Defluxions, &c. By the author of “The Family Companion for Health.” London, 1729, pp. 6, 7. [618] “Variations of the weather and Epid. Diseases, 1726-34 at Ripon.” Appendix to Essay on the Smallpox. Lond. 1740, p. 35. [619] Comment. Nosol. p. 142. [620] This epidemic appears to have made a much greater impression in Italy. The Political State of Great Britain for 1730, p. 172, under the date of 12th January, N. S. speaks of “the influenza, a strange and universal sickness and lingering distemper,” as causing thirty deaths a day in the public hospital of Milan, as well as fatalities at Rome, Bologna, Ferrara and Leghorn, including the deaths of two cardinals. [621] Chronological History, p. 10. [622] Edinburgh Medical Essays and Observations, II. p. 22, Art. 2. “An Account of the Diseases that were most frequent last year in Edinburgh” (June, 1832 to May, 1833): There had been tertian agues throughout the month of June, 1732, and from August to October an epidemic in the suburbs and villages near Edinburgh, of a slow fever, having symptoms like the “comatose” fever of Sydenham, or the remittent of children. [623] Op. cit. p. 47. [624] John Arbuthnot, M.D., Essay concerning the Effects of Air on Human Bodies. London, 1733, p. 193. His remarks upon the “hysteric” maladies that were common after the wave of influenza in Jan.-Feb. 1733, are referred to in the chapter on Continued Fevers, along with the corresponding information from Hillary, of Ripon. [625] Gent. Magaz. 1733, Jan. p. 43. [626] Huxham, Obs. de aere et morbis epidemicis, 1728-52, Plymuthi factae. [627] De Aere, &c. pp. 3, 136-8. [628] Rutty, Chronol. Hist. of Diseases in Dublin. Lond. 1770. [629] Pringle, Diseases of the Army, p. 16. [630] Letters of Horace Walpole, ed. Cunningham, I. 235. [631] Gent. Magaz. XIII. May 1743, p. 272. [632] R. Chambers, Domestic Annals of Scotland, III. 610. [633] Rutty, u. s. under the year 1743. In an earlier passage, he says that the influenza of 1743 raised the Dublin weekly bills to a highest point of 67, so that it must have been very slight in that city. [634] Huxham, Obs. de aere etc., 2nd ed. 3 vols. Lond. 1752-70, II. 99. [635] W. Watson, Phil. Trans. LII. 646. [636] Cleghorn, Observations on the Epidemical Diseases in Minorca, 1744-49, p. 132. [637] This influenza was observed in the North American Colonies. It is noteworthy that Huxham, of Plymouth, records under October, 1752, that hundreds of people at once had cough, sore throat, defluxions from the nose, eyes and mouth, attended with a slight fever, and more or less of a rash, several having a great flux of the belly.—On Ulcerous Sore Throat, 1757, p. 13. [638] W. Hillary, M.D., Obs. on ... Epid. Diseases in Barbadoes. Lond. 1760. [639] It is not described for England, unless a reference by Bisset for Cleveland, Yorkshire, should apply to it. Short says, under the year 1758 (Increase and Decrease of Mankind in England, &c. 1767): A healthy year in general, “only in the harvest was a very sickly mortal time among the poor, of a putrid slow fever, which carried off many. An epidemic catarrh broke out in November, and made a sudden sweep over the whole kingdom.” Barker, of Coleshill, says, in his Putrid Constitution of 1777 (Birmingham, 1779, p. 49): “In the remarkable intermittents of 1758 or 9 ... the early and consequently injudicious use of the bark was attended with such fatal effects that a few doses only sometimes totally oppressed the head, brought on a most rapid delirium, and cut off persons in half-an-hour.” [640] Robert Whytt, M.D., “On the Epidemic Disorder of 1758 in Edinburgh and other parts of the South of Scotland.” Med. Obs. and Inq. by a Society of Physicians, 6 vols. Lond. II. (1762), p. 187. With notices by Millar, of Kelso, and Alves, of Inverness. [641] Archibald Smith, M.D., “Notices of the Epidemics of 1719-20 and 1759 in Peru,” &c. from the Medical Gazette of Lima, on the authority of Don Antonio de Ulloa. Trans. Epid. Soc. II. pt. 1, p. 134. [642] Horace Walpole’s Letters, ed. Cunningham, III. 281. [643] C. Bisset, Essay on the Medical Constitution of Great Britain, 1 Jan. 1758, to Midsummer 1760. Lond. 1762, p. 279. [644] Extract from the parish register printed by Dr G. B. Longstaff in an appendix to his Studies in Statistics. Lond. 1891, p. 443. [645] Increase and Decrease of Mankind in England &c. London, 1767. [646] Rutty, op. cit. p. 275. Compare Watson, supra, p. 351. [647] G. Baker, De Catarrho et de Dysenteria Londinensi epidemicis, 1762, Lond. 1764; W. Watson, “Some remarks upon the Catarrhal Disorder which was very frequent in London in May 1762, and upon the Dysentery which prevailed in the following autumn.” Phil. Trans. LII. (1762), p. 646. [648] Professor Alexander Monro, primus, of Edinburgh, describes his own attack in a letter to his son, Dr Donald Monro, 11 June, 1766 (Works of Alex. Monro, M.D. with Life, Edin. 1781, p. 306): “My case is this: in May, 1762, I had the epidemic influenza, which affected principally the parts in the pelvis; for I had a difficulty and sharp pain in making water and going to stool. My belly has never since been in a regular way, passing sometimes for several days nothing but bloody mucus, and that with considerable tenesmus” &c. Dysentery was epidemic in 1762 as well as influenza. [649] Donald Monro, M.D., Diseases of the British Military Hospitals in Germany, &c. Lond. 1764, p. 137. [650] Med. Trans. published by the College of Physicians in London, I. 437. Heberden’s paper was read at the College, Aug. 11, 1767. [651] The nearest approach to Heberden’s London influenza of 1767 is an epidemic that Sims observed in Tyrone in the autumn of 1767; a season remarkable for measles and acute rheumatism. At the same time that the acute rheumatism prevailed, a fever showed itself, like it; the patients for two or three days were languid, chilly, with pains in the bones, headache, stupor, dry tongue, costiveness. It was marked by remissions, was by no means mortal, and usually ended by a sweat from the 14th to the 17th day, followed by a copious deposit in the urine. James Sims, Obs. on Epidemic Disorders, Lond. 1773, p. 84. [652] Anthony Fothergill, Mem. Med. Soc. III. 30. This paper is not included in John Fothergill’s series. There is also a separate Dublin essay, Advice to the People upon the Epidemic Catarrhal Fever of Oct. Nov. Dec. 1775. By a Physician. [653] I have not found the weekly bills for this year in London; but the following averages, taken from the four-weekly or five-weekly totals in the Gentleman’s Magazine, will show how slight the rise was:
[654] W. Grant, M.D., Observations on the late Influenza as it appeared at London in 1775 and 1782. Lond. 1782. Also, by the same, A Short Account of the Present Epidemic Cough and Fever, in a letter &c. First printed at Bath, and afterwards at London, 1776. [655] MS. Infirmary Book. [656] The reports collected by Dr John Fothergill (Med. Obs. and Inquir. VI. 340) were by himself, and by Pringle, Baker, Heberden and Reynolds, of London; Cuming, of Dorchester; Glass, of Exeter (long account): Ash, of Birmingham; White, of York; Haygarth, of Chester; Pulteney, of Blandford; Thomson, of Worcester; Skene, of Aberdeen; and Campbell, of Lancaster. The papers of this collective inquiry, as well as the two collections in 1782, the collection of Simmonds in 1788, that of Beddoes in 1803 (in a digest) and the Report of the Provincial Medical Association in 1837, together with some other extracts from books or papers, were brought together in a volume, without much editing, by Dr Theophilus Thompson, under the title of The Annals of Influenza in Great Britain from 1510 to 1837. London, 1852. This has been reprinted and brought down to date by Dr Symes Thompson, 1891. [657] Mem. Med. Soc. III. 34. [658] Life of Sir Robert Christison, 2 vols. Edin. 1885, vol. I. (Autobiography), p. 82. [659] For the year 1730, under the date 12 January, p. 172. [660] “An Account of the Epidemic Catarrh of the Year 1782; compiled at the request of a Society for promoting Medical Knowledge.” By Edward Gray, M.D., F.R.S., Medical Communications, I. (1784), p. 1. [661] “An Account of the Epidemic Disease called the Influenza, of the Year 1782, collected from the observations of several physicians in London and in the Country; by a Committee of the Fellows of the Royal College of Physicians in London.” Medical Transactions published by the Coll. of Phys. in London, III. (1785), p. 54. Read at the College, June 25, 1783. [662] John Clark, M.D., On the Influenza at Newcastle. Dated 26 May, 1782; Arthur Broughton, The Influenza or Epid. Catarrh in Bristol in 1782. London, 1782; W. Falconer, Account of the Influenza at Bath in May-June, 1782. Bath, 1782. [663] Gregory, cited by Christison, Life &c. I. 84: “I have been told of the haymakers attempting to struggle with the sense of fatigue, but being obliged in a few minutes to lay down their scythes and stretch themselves on the field.” [664] Gray, u. s. p. 107. [665] The London Medical Journal, III. (1783), 318. [666] College of Physicians’ Report: “A family which came in the Leeward Islands fleet in the end of September, 1782, was attacked by it in the beginning of October. This family afterwards told the physician who attended them that several of their acquaintances, who came over in the same fleet with them, had been attacked at the same time and in the same manner as themselves.” [667] He had another experience not quite the rule: “Children and old people either escaped this influenza entirely, or were affected in a slight manner.” [668] R. Hamilton, M.D., “Some Remarks on the Influenza in Spring, 1782,” Mem. Med. Soc. II. 422. This author had some difficulty in deciding where the influenza ended and the epidemic ague began. [669] Trans. Col. Phys. “On the late Intermittent Fevers,” III. 141. Read at the College, 10 Jan., 1785. [670] Ibid. p. 168. [671] Febris Anomala, or the New Disease. Lond. 1659, p. 1. [672] “Remarks on the Treatment of Intermittents, as they occurred at Hampstead in the Spring of 1781.” By Thomas Hayes, Surgeon. Lond. Med. Journ. II. 267. [673] Epidemicks (1777-95), pp. 58, 72, 75, &c. Barker’s annals from 1779 to 1786 are full of references to agues, “bad burning fevers” and the like, but are on the whole too confused to be of much use for history. See the Boston bills under Smallpox. [674] W. Moss, Familiar Medical Survey of Liverpool. Liverpool, 1784, p. 117. This writer’s object is to show that Liverpool escaped most of the epidemic diseases that troubled other places, including typhus fever. As to the influenzas he says: “The influenza of 1775, so universal and very fatal in many parts, was less fatal here; and also that much slighter complaint, distinguished by the same title, which appeared in the spring of 1783.” [675] Gent. Magaz. LIII. pt. 2, p. 920. Letter dated from “Pontoon.” [676] William Coley, Account of the late Epidemic Ague in the neighbourhood of Bridgenorth, Shropshire, in 1784 ... to which are added some observations on a Dysentery that prevailed at the same time. Lond. 1785. [677] Baker, u. s. [678] “An Account of the Effects of Arsenic in Intermittents.” By J. C. Jenner, surgeon at Painswick, Gloucestershire. Lond. Med. Journ. IX. (1788), p. 47. [679] Ibid. VII. (1786), p. 163. [680] Table compiled by Dr Mackenzie, and printed by Christison, Trans. Soc. Sc. Assoc. Edin. Meeting, 1863, p. 97. Christison pointed out very fairly the difficulties in the way of accepting the drainage-theory for the decline of ague (p. 98), but he had not realized the fact that the disease used to come in epidemics at long intervals. [681] e.g. parish of Dron, Perthshire (IX. 468): “The return of spring and autumn never failed to bring along with them this fatal disease [ague], and frequently laid aside many of the labouring hands at a time when their work was of the greatest consequence and necessity.” That had now ceased, owing to drainage. See also Cramond parish, I. 224, and Arngask, Perthshire, I. 415. [682] The following extracts are from Barker’s book, Epidemicks, Birmingham [1795]: 1782. Influenza in the latter end of spring. Nine out of ten in Lichfield and other towns had violent defluxions of the nose, throat and lungs, bringing on violent sneezings, soreness of the throat, coughs, &c. attended with a pestilential fever, of which many were relieved by perspiration.... Some had swelled faces, and violent pains in the teeth.... Some, giddiness and violent headaches, accompanied with a slow fever, and even loss of memory.... By its running through whole families it appeared also to be communicable by infection. 1783. The influenza also began to appear again; and those who had coughs last year began now to be afflicted with them again, the disorder at length frequently ending in a consumption. Also dogs in this year and the next had running at the eyes and a loss of the use of their hind legs, which in the end killed most of those that were seized with it. Horses also suffered. 1786. In the middle of this season the influenza returned, and colds and coughs were epidemical. 1788 [spring]. A species of influenza of the pestilential kind, akin to that of 1782, has almost constantly returned in spring and autumn since that time ... [summer] A species of influenza, as in the spring, and it is also at Edinburgh. 1789 [spring]. Influenza returned. Even dogs affected. 1791. Influenza very bad, especially in London. [683] Samuel Foart Simmons, M.D., F.R.S., “Of the Epidemic Catarrh of the year 1788.” Lond. Med. Journ. IX. (1788), p. 335. [684] Vaughan May, surgeon to H. M. Ordnance, “Observations on the Influenza as it appeared at Plymouth, in the summer and autumn of the year 1788.” Duncan’s Med. Commentaries, Decade 2, vol. iv. p. 363. [685] Falconer, “Influenzae Descriptio, uti nuper comparebat in urbe Bathoniae, mensibus Julio, Augusto et Septembri A.D. 1788.” Mem. Med. Soc. III. 25. [686] George Bew, M.D., physician at Manchester, “Of the Epidemic Catarrh of the year 1788.” Lond. Med. Journ. IX. (1788), p. 354. “The influenza has been very prevalent,” writes Withering, of Birmingham, to Lettsom, 19 Aug. 1788. Mem. of Lettsom, III. 133. [687] Related to Dr Simmons (1. c. p. 346), by Mr Boys, surgeon, of Sandwich, who was told it by his son, a lieutenant on board the ‘Rose.’ [688] In a note to Simmons’ paper, u. s., p. 342. [689] “An Account of an Epidemic Fever that prevailed in Cornwall in the year 1788.” Lond. Med. Journal, X. p. 117 (dated Truro, Jan. 26, 1789). [690] Bew, u. s., p. 365. Carmichael Smyth has a similar remark on the influenza of 1782: “This epidemic distemper very soon declined. But it seemed to leave behind it an epidemical constitution which prevailed during the rest of the summer; and the fevers, even in the end of August and beginning of September, assumed a type resembling, in many respects, the fever accompanying the influenza.” [691] A solitary reference occurs to an influenza in 1792, which I have not succeeded in verifying:—B. Hutchinson, “An Account of the Epidemic Disease commonly called the Influenza, which appeared in Nottinghamshire and most other parts of the kingdom in the months of November and December, 1792.” New. Lond. Med. Journ., Lond. 1793, II. 174. Cited in the Washington Medical Catalogue. [692] Robert Willan, M.D., Reports on the Diseases in London, particularly during the years 1796, ’97, ’98, ’99 and 1800. London, 1801, pp. 76, 253. [693] Published in the Med. and Phys. Journal from August to December, 1803. [694] Memoirs of the Medical Society, vol. VI. [695] R. Hooper, M.D., Obs. on the Epidemic Disease now prevalent in London. London, 1803. R. Pearson, M.D., Obs. on the Epid. Catarrhal Fever or Influenza of 1803. Lond. 1803. [696] J. Herdman, The prevailing Epid. Disease termed Influenza. Edin. 1803. [697] W. Falconer, M.D., The Epidemic Catarrhal Fever commonly called the Influenza, as it appeared at Bath &c. Bath, 1803. [698] John Nott, M.D., Influenza as it prevailed in Bristol in Feb.-April, 1803. Bristol, 1803. [699] Med. and Phys. Journ. X. 104. [700] Dr Currie of Chester, Med. and Phys. Journ. X. 213. [701] Ib. X. 527, quoted by Beddoes from memory, the letter from Navan having been lost. [702] Alvey, Mem. Med. Soc. VI. 462. [703] Dr Carrick, of Bristol, in Duncan’s Annals of Med. III. Compare the report for Fraserburgh in 1775, supra, p. 360. [704] Frazer, Med. and Phys. Journ. X. 206, dated 12 June, 1803. [705] Hirsch cites authorities for influenza in Edinburgh, London, Nottingham and Newcastle in the winter of 1807-8. In Roberton’s monthly reports from Edinburgh (Med. and Phys. Journ. XXI.), and Bateman’s quarterly reports from London, I find only common colds recorded. Clarke for Nottingham (Ed. Med. Surg. Journ. IV. 429) says catarrh was so general “as to have acquired the name of influenza; but there was no reason to suppose it contagious.” [706] W. Royston, “On a Medical Topography,” Med. and Phys. J. XXI. 1809, (Dec. 1808), p. 92: “After the unusual heat of the last summer, the frequency of intermittents in the autumn was increased in the fens of Cambridgeshire to an almost unprecedented degree; and even quadrupeds were not exempt, for distinctly marked cases of tertian were observed in horses. In the year 1780 a similar prevalence of this disease occurred in the same part; and though in an interval of 28 years many and frequent sporadic cases have arisen, yet its universality during that period was suspended. We have to regret that a correct record of the constitution of the year 1780, as applying to this particular district, has not been preserved in such a manner as to admit of a direct comparison with that of 1808. If it were possible, from authentic documents to compare the history of these two seasons, much light might be thrown on the obscure cause of intermittents.” Clarke, of Nottingham, (l. c.) says there were some cases of irregular ague among a few privates of the regiment there, who had all come from a marshy quarter, some of them with the fever on them. The paroxysms came at unusually long intervals. Bark increased the fever. [707] Lecture on Agues, in the Lond. Med. Gaz. IX. 923-4, 24 March, 1832. [708] Lancet, s. d., p. 438. [709] Lond. Med. Gazette, 2 July, 1831. [710] John Burne, M.D., Ibid. VIII. (1831), p. 430. [711] G. Bennett, Lond. Med. Gaz. 23 July, 1831. [712] Bellamy, Ibid. [713] “Report of Diseases among the Poor of Glasgow,” Glas. Med. Journ. IV. 444. [714] McDerment, ibid. V. 230: “In June and July to an extent unequalled” etc. [715] During the last general election before the passing of the Reform Bill, which was held in the month of June, 1831, a number of the Aberdeen radicals went out on a hot and dusty day to meet the candidate of their party who was posting from the south. It was remarked that all those who had been of this company “caught cold,” unaccountably but as if from some common cause. The date would correspond to the prevalence of influenza elsewhere. [716] Mr Kingdon, reported in the Lancet, s. d. [717] Venables, Lancet, II. May, 1833. [718] Hingeston, Lond. Med. Gaz. XII. 199. [719] Gent. Magaz., April, 1833, p. 362. [720] Whitmore, Febris anomala, or the New Disease, etc., London, 1659, p. 109:—“And for a plethora or fulness of blood, if that appears (though this may seem a paradox yet ’tis certain) that it is so far in this disease from indicating bleeding that it stands absolutely as a contradiction to it and vehemently prohibits it. And whereas they think the heat, by bleeding, may be abated and so the feaver took off, they are mistook, for by that means the fermentation through the motion of the blood is highly increased, so as sad experience hath manifested in a great many: upon the bleeding they have within a day or two fallen delirious and had their tongues as black as soot, with an intolerable thirst and drought upon them.... Petrus a Castro, who rants high for letting blood, at last as if he had been humbled with the sad success, saith etc.” [721] A System of Clinical Medicine, Dublin, 1843, pp. 500-501. Lecture delivered in the session 1834-35. [722] Rawlins, Lond. Med. Gaz. s. d. [723] Ed. Med. Surg. Journ. XLIII. 1835, p. 26. [724] Parsons, “Report of Outcases, Birmingham Infirmary, 1 Jan. to 31 Dec. 1833.” Trans. Provin. Med. Surg. Assoc. II. 474. [725] In the report upon the influenza of 1837 by a Committee of the Provincial Medical Association, the preceding epidemic is uniformly referred to the year 1834. Graves, in a clinical lecture upon that of 1837, speaks two or three times of the last as that of 1834, and, in another place, he calls it the epidemic of 1833-34. But these, I think, are mere laxities of dating, of which there are many other instances where the date is recent and not yet historical. [726] As early as 1612 a proposal had been made to James I. for “a grant of the general registrarship of all christenings, marriages and burials within this realm.” State Papers, Rolls House, Ja. I. vol. LXIX. No. 54. It was a device for raising money. [727] The account in the Gentleman’s Magazine for February, 1837, p. 199, is almost identical with the paragraph in the number for April, 1833: “An influenza of a peculiar character has been raging throughout the country, and particularly in the Metropolis. It has been attended by inflammation of the throat and lungs, with violent spasms, sickness and headache. So general have been its effects that business in numerous instances has been entirely suspended. The greater number of clerks at the War Office, Admiralty, Navy Pay Office, Stamp Office, Treasury, Post-Office and other Government Offices have been prevented from attending to their daily avocations.... Of the police force there were upwards of 800 incapable of doing duty. On Sunday the 13th the churches which have generally a full congregation presented a mournful scene &c. ... the number of burials on the same day in the different cemeteries was nearly as numerous as during the raging of the cholera in 1832 and 1833. In the workhouses the number of poor who have died far exceed any return that has been made for the last thirty years.” [728] Graves, u. s., p. 545. [729] Robert Cowan, M.D., Journ. Stat. Soc. III. 257. [730] Peyton Blakiston, A Treatise on the Influenza of 1837, containing an analysis of one hundred cases observed at Birmingham between 1 Jan. and 15 Feb. Lond. 1837. [731] These and some former particulars are from the “Report upon the Influenza or Epidemic Catarrh of the winter of 1836-37,” compiled by Robt. J. N. Streeten, M.D. for the Committee of the Provincial Medical Association. Trans. Prov. Med. Assoc. VI. 501. [732] Streeten’s Report, u. s., p. 505. [733] Statist. Report on Health of Navy, 1837-43. [734] Jackson, Dubl. Med. Press, VIII. 69; Brady, Dubl. Journ. Med. Sc. XX. (1842), 76. [735] Laycock, Dubl. Med. Press, VII. 234. Several cases of sudden and great enlargement of the liver and of suppression of urine were judged to be part of the epidemic. [736] Ross, Lancet, 1845, I. p. 2. [737] Report of Holywood Dispensary for 1842, Dublin Med. Press, IX. 204. [738] Hall, Prov. Med. Journ. 1844, p. 315. [739] M’Coy, Med. Press, XI. 133. [740] Fleetwood Churchill, Dubl. Quart. Journ., May, 1847, p. 373. [741] Farr, in Rep. Reg.-Gen. [742] Farr, in the Report of the Registrar-General for 1848. He cites (p. xxxi) Stark for Scotland, that it “suddenly attacked great masses of the population twice during November”—on the 18th, and again on the 28th. [743] A curious trace of the temporary interest excited by influenza in 1847-8 remains in a great book of the time, Carlyle’s Letters and Speeches of Cromwell, the third edition of which, with new letters, was then under hand. One of the new letters related to the death of Colonel Pickering from the camp-sickness among the troops of Fairfax at Ottery St Mary in December, 1645. Carlyle’s comment is: “has caught the epidemic ‘new disease’ as they call it, some ancient influenza very prevalent and fatal during those wet winter operations.” “New disease” was the name given by Greaves to the war-typhus in Oxfordshire and Berkshire in 1643, but neither that nor the sickness at Ottery (which is not called “new disease” in the documents) had anything of the nature of influenza. [744] But Dr Rose Cormack, who had known relapsing fever well in Edinburgh, wrote from Putney, near London, in October, 1849: “For some months past the majority of cases of all diseases in this neighbourhood have ... presented a well-marked tendency to assume the remittent and intermittent types.” “Infantile Remittent Fever,” Lond. Journ. of Med., Oct. 1849, reprinted in his Clinical Studies, 2 vols., 1876. [745] T. B. Peacock, M.D., On the Influenza, or Epidemic Catarrhal Fever of 1847-8. London, 1848. [746] Haviland, Journ. Pub. Health, IV. 288, (94 cases in June-Aug. in a village). [747] See F. Clemow, M.D., of St Petersburg, “The Recent Pandemic of Influenza: its place of origin and mode of spread.” Lancet, 20 Jan. and 10 Feb. 1894. These papers bring together and discuss the Russian opinions, official and other. The Army Medical Report favoured the view that the birthplace of this pandemic in the autumn of 1889 was an extensive region occupied by nomadic tribes in the northern part of the Kirghiz Steppe. There is evidence of its rapid progress westwards over Tobolsk to the borders of European Russia. Influenza is said to be constantly present in many parts of the Russian Empire; but the circumstances that have, on four or five occasions in the 19th century, set the infection rolling in a great wave westwards from the assumed source are wholly unknown. [748] The collective inquiry on the epidemics was made by the medical department of the Local Government Board, the result being given in two reports: Report on the Influenza Epidemic of 1889-90, Parl. Papers, 1891, and Further Report and Papers on Epidemic Influenza, 1889-92, Parl. Papers, Sept. 1893. By H. Franklin Parsons, M.D. Statistical tables comparing the epidemics in London with those in some other capitals were published by F. A. Dixey, M.D., Epidemic Influenza, Oxford, 1892. [749] The notable difference between the type of this epidemic and that of the epidemics of 1833, 1837 and 1847, from which the conventional notion of “influenza cold” was derived, is perhaps the explanation of the following apt and erudite remark by Buchanan, on “influenza proper,” in his introduction to the first departmental report, 1891: “It would be no small gain to get more authentic methods of identifying influenza proper from among the various grippes, catarrhs, colds and the like—in man, horse, and other animals—that take to themselves the same popular title” (p. xi). [750] The volume by Julius Althaus, M.D., Influenza: its Pathology, Complications and Sequelae, 2nd ed., Lond. 1892, includes a summary and bibliography of recent observations. [751] Noah Webster, Brief History of Epidemick Diseases, I. 288; Warren, of Boston, to Lettsom, 30 May, 1790, Lettsom’s Memoirs, III. 238: “whether this [the second] is a variety of influenza, or a new disease with us, I am at a loss to determine.” [752] In Twysden’s Decem Scriptores, col. 579. [753] Boyle’s Works, 6 vols., London, 1772, V. 52. [754] Seneca, Nat. Quaest. § 27, cited by Webster. After earthquakes, “subitae continuaeque mortes, et monstrosa genera morborum ut ex novis orta causis.” The passage cited from Baglivi (p. 530) looks like a repetition of this: “imo nova et inaudita morborum genera ... post terraemotus.” [755] Cited by Horace E. Scudder, in Noah Webster. New York and London, 1881, p. 105. [756] Brief History of Epidemic and Pestilential Diseases, 2 vols., Hartford, 1799. [757] Brief History of Epidemic and Pestilential Diseases, II. 15. [758] Id. II. 34, 84. Dr Robert Williams, in his work on Morbid Poisons (II. 670) argues for Webster’s electrical theory of influenza without knowing, or at least without saying, that it was Webster’s. The much-advertised writings of Mr John Parkin on The Volcanic Theory of Epidemics (or other title) follow Webster very closely both in the main idea and in its ramifications, but without acknowledgment to the American philosophe. Milton’s rule was that one might take from an old author if one improved upon him; but neither Williams nor Parkin has improved upon Webster. [759] Ibid. II. 30. [760] “Catalogue of Recorded Earthquakes from 1606 B.C. to A.D. 1850.” British Assocn. Reports, 1852-54. [761] Abraham Mason, Phil. Trans. LII. Part 2, p. 477. [762] Webster, I. 150. [763] Hillary, Changes of the Air, etc., p. 82. [764] Hillary, Changes of the Air, etc., p. 80. [765] Webster, I. 250. [766] Hamilton, Phil. Trans. LXXIII. 176. [767] Mallet’s Catalogue, u. s. [768] Holm, Vom Erdbrande auf Island im Jahre 1783, Kopenhagen, 1784, says: “Since the outbreak began, the atmosphere of the whole country has been full of vapour, smoke and dust, so much so that the sun looked brownish-red, and the fishermen could not find the banks.... Old people, especially those with weak chests, suffered much from the smell of sulphur and the volcanic vapours, being afflicted with dyspnoea. Various persons in good health fell ill, and more would have suffered had not the air been cooled and refreshed from time to time by rains,” pp. 57, 60. The real sickness of Iceland in those years had been before the volcanic eruptions, in 1781 and 1782, when some parts of the island were almost depopulated by the famine and pestilential fevers that followed the unusual seasons. [769] Phil. Trans. II. (1667), p. 499. [770] Ibid. March-Apr. 1694, p. 81. Sloane had himself felt several shocks at Port Royal on the 20th October, 1687, between four and six o’clock in the morning, which were due to the same earthquake that destroyed Lima in Peru. [771] Phil. Trans. XVIII. p. 83 (March-April, 1794). Series of reports from Jamaica collected by Sloane. [772] A few cases have been exceptionally seen at Spanish Town, six miles from the head of the bay, the infection of which was supposed to have been brought from the shore by sailors, and it has also prevailed in the barracks on the high ground of Newcastle not far from the shore. [773] Without seeking to argue for the connexion between particular earthquakes and influenzas, but merely to illustrate the possibilities, I append here an instance that ought not to be overlooked. On the 1st of November, 1835, there was a great earthquake in the Moluccas, which so completely changed the soil of the island of Amboina, that it became notably subject to deadly miasmatic or malarious fevers from that time forth. For three weeks before the earthquake the atmosphere had been full of a heavy sulphurous fog, so that miasmata were rising from the soil by some unwonted pressure before the actual cataclysm. There is no doubt at all that Amboina became “malarious” in a most marked degree from the date of the earthquake; it is a classical instance of the sudden effect of great changes in the earth’s crust upon the frequency and malignity of remittent and intermittent fevers, according to the testimony of physicians in the Dutch East Indian service. The influenza nearest to the earthquake was about a year after, at Sydney, Cape Town, and in the East Indies, during October and November, 1836. The epidemic appeared about the same time in the north-east of Europe, spread all over the continent, and reached London in January, 1837. There was again influenza in Australia and New Zealand in November, 1838, two years after the last outbreak in that region. [774] Phil. Trans. for the year 1694, p. 5. [775] Mallet, “First Report on the Facts of Earthquake Phenomena.” Trans. Brit. Assoc. for 1850, Lond. 1851. Cited from von Hoff. [776] Archibald Smith, M.D., “Notices of the Epidemics of 1719-20 and 1759 in Peru,” etc. Trans. Epid. Soc. II. pt. 1, p. 134. From the Medical Gazette of Lima, 15 March, 1862. [777] Bell’s Travels, in Pinkerton, VII. 377. [778] See an article “Railways—their Future in China,” by W. B. Dunlop, in Blackwood’s Magazine, March, 1889, pp. 395-6. A letter in the Pall Mall Gazette, dated 23 May, 1891, and signed “Shanghai,” recalled the outbreak of Hongkong fever, “the symptoms of which bore a curious resemblance to the influenza epidemic,” at the time when much building was going on upon the slope of Victoria Peak: “It was said at the time—I do not know with what truth—that in this turning-up of the soil, several old Chinese burying-places were included.” [779] Essay on the Most Effective Means of preserving the Health of Seamen in the Royal Navy. London, 1757, p. 83. [780] See The Eruption of Krakatoa and subsequent phenomena. Report of the Krakatoa Committee of the Royal Society.... Edited by G. J. Symons, London, 1888. [781] Edin. Med. Essays and Obs. II. 32. [782] Trans. Col. Phys. III. 62. [783] Gent. Magaz. 1782, p. 306. [784] R. Robertson, M.D., Observations on Jail, Hospital or Ship Fever from the 4th April, 1776, to the 30th April, 1789. Lond. 1789, New ed., p. 411. [785] Trotter, Medicina Nautica, I. 1797, p. 367. [786] Notes of a lecture on Influenza, by Gregory, taken by Christison about the year 1817, in the Life of Sir Robert Christison, I. 82. [787] College of Physicians’ Report, Trans. Col. Phys. III. 63. [788] This is inferred from the varying number of ships in the two fleets in the several notices of their movements in the Gentleman’s Magazine, for May and June, 1782. [789] Brian Tuke to Peter Vannes, 14 July, 1528: “For when a whole man comes from London and talks of the sweat, the same night all the town is full of it, and thus it spreads as the fame runs.” Cal. State Papers, Henry VIII. IV. 1971. [790] Webster, II. 63. [791] College of Physicians’ Report. Trans. Col. Phys. III. (1785), p. 60-61. “Information has been received” of the incident. [792] Statist. Report of Health of Navy, 1837-43. Parl. papers, 1 June, 1853, p. 8. [793] Ibid. p. 14. [794] Ibid. s. d. [795] Report on Health of Navy, 1857, p. 69. [796] Ibid. p. 41. [797] Ibid. p. 131. [798] Ibid. p. 112. [799] Report for 1856, p. 100. [800] ChaumeziÈre, Fievre catarrhals Épidemique, observÉe À bord du vaisseau ‘Le Duguay-Trouin’ aux mois de Fevr. et Mars, 1863. Paris, 1865. Cited by Hirsch. [801] Dr Guthrie, of Lyttelton. [802] Macdonald, Brit. Med. Journ., 14 July, 1886. [803] Cruise of H.M.S. ‘Galatea’ in 1867-8. [804] R. A. Chudleigh, in Brit. Med. Journal, 4 Sept. 1886. The experiences are not altogether recent, for they were noted for “the Chatham Islands and parts of New Zealand” by Dieffenbach, in his German translation of Darwin’s Naturalist’s Voyage round the World. See English ed. 1876, p. 435 note. [805] Pall Mall Gazette, 11 Dec. 1889. [806] Hirsch, Geograph. and Histor. Pathol. I. 29. Engl. Transl. [807] See the chapter on Sweating Sickness in the first volume of this History, p. 269, and the author’s other writings there cited. [808] See the first volume, pp. 456-461. I shall add here a reference to smallpox among young people in Henry VIII.’s palace at Greenwich in 1528. Fox, newly arrived from a mission to France, writes to Gardiner, 11 May, 1528 (Harl. MS. 419, fol. 103): The king “commanded me to goe unto Maystress Annes chamber, who at that tyme, for that my Lady prynces and dyvers other the quenes maydenes were sicke of the small pocks, lay in the gallerey in the tilt yarde.” [809] Selections from the Records of the Kirk Session, Presbytery and Synod of Aberdeen. Edited by John Stuart, for the Spalding Club, Aberd. 1846, I. 427. [810] Mead to Stutteville, in Court and Times of Charles I., I. 359. Joan, Lady Coke to Sir J. Coke, 26 June, 1628. Cal. Coke MSS. [811] Lord Dorchester to the Earl of Carlisle, 30 Aug. 1628, in C. and T. Charles I.: “Your dear lady hath suffered by the popular disease, but without danger, as I understand from her doctor, either of death or deformity.” [812] Gilbert Thacker to Sir J. Coke at Portsmouth, 9 June, 1628; Thomas Alured to the same, 21 June; Richard Poole to the same, 23 June. Cal. Coke MSS., I. Thomas Alured’s house “hath been visited in the same kind, once with the measles and twice with the smallpox, though I thank God we are now free; and I know not how many households have run the same hazard.” [813] Harl. MS., No. 2177. [814] The original heading in the Bills of Mortality was “flox and smallpox.” “Flox” meant flux, or confluent smallpox, which was so distinguished, as if in kind, from the ordinary discrete form, seldom fatal. Huxham, in 1725, Phil. Trans. XXXIII. 379, still used these terms: “When the pustules broke out in less than twenty-four hours from the seizure, they were always of the flux kind, as is commonly observed.... Pocks which at first were distinct would flux together during suppuration.” Dover, Physician’s Legacy, 1732, p. 101, has “the flux smallpox, or variolae confluentes,” as one of the varieties: and again, pustules “fluxing in some parts, in others distinct.” [815] Having been omitted by Graunt in his table. Op. cit. 1662. [816] Cal. State Papers, under the dates. The epidemic seems to have revived in 1642. An affidavit among the papers of the House of Lords, excusing the attendance of a witness, states that Thomas Tallcott has recently lost his wife and one child by smallpox, and that he himself, six of his children and three of his servants are now visited with the same disease. 13 July, 1642, Hist. MSS. Com. V. 38. The Mercurius Rusticus, 1643, says that Bath was much infected both with the plague and the smallpox. Cited in Hutchins, Dorsetshire, III. 10. [817] Remaining Works. Transl. by Pordage. Lond. 1681. “Of Feavers,” p. 142. In one of his cases Willis was at first uncertain as to the diagnosis, because “the smallpox had never been in that place.” [818] Histor. MSS. Commis. V. 156-154. Sutherland Letters. [819] Sutherland Letters, u. s. Andrew Newport to Sir R. Leveson at Trentham. [820] Mary Barker to Abel Barker, 26 May and 2 June, 1661. Hist. MSS. Com. V. 398: “There is many dy out in this town, and many abroad that we heare of”; the squire’s mother is living “within a yard of the smallpox, which is also in the house of my nearest neighbour”; her own children had whooping cough, but do not appear to have taken smallpox. [821] Hactenus Inaudita, or Animadversions upon the new found way of curing the Smallpox. London, 1663. Dated 10 July, 1662. The burden of his own complaint is of a prominent personage in the smallpox who was killed, as he maintains, by enormous doses of diacodium, an opiate with oil of vitriol, much in request among the partisans of the cooling regimen. [822] His first book was ?e?? ?d??p?s?a?, or A Discourse of Waters, their Qualities and Effects, Diaeteticall, Pathologicall and Pharmacuiticall. By Tobias Whitaker, Doctor in Physicke of Norwich. Lond. 1834. In 1638, being then Doctor in Physick of London, he published The Tree of Humane Life, or the Bloud of the Grape. Proving the Possibilitie of maintaining humane life from infancy to extreame old age without any sicknesse by the use of wine. An enlarged edition in Latin was published at Frankfurt in 1655, and reprinted at the Hague in 1660, and again in 1663. The passages cited in the text occur in his Opinions on the Smallpox. London, 1661. [823] His only reference to the deaths in the royal family, which were currently set down to professional mismanagement, comes in where he opposes the prescription of Riverius to bathe the hands and feet in cold water: “this hath proved fatall,” he says, “in such as have rare and tender skins, as is proved by the bathing of the illustrious Princess Royal. Therefore I shall rather ordain aperient fomentations in their bed, to assist their eruption and move sweat.” [824] Pyretologia, II. 94, 112. [825] Walter Harris, M.D., De morbis acutis infantum, 1689. There were several editions, some in English. [826] Jurin, Letter to Cotesworth. Lond. 1723, p. 11. [827] Speaking of malignant sore-throat, he says: “The younger the patients are, the greater is their danger, which is contrary to what happens in the measles and smallpox.” Commentaries on Diseases, p. 25. [828] Andrew’s Practice of Inoculation impartially considered. Exeter, 1765, p. 60. [829] Duvillard (Analyse et Tableaux de l’Influence de la Petite VÉrole sur la MortalitÉ À chaque Age. Paris, 1806) gives the ages at which 6792 persons died of smallpox at Geneva from 1580 to 1760, according to the registers of burials:
The public health of Geneva altered very much for the better in the course of two centuries from 1561 to 1760. From 1561 to 1600, in every hundred children born, 30·9 died before nine months, on an annual average, and 50 before five years. From 1601 to 1700 the ratios were 27·7 under nine months, and 46 before five years. From 1701 to 1760 the deaths under nine months had fallen to 17·2 per cent., and under five years to 33·6 per cent. (Calculated from a table in the BibliothÈque Britannique, Sciences et Arts, IV. 327.) Thus, with an increasing probability of life, the age-incidence of fatal smallpox may have varied a good deal within the period from 1580 to 1760. It is given by Duvillard separately for the years 1700-1783 (inclusive of measles): during which limited period a smaller ratio died under nine months, and a larger ratio above the age of five years, than in the aggregate of the whole period from 1580 to 1760. Whatever may have been the rule at Geneva, it cannot be applied to English towns; for, while some 30 per cent. of the smallpox deaths were at ages above five in the Swiss city (1700-1783), only 12 per cent. were above five in English towns such as Chester and Warrington in 1773-4. [830] Pyretologia, 2 vols. Lond. 1692-94, vol. II. [831] Natural History of Oxfordshire. Oxford, 1677, p. 23. [832] In his Diary, under the year 1646, homeward journey from Rome. [833] The physician was “a very learned old man,” Dr Le Chat, who had counted among his patients at Geneva such eminent personages as Gustavus Adolphus and the duke of Buckingham. [834] Dr Dover has left us an account of Sydenham’s practice in the smallpox as he himself experienced it: “Whilst I lived with Dr Sydenham, I had myself the smallpox, and fell ill on the twelfth day. In the beginning I lost twenty ounces of blood. He gave me a vomit, but I find by experience purging much better. I went abroad, by his direction, till I was blind, and then took to my bed. I had no fire allowed in my room, my windows were constantly open, my bedclothes were ordered to be laid no higher than my waist. He made me take twelve bottles of small beer, acidulated with spirit of vitriol, every twenty-four hours. I had of this anomalous kind to a very great degree, yet never lost my senses one moment.” The Ancient Physician’s Legacy. London, 1732, p. 114. [835] Scotia Illustrata. Lib. II., cap. 10. [836] De Febribus &c., Lond. 1657: cap. ix. “De Variolis et Morbillis,” p. 141. [837] “First of all,” he says, “let the patient be kept with all care and diligence from cold air, especially in winter, so that the pores of the skin may be opened and the pocks assisted to come out. Therefore let him be kept in a room well closed, into which cold air is in no manner to enter, and let him be sedulously covered up in bed.... I desire the more to admonish my friends in this matter, for that Robert Cage, esquire, my dear sister’s husband,” etc. [838] Besides cases to show the ill effects of blooding, vomits, purges and cooling medicines such as spirit of vitriol, he gives examples as if to refute Sydenham’s favourite notion that salivation, diarrhoea and menstrual haemorrhage were relieving or salutary. Morton’s chief object was to bring out the eruption, and to get it to maturate kindly; an eruption which languished, or did not rise and fill, was for him the most untoward of events. Sydenham, on the other hand, argued that the danger was in proportion to the number of pustules and to the total quantity of matter contained in them; and he sought, accordingly, to restrain cases which threatened to be confluent by an evacuant treatment or repressive regimen. [839] Walter Lynn, M.B., A more easy and safe Method of Cure in the Smallpox founded upon Experiments, and a Review of Dr Sydenham’s Works, Lond. 1714; Some Reflections upon the Modern Practice of Physic in Relation to the Smallpox, Lond. 1715. F. Bellinger, A Treatise concerning the Smallpox, Lond. 1721. [840] Letter from Woodward to the Weekly Journal, 20 June, 1719, in Nichols, Lit. Anecd. VI. 641. [841] Rev. Dr Mangey to Dr Waller, 4 March, 1720, London. Nichols’ Lit. Anecd. I. 135. [842] Huxham, Phil. Trans. XXXII. (1725), 379. [843] Gent. Magaz., Sept. 1752. [844] John Barker, M.D., Agreement betwixt Ancient and Modern Physicians, Lond. 1747. Also two French editions. It is on Van Helmont that Barker pours his scorn for “breaking down the two pillars of ancient medicine—bleeding and purging in acute diseases.” That upsetting person forbore to bleed even in pleurisy; the only thing that he took from the ancient medicine was a thin diet in fevers; “and yet this scheme, as wild and absurd as it seems, had its admirers for a time.” [845] Lynn (u. s. 1714-15) agrees as to the matter of fact, namely, that the mortality from smallpox was greater among the richer classes, who were too much pampered and heated in their cure, than among the poorer, who had not the means to fee physicians and pay apothecaries’ bills. [846] He was under the tutelage of John Churchill, duke of Marlborough, who does not give a name to the malady (Coxe’s Life of Marlborough). Dr James Johnstone, junr., of Worcester, in his Treatise on the Malignant Angina, 1779, p. 78, claims the death of the Duke of Gloucester as from that cause, on the evidence of Bishop Kennet’s account. [847] In the Gentleman’s Magazine, under the dates. [848] A Direct Method of ordering and curing People of that Loathsome Disease the Smallpox, being the twenty years’ practical experience of John Lamport alias Lampard, London, 1685. The writer was probably an empiric, “Practitioner in Chyrurgery and Physick,” dwelling at Havant, and attending the George at Chichester on Mondays, Wednesdays and Fridays, the Half Moon at Petersfield on Saturdays. He says: “One great cause of this disease being so mortal in the country is because the infection doth make many physicians backward to visit such patients, either for fear of taking the disease themselves or transferring the infection to others.” He has another fling at the regular faculty: “Do not run madding to Dr Dunce or his assistance to be let bloud.” Empirics, although they were commonly right about blood-letting, were under the suspicion of not speaking the truth about their cures. [849] Macaulay, History of England, IV. 532. The moving passage on the former horrors of smallpox, À propos of the death of Queen Mary in 1694, is familiar to most, but it may be cited once more in the context of a professional history: “That disease, over which science has since achieved a succession of glorious and beneficent victories, was then the most terrible of all the ministers of death. The havoc of the plague had been far more rapid: but plague had visited our shores only once or twice within living memory; and the smallpox was always present, filling the churchyards with corpses, tormenting with constant fears all whom it had not yet stricken, leaving on those whose lives it spared the hideous traces of its power, turning the babe into a changeling at which the mother shuddered, and making the eyes and cheeks of the betrothed maiden objects of horror to the lover.” It is not given to us all to write like this; but it is possible that the loss of picturesqueness may be balanced by a gain of accuracy and correctness. [850] Kellwaye, u. s., 1593. [851] Dr Richard Holland in 1730 (A Short View of the Smallpox, p. 75), says: “A lady of distinction told me that she and her three sisters had their faces saved in a bad smallpox by wearing light silk masks during the distemper.” [852] As I do not intend to come back to the subject of pockmarked faces, I shall add here that I have found nothing in medical writings of the 18th century, nor in its fiction or memoirs, to show that pockpitting was more than an occasional blemish of the countenance. At that time most had smallpox in infancy or childhood, when the chances of permanent marking would be less. The disappearance of pockpitted faces was discovered long ago. The report of the National Vaccine Board for 1822 says: “We confidently appeal to all who frequent theatres and crowded assemblies to admit that they do not discover in the rising generation any longer that disfigurement of the human face which was obvious everywhere some years since.” The members of this board were probably seniors who remembered the 18th century; and it is quite true that the first quarter of the 19th century was singularly free from smallpox in England except in the epidemic of 1817-19. But the above passage became stereotyped in the reports: exactly the same phrase, appealing to what they all remembered “some years since,” was used in the report for 1825, a year which had more smallpox in London than any since the 18th century, and again in the report for 1837, the first year of an epidemic which caused forty thousand deaths in England and Wales. These stereotyped reminiscences are apt to be as lasting a blemish as the pockholes themselves. [853] Collinson, Hist. of Somerset, III. 226, citing Aubrey’s Miscellanies, 33. [854] Blomefield, Hist. of Norfolk, III. 417. [855] Thoresby, Ducatus Leodiensis, ed. Whitaker. App. p. 151. [856] Cal. Le Fleming MSS. p. 408 (Hist. MSS. Com.). There are also many references to smallpox from 1676 onwards in the letters of the Duke of Rutland at Belvoir, lately calendared for the Historical MSS. Commission. [857] In the London Gazette of 11-14 May, 1674, the Vice-Chancellor and two doctors of medicine of the University of Cambridge contradicted by advertisement a report that smallpox and other infections were prevalent in the university. [858] Marquis of Worcester to the Marchioness, [London] 8 June, 1675 (Beaufort MSS. Hist. MSS. Commis. XII. App. 9, p. 85): “They will have it heere that the smallpox and purple feaver is at the Bath, and the Dutchesse of Portsmouth puts off her journey upon it. The king askt me about it as soon as I came to towne. Pray enquire, and lett me know the truth.” The London Gazette of 17-21 June and 28 June-1 July, 1775, had advertisements “that it hath been certified under the hands of several persons of quality” that Bath and the country adjacent was wholly free of the plague or any other contagious distempers whatsoever. [859] Burnet, History of his own Time, IV. 240. [860] Walter Harris, M.D., De morbis acutis infantum. Ed. of 1720, p. 161. [861] John Cury, M.D., An Essay on Ordinary Fever. Lond. 1743, p. 40. [862] See p. 438. [863] Macaulay hardly realized the anomalous character of the queen’s attack of smallpox. “The physicians,” he says, “contradicted each other and themselves in a way which sufficiently indicates the state of medical science in that day. The disease was measles; it was scarlet fever; it was spotted fever; it was erysipelas.... Radcliffe’s opinion proved to be right.” There had been some doubt on the first appearance of the eruption whether it would turn to measles or smallpox. Sydenham says that it was often difficult to make the diagnosis at that stage, and in the queen’s case the first signs were anomalous as well. Next day, however, the eruption all over the body became “smallpox in its proper and distinct form.” But it did not long remain so; the livid spots, into which the pustules subsided, again raised doubts in the minds of some of the physicians whether it was not measles after all; and there was undoubtedly erysipelas of the face. Harris took the middle course of diagnosing “smallpox and measles mingled,” a name by which the form that we now call haemorrhagic smallpox had been known from the early part of the seventeenth century. It was at this late and ominous stage of the illness that Radcliffe was called in; it is not correct to say, as the historian says, that he was the first to pronounce “the more alarming name of smallpox.” The diagnosis was then a matter of little moment, for the queen was dying. He declared that “her majesty was a dead woman, for it was impossible to do any good in her case when remedies had been given that were so contrary to the nature of her distemper; yet he would endeavour to do all that lay in his power to give her ease.” (Munk’s Roll of the College of Physicians, II. 458.) For some unexplained reason Radcliffe was made to bear the blame of the queen’s death, an accusation which he deserved as little as he deserved the credit given him by the historian of having been the only physician to make the correct diagnosis. Macaulay is equally unfortunate in his remark that smallpox “was then the most terrible of all the ministers of death,” in his comparison of it to plague, and in his rhetoric generally. The haemorrhagic form, of which the queen died, was rare. Dover adds it as a fourth variety, but admits that he had seen only five cases of it. Ferguson, of Aberdeen, as late as 1808, in a paper on measles (Med. and Phys. Journal, XXI. 359), described a haemorrhagic case of smallpox which he once saw, without knowing that it was a recognized variety of smallpox at all. However terrible a minister of death smallpox may sometimes have been, it happened that there was comparatively little of it in London during the period covered by Macaulay’s history; and it certainly did not “fill the churchyards,” as he might have found out by referring to that not altogether recondite source, the bills of mortality. From 1694 to 1700 fevers caused three and a half times more deaths than smallpox. In the year 1696, when “the distress of the common people was severe,” the smallpox deaths in London were 196, or about one-hundredth part of the mortality from all causes. [864] Blomefield, III. 432. The following are two cases from the London epidemic of 1710: June, 15.—“Lord Ashburnham’s brother has the smallpox, and the first, concluding he had had it, went to him, and now himself very ill of them. Doctor Garth, who says none has them twice, examined the servants, and they tell him he was but six days ill then; so he concludes that was not the smallpox.” Cal. Belvoir MSS., II. 190. [865] Lynn, u. s. He recalls a remark made by a writer in 1710 that the severity of that epidemic “was not due to a peculiar state of the air, but to a defect in some of our great physicians, who, being too fully employed, could not give due attendance to all or even to any of their patients through the multiplicity of them: for want of which, and the severity of their injunctions, which hindered others from applying anything in their absence, many persons were lost who might otherwise have been saved with due care.” [866] John Woodward, M.D., The State of Physick and Diseases, with an inquiry into the causes of the late increase of them, but more particularly of the Smallpox; with some considerations on the new practice of purging in that disease. London, 1718. [867] See the account of the Dispensary of the College of Physicians in Warwick Lane, in Munk’s Roll of the Coll. of Phys. II. 499, under the head of Sir Samuel Garth. The dispensary was started in 1687 and languished until 1724. The General Dispensary in Aldersgate Street was opened in 1770 with Dr Hulme as physician, and Dr Lettsom as additional physician in 1773. [868] Letter of 27 March, year not given. Hist. MSS. Com. V. 618. See also the letter of 4 March, 1720, from Mangey to Waller, cited above, p. 450. [869] Dr Philip Rose, of Bedfordbury (“over against a baker, next door to the Old Black Horse, two doors from Chandos Street, St Martin’s parish”), having been called by Lady Wyche to see her butler, pronounced him to be in the smallpox; whereupon the lady informed the physician that “she knew an eminent nurse who had managed above twenty of my Lord Cheyney’s servants in the smallpox, and every one of them had recovered.” Her butler was accordingly carried to this nurse’s house in a by street near Swallow Street. An Essay on the Smallpox. By Philip Rose, M.D. Lond. 1724, p. 18. [870] “An Account or History of the Procuring the Small Pox by Incision, or Inoculation; as it has for some time been practised at Constantinople.” Being the Extract of a Letter from Emanuel Timonius, Oxon. et Patav. M.D., S.R.S., dated at Constantinople, December, 1713. Communicated to Phil. Trans. XXIX. (Jan.-March, 1714) 72, by Dr Woodward, Gresham Professor of Physic. Timoni had been in England in 1703, and had been incorporated a doctor of medicine at Oxford on his Padua degree: hence, perhaps, his correspondence. [871] An Essay on External Remedies, Lond. 1715, p. 153. Kennedy settled in practice in London as an ophthalmic surgeon, and appears to have enjoyed the patronage of Arbuthnot. His other work, Ophthalmographia, or Treatise of the Eye and its Diseases, with appendix on Diseases of the Ear, Lond. 1723, which is dedicated to Arbuthnot, shows a knowledge of optics and of the structure of the parts concerned in operations on the eye. [872] Sloane, Phil. Trans. XLIX. (1756), p. 516, “An Account of Inoculation given to Mr Ranby to be published, anno 1736.” [873] Jacobus Pylarinus, Nova et Tuta Variolas excitandi per Transplantationem Methodus, nuper inventa et in usum tracta, qua rite peracta immunia in posterum praeservantur ab hujusmodi contagio corpora. Venetiis, 1715. Privilege dated 10 Nov., 1715. Reprinted in Phil. Trans. XXIX. (Jan.-March, 1716), p. 393. [874] A Dissertation concerning Inoculation of Smallpox. By W. D[ouglass], Boston, 1730. [875] loc. cit. [876] Published under the initials J. C., M.D. [877] De Peste dissertatio habita Apr. 17, 1721, cui accessit descriptio inoculationis Variolarum, a Gualt. Harris, Lond. 1721. [878] Phil. Trans. XLIX. 104. [879] Sloane, u. s., 1736. [880] Jurin, Account of the Success of Inoculating the Smallpox. Annual reports from 1723 to 1726. [881] Alexander Monro, primus, An Account of the Inoculation of the Smallpox in Scotland. Edin. 1765 (Reply to circular of queries issued by the dean and delegates of the Faculty of Medicine of Paris). [882] Phil. Trans. 1722: papers by Perrot Williams, M.D. (p. 262), and Richard Wright (p. 267). [883] Voyages du Sr. A. de la Motraye. Tome II. La Haye, 1727, Chap. III. p. 98. He saw Timoni at Constantinople on his return from the Caucasus. Timoni used “a three-edged surgeon’s needle,” which is more intelligible than three needles tied together. La Motraye’s travellers’ tales have not enjoyed the best credit. But this of the inoculation in Circassia has been made by Voltaire the sole basis of his spirited account of inoculation as the national practice of that country (Lettres sur les Anglais, Lettre XI. “Sur l’insertion de la petite-vÉrole,” 1727, reprinted as the article “Inoculation” in his Dict. Philosophique, 1764). There has never been a grosser instance of a myth constructed in cold blood. The fable does not need refutation because it is mere assertion, in the manner of a philosophe. But the British ambassador at Constantinople made inquiries concerning the alleged Georgian or “Circassian” practice in 1755, at the instance of Maty, the foreign secretary of the Royal Society (Phil. Trans. XLIX. 104). A Capuchin friar, “a grave sober man” who had returned shortly before from a sixteen years’ residence in Georgia and “gives an account of the virtues and vices, good and evil, of that country with plainness and candour,” solemnly declared to Mr Porter that he never heard of inoculation “at Akalsike, Imiritte or Tiflis,” and was persuaded that it had never been known in the Caucasus. It was impossible that either the public or private practice of inoculation could have been concealed from him, as he went in and out among the people practising physic. He had often attended them in the smallpox, which, he said, was unusually severe there. On the other hand La Motraye says: “I found the Circassians becoming more beautiful as we penetrated into the mountains. As I saw no one marked with the smallpox, it occurred to me to ask if they had any secret to protect them from the ravages which this enemy of beauty makes among all nations. They told me, Yes; and gave me to understand that it was inoculating, or communicating it to those whom they wished to preserve by taking the matter from one who had it and mixing the same with the blood at incisions which they made. On this I resolved to see the operation, if it were possible, and made inquiry in every village that we passed through if there was anyone about to have it done. I soon found an opportunity in a village named Degliad, where I heard that they were going to inoculate a young girl of four or five years old just as we were passing.” This was published fifteen years after, Timoni’s account being given in an Appendix. [884] Travels, IV. 484. See also for Algiers, Lond. Med. Journ. XI. 141. In those cases there was no inoculation by puncture or otherwise. [885] Miscell. Curiosa s. Ephemer. Med.-Phys. Acad. Nat. Curios. Decuria I., An. 2, Obs. CLXV. 1671. D. Thomae Bartholini, “Febris ex Imaginatione.” Scholion by D. Henr. Vollgnad, Vratislaviae practicus. [886] Miscell. Curiosa, l. c. 1677. [887] See Drage, Pyretologia. Lond. 1665. [888] Nuremberg, 1662, p. 529. [889] La Condamine cites Bartholin’s essay on Transplantation as if it really contained the germ of inoculation, which it does not, the single reference in it to smallpox being in a passage where the contagion of that, as well as of plague, syphilis and dysentery, is said to be capable of being turned aside from one to another. [890] Drage (Pyretologia) gives a case where an ague passed from one person to another in the fumes of blood drawn in phlebotomy. He says also (Sicknesses and Diseases from Witchcraft, 1665, p. 21) that a witch could be made to take back a disease by scratching her and drawing blood. [891] De Transplantatione Morborum. Hafniae, 1673, p. 24. [892] De Febribus, u. s. In the plague, a live cock applied to the botch was thought to draw the venom; the cock was then to be buried. Also crusts of hot ryeloaf hung in the room where one had died of plague absorbed the venom. Gabelhover, The Boock of Physicke, Dort, 1599, p. 298. Bread was used for the same purpose in fevers as late as 1765. Muret, MÉm. par la SociÉtÉ Econom. de Berne, 1766. [893] Dissertationes in Inoculationem Variolarum, a J. À Castro, G. Harris, et A. le Duc. Lugd. Bat. 1722. [894] Gardiner’s Triall of Tabacco. London, 1610, fol. 38. [895] Ibid. fol. 43. The City Remembrancer, 1769, a work claiming to be Gideon Harvey’s, says that in the Great Plague of London, 1665, some low persons contracted the French pox of purpose to keep off the infection of plague. [896] Inquiry how to prevent the Smallpox, Chester, 1785:—“No care was taken to prevent the spreading; but on the contrary there seemed to be a general wish that all the children might have it.” Cited from Mr Edwards, surgeon, of Upton, near Chester. Again (Sketch of a Plan, &c., 1793, p. 491), “They neither feared it nor shunned it. Much more frequently, by voluntary and intentional intercourse, they endeavoured to catch the infection.” [897] History of Physic, Lond. 1725-26, II. 288. This was written at a time when the novelty of inoculation had passed off, and may be taken as Freind’s mature opinion. Douglass, of Boston, writing in 1730, implies that Freind’s objections had been overcome; which may mean no more than he says in general: “Yet from repeated tryals the Anti-Inoculators do now acknowledge that inoculation, generally speaking, is a more easy way of undergoing the smallpox.” Condamine, in his French essay of 1755, counts Freind among the original supporters of inoculation, and ridicules the opposition to it. Munk, in citing the title of Wagstaffe’s Letter to Dr Freind showing the danger and uncertainty of Inoculating the Smallpox (London, 1722), omits the words “to Dr Freind,” at the same time describing the pamphlet as “specious.” There seems no reason to doubt that Freind shared Wagstaffe’s views. [898] Hecquet, of Paris, who is supposed to have been the original of Dr Sangrado in ‘Gil Bias,’ gave the following reasons against inoculation (Raisons de doutes contre l’Inoculation): “Its antiquity is not sufficiently ascertained: the operation rests upon false facts: it is unjust, void of art, destitute of rules: ... it doth not prevent the natural smallpox: ... it bears no likeness to physic, and savours strongly of magic.” [899] James Jurin, M.D., Account of the Success of Inoculation, 1724, p. 3. [900] G. Baker, M.D., Oratio Harveiana, 1761, p. 24. [901] Sloane, Phil. Trans. XLIX. 516. [902] They are given in Maitland’s Vindication, 1722, and in one of Jurin’s papers. [903] In regard to the last of them, when Frewen in 1759 was controverting the fancy of Boerhaave and Cheyne that smallpox might be hindered from coming on in a person exposed to contagion by a timely use of the Aethiops mineral, he said there was a fallacy in the evidence, because many persons ordinarily escape smallpox “who had been supposed to be in the greatest danger of taking it.” Huxham also pointed out that a person might be susceptible at one time but not at another, or insusceptible altogether; and the elder Heberden wrote: “Many instances have occurred to me which show that one who had never had the smallpox may safely associate, and even be in the same bed with a variolous patient for the first two or three days of the eruption without any danger of receiving the infection.” William Heberden, sen., M.D., Commentaries on Disease, 1802, p. 437. [904] Dr James Jurin was educated at Cambridge, and elected a fellow of Trinity College. He became a schoolmaster at Newcastle, where he also gave scientific lectures. Coming to London, with a Leyden medical degree, he devoted himself to the Newtonian mathematics and was made one of the secretaries of the Royal Society, Newton being the president. He was one of the original physicians of the new hospital founded in the Borough by Guy, the rich bookseller. He made a fortune by medical practice, and was elected president of the College of Physicians a few weeks before he died. In medicine his name is associated with the inoculation statistics, the idea of which, as well as most of the substance, he got from Nettleton, and with “Jurin’s Lixivium Lithontripticum,” or solvent for the stone, the idea of which belonged originally to Mrs Johanna Stevens, and was sold by her to the State for five thousand pounds on the 16th of June, 1739, the prescriptions having been made public in the London Gazette of 19th June. On the 15th of December, 1744, Jurin was called to see the Earl of Orford (Sir Robert Walpole), who was suffering from stone, either renal or vesical. He began administering his alkaline solvent, “four times stronger than the strongest capital soap-lye,” and during the six weeks of his attendance had given his patient thirty-six ounces of it. Horace Walpole made him angry by arguing on the medicine: “It is of so great violence that it is to split a stone when it arrives at it, and yet it is to do no damage to all the tender intestines through which it must first pass. I told him I thought it was like an admiral going on a secret expedition of war with instructions which are not to be opened till he arrives in such a latitude.” (Letters of Horace Walpole, Cunningham, I. 339.) His services were at length dispensed with, and the earl, whose case was probably hopeless before, died in a few weeks. A war of pamphlets followed, Ranby, the serjeant-surgeon, maintaining that the patient had “died of the lixivium.” Mead, also, expressed himself strongly upon the attempt to use a modification of Mrs Stevens’s solvent. [905] The fatalities are given somewhat fully in Jurin’s annual accounts of the Success of Inoculation, 1723-27. [906] John Wreden, body-surgeon to the Prince of Wales, author of An Essay on the Inoculation of the Smallpox (Lond. 1779), may also be counted among those who gave a more real smallpox. See especially his cases at Hanover. [907] H. Newman, “Way of Proceeding in the Smallpox Inoculation in New England.” Phil. Trans. XXXII. (1722), p. 33. [908] Thomas Nettleton, Letter to Whitaker. Ibid. p. 39. [909] Phil. Trans. l. c. p. 46. A remark follows which is not quite clear: “There is one observation which I have made, tho’ I would not yet lay any great stress upon it, that in families where any have been inoculated, those who have been afterwards seized never had an ill sort of smallpox, but always recovered very well.” [910] Phil. Trans. 1722, p. 209. Dated from Halifax, 16 Dec. 1722. [911] Dr William Douglass to Dr Cadwallader Colden, 28 July, 1721, and 1 May, 1722, in Massachu. Hist. Soc. Collections, Series 4, vol. II. pp. 166-9. Also A Dissertation concerning Inoculation of Smallpox. By W. D[ouglass]. Boston, 1730; and A Practical Essay concerning the Smallpox. By William Douglass, M.D. Boston, 1730. [912] Boylston, Account of the Smallpox inoculated in New England. London, 1726. [913] This was admitted, in a manner, for the great Boston epidemic of 1752, by the Rev. T. Prince, Gent. Magaz. Sept. 1753, p. 414. The epidemic attacked 5545 (in a population of 15,684), and cut off 569. The numbers inoculated were 2124 (including 139 negroes), of which number 30 died and were included in the total of 569. Many of the inoculated, says Prince, were not careful to avoid catching the infection in the natural way; “for I have known some, as soon as inoculated, receive visits from their friends, who had been with the sick of the same disease and ’tis likely carried infection with them; it seems highly probable that the inoculated received the infection from them into their vitals.” It may be supposed that the inoculated who were more careful formed a part of the 1843 who “moved out of town.” More than a third of the population took natural smallpox in some four months (April to July) of 1752, more than a third had had it before, a severe epidemic having occurred in 1730 as well as in 1721. [914] Clinch, Rise and Progress of the Smallpox, with an Appendix to prove that Inoculation is no Security from the Natural Smallpox. 2nd ed. 1725. [915] C. Deering, M.D., An Account of an Improved Method of treating the Smallpox. Nottingham, 1736, p. 27. Woodville appears to accept this case as authentic. [916] Pierce Dod, M.D., F.R.S., Several Cases in Physic. London, 1746. [917] Kirkpatrick, and after him Woodville, treat the alleged experience of Jones as pure fiction. [918] La Condamine, of Paris, an amateur enthusiast for inoculation, did all he could to upset the case. He got his friend Dr Maty, foreign secretary of the Royal Society, to make inquiry through the British ambassador to the Porte. It happened that Angelo Timoni, son of the inoculator, was at that time an interpreter at the British Embassy; he applied to his mother, who re-affirmed the facts as to the inoculation of her child in infancy, and her death by the natural smallpox twenty-four years after. The only defence left was that the inoculation had not been done by Dr Timoni’s own hand. La Condamine, MÉmoires pour servir À l’Histoire de l’Inoculation. 2me MÉmoire. Paris, 1768. [919] Rush to Lettsom, Philadelphia, 17 June, 1808, in Pettigrew’s Memoirs of Lettsom, III. 201. [920] Fuller, in his Exanthematalogia, makes a somewhat late defence of it in 1729. But Richard Holland, who published in 1730 A Short View of the Smallpox, does not mention inoculation, and in the following passage he writes of smallpox as if the extravagant hopes of the preceding years had vanished: “This last season having afforded too many melancholy instances of the fatal effects of the distemper, though under the care and direction of the most eminent physicians, since the disease, notwithstanding the plainness of its symptoms, is become the opprobrium medicinae,” &c. (p. 3). [921] Phil. Trans. Jan.-March, 1722: “The way of proceeding in the Small Pox inoculated in New England.” Communicated by Henry Newman, Esq. of the Middle Temple, p. 33, § 3: “Yet we find the variolous matter fetched from those that have the inoculated smallpox altogether as agreeable and effectual as any other.” [922] An Essay on Inoculation: occasioned by the Smallpox being brought into S. Carolina in the year 1738. By J. Kilpatrick. London, 1743, p. 50. The essay had been “first printed in South Carolina,” the London edition of 1743 having an Appendix dealing historically with the Charleston epidemic of 1738. [923] Thomas Frewen, M.D., The Practice and Theory of Inoculation. London, 1749. [924] J. Kirkpatrick, M.D., Analysis of Inoculation, with a consideration of the most remarkable appearances in the Small Pocks. Lond. 1754. [925] Kirkpatrick, Analysis. [926] La Condamine, MÉmoires pour servir, &c. (DeuxiÈme Discours), 1768, p. 91. It matters little what Lobb may or may not have done. But it does not appear that Boerhaave ever tried to get rid of the eruption of smallpox by means of drugs. In the chapter of his Aphorisms, “De Variolis” (§ 1392) he says that he imagines a specific might be found, in the class of antidotes, to correct and destroy the variolous virus, indicating antimony and mercury as likely agents for the purpose owing to certain physical properties of the medicinal preparations of them. Ruston (An Essay on Inoculation, 3rd ed. 1768) says that Boerhaave, who died in 1738, “never practised it himself; nor seems to have understood the manner in which these medicines operate to produce their salutary effects.” However they were known as the Boerhaavian antidotes to smallpox, and were used in Rhode Island, it is said with great success and as a secret. Ruston used them in England, and discovered by an analysis that Sutton’s secret powders were the same. They seem also to have been used by Cheyne to prevent the development of smallpox in persons who had been exposed to contagion and had presumably taken the contagion. Frewen, in 1759, published a pamphlet to show the improbability of antimony and mercury having any such action, and the fallacy of the claims made for their success. [927] The Duchess gave the following account of her own case (Gent. Magaz. Nov. 1765, p. 495, sent by Gatti to a friend in London): “On the 12th of March, 1763, I was inoculated for the smallpox, and about four or five days afterwards a redness appeared round the orifice, which Mons. Gatti called an inflammation, and assured me was a sign that the smallpox had taken effect: these were the very terms he used. The redness or inflammation increased every day, and about the seventh or eighth day, the wound began to suppurate. There appeared also about the wound six small risings, or pimples, which successively suppurated and disappeared the next day. Mons. Gatti, upon their appearance, again assured me that the smallpox had taken effect. In the afternoon of the eleventh or twelfth day of my inoculation I felt a general uneasiness and emotion, a pain in my head and my back, and about my heart, in consequence of which I went to bed sooner than ordinary. I slept well, however, and rose without any disorder in the morning. These symptoms Mons. Gatti assured me were the forerunners of the eruption. The next day a pretty large rising or pimple appeared in my forehead, turned white, and then died away, leaving a mark which continued many days. “The wound in my arm continued to suppurate seven or eight days, and Mons. Gatti now assured me that I had nothing to fear from the smallpox; and upon this assurance I relied without the least doubt, and continued in perfect confidence of my security till the natural smallpox appeared. I continued very well during the whole time of my inoculation, except one day, as mentioned above, and I went out every day. “Monmorency, D. de Boufflers.” [928] Gibbon’s Autobiography. It was to Dr Maty that Gibbon, in 1759, submitted his French essay on the Study of Literature, having had a fair copy of it transcribed by one of the French prisoners at Petersfield. Of Maty he says: “His reputation was justly founded on the eighteen volumes of the Journal Britannique, which he had supported almost alone, with perseverance and success. This humble though useful labour, which had once been dignified by the genius of Bayle and the learning of Le Clerc, was not disgraced by the taste, the knowledge and the judgment of Maty.” [929] Angelo Gatti, M.D., New Observations on Inoculation. Translated from the French by M. Maty. Lond. 1768. The French edition was published at Brussels in 1767. [930] John Andrew, M.D., The Practice of Inoculation impartially considered. Dated 17 June, 1765, Exeter, p. 61. [931] La Pratique de l’Inoculation. Paris, An. VII. (1798), p 51. [932] Andrew, u. s. p. 53. [933] “I am sorry to have found that this operation has not always secured the patient from having the smallpox afterwards, if the eruptions have been imperfect without maturation. I attended one in a very full smallpox, which ran through all its stages in the usual manner; yet this patient had been inoculated ten years before, and, on the 5th day after inoculation, began to be feverish, with a headache, followed by a slight eruption, which eruption soon went off without coming to suppuration; the place of inoculation had inflamed and remained open ten days, leaving a deep scar, which I saw.” William Heberden, Senr., M.D., Commentaries on Disease (p. 436). This was published in 1802, after the author’s death; but as he was in the height of his practice from 1760 onwards, the case, which is undated, may be taken as illustrating Heberden’s position in the Suttonian controversy. [934] Benj. Chandler, M.D., An Essay on the Present Method of Inoculation. Lond. 1767. [935] Method of Inoculating the Smallpox. Lond. 1766. Baker thought he was “an enemy of improvement and no philosopher,” who stood upon the antecedent improbability of securing the patient by a minimal inoculation such as Sutton used. [936] Giles Watts, M.D., Vindication of the Method of Inoculating. London, 1767. [937] William Bromfeild, Thoughts on the Method of treating Persons Inoculated for the Smallpox. Lond. 1767. He was a Court surgeon and a man of some eminence. Morgagni dedicated one of the books of his De Sedibus et Causis Morborum to him as representing the Royal Society. [938] W. Langton, M.D., Address to the Public on the present Method of Inoculation. London and Salisbury, 1767. Dr Thomas Glass, of Exeter, replied in 1767 to Bromfeild and Langton, in A Letter to Dr Baker on the Means of procuring a Distinct and Favourable Kind of Smallpox. Lond. 1767, and in a Second Letter to Dr Baker, 1767. [939] W. Watson, M.D., An Account of a Series of Experiments instituted with a view of ascertaining the most successful Method of Inoculating the Smallpox. London, 1768. [940] John Mudge, Surgeon at Plymouth, A Dissertation on the Inoculated Smallpox. London, 1777. A copy of this essay was found in the library of Dr Samuel Johnson. The Doctor was a friend of the author’s father, the Rev. Archdeacon Mudge, whose published sermons he has characterized in one of his most amusing balanced sentences of praise qualified with blame. Johnson stood godfather to one of John Mudge’s children. Notes on “Dr Johnson’s Library,” by A. W. Hutton. [941] Edward Jenner, M.D., Inquiry into the Causes and Effects of the Variolae Vaccinae, or Cowpox. Lond. 1798, p. 56. See also his Further Observations on the Cowpox. 1799. [942] Langton cites the following advertisement put out on 18 June, 1767, in his own district by Messrs Slatter and Duke, surgeons, of Ringwood, Hants: “The first objection I shall take notice of is that the disorder being in general so light, it is imagined there is danger of a second infection [i.e. a natural attack]. Whenever this has been supposed to have happened, I am certain the operation has failed, which not being discovered by the operator, proves to me that he was not experienced in the practice; for it may always be determined in four, five, or six days, sometimes sooner; and if there is the least reason to doubt, it is very easy to inoculate a second, third or fourth time, which may be done without the least inconvenience. I have inoculated several patients three or four times for their own satisfaction, having very little or perhaps no eruption.” [943] Mem. Med. Soc. Lond. IV. 114. [944] John Covey, of Basingstoke, 8 May, 1786, in London Medical Journal, VII. p. 180. [945] Address to the Inhabitants of Liverpool on the subject of a General Inoculation for the Smallpox. 1 September, 1781. [946] The account of the London charity is taken from the History of Inoculation in Great Britain (1796) by Woodville, who became physician to it in 1791. [947] Med. Obs. and Inquiries, III. (1767), p. 287. The passage quoted (p. 306, note) is almost exactly in the words of Hufeland long after, with reference to the probable extinction of smallpox by cowpox. See his Journal, X. pt. 2, p. 189. [948] J. C. Lettsom, A Letter to Sir Robert Barker, F.R.S. and G. Stacpoole, Esq. upon General Inoculation. London, 1778. [949] A Plan of the General Inoculating Dispensary, &c. Lond. (no date). [950] T. Dimsdale, Thoughts on General and Partial Inoculation. Lond. 1776. An Introduction to the Plan of the Inoculation Dispensary. 1778. Remarks on Dr Lettsom’s letter to Barker and Stacpoole. 1779. [951] Lettsom, Obs. on Baron Dimsdale’s Remarks, &c. 1779; and other pamphlets on both sides. [952] Clark, Report of the Newcastle Dispensary. 1789. [953] Currie to Haygarth, 28 Nov. 1791, in Sketch of a Plan, etc., pp. 451, 207. [954] J. C. Jenner, “An Account of a General Inoculation at Painswick.” Lond. Med. Journ. VII. 163-8. [955] Gent. Magaz. April, 1788, reported by the Hon. and Rev. Mr Stuart, who was a grandson of Lady Mary Wortley Montagu. [956] Monro, Account of Inoculation in Scotland, 1765; in his Works. Edin. 1781, p. 693. [957] Statistical Account of Scotland. 1791-99, III. 376. [958] Ibid. IV. 130. It was about the year 1782 that the College of Physicians of Edinburgh appointed a committee to inquire into the mode of conducting the gratis inoculations of the poor, which had been tried at Chester, Leeds, Liverpool, &c. in 1781-82. Haygarth, u. s. 1784, p. 207. [959] Ibid. III. 582. [960] Ibid. XX. 502-7. [961] Ibid. XX. 348. Account by Rev. Abercromby Gordon, who gives in a note (p. 349) the following instance of professional zeal: “A surgeon in the north, presuming that self-interest has a stronger hold on man than superstition, has lately opened a policy of insurance for the smallpox! If a subscriber gives him two guineas for inoculating his child, the surgeon in the event of the child’s death pays ten guineas to the parent; for every guinea subscribed, four guineas, for half a guinea, two guineas, and for a crown one guinea.” [962] James Lucas, Lond. Med. Journ. X. 269. [963] Currie to Haygarth, 28 Nov. 1791, in the latter’s Sketch of a Plan, &c. p. 453. [964] A Conscious View of Circumstances and Proceedings respecting Vaccine Inoculation. Bath, 1800. The author was probably James Nooth, senior surgeon to the Bath Hospital, who removed to London and practised in Queen Anne Street, holding the appointment of surgeon to the Duke of Kent. He wrote on cancer of the breast. [965] Tracts on Inoculation. London, 1781. [966] R. Pulteney, M.D., in a letter of 21 June, 1766, to Dr G. Baker, given in his Inquiry into the Merits of a Method of Inoculating the Smallpox. Lond. 1766. [967] Pulteney, “Births, Deaths and Marriages of Blandford Forum, 1733-1772.” Phil. Trans. LXVIII. 615. [968] Pulteney to Baker, App. to Inquiry into the method of Inoculating. 1766; Hutchins, Dorsetshire, I. 217. [969] On 23 July, 1785, the apothecary makes a note in his book: “Some inspectors are not sufficiently careful to send information to the Hospital when children have had the smallpox.” MS. Records. [970] Experiments, &c. 1768. [971] Sir W. Watson, M.D., F.R.S., “On the Putrid Measles of London, 1763 and 1768.” Med. Obs. and Inquiries, IV. 153. [972] Charles Kite, surgeon, Gravesend, “An Account of some anomalous Appearances consequent to Inoculation of Smallpox.” Memoirs Med. Soc. Lond. IV. (1794), p. 114. [973] Fosbroke, Lond. Med. Repository. June, 1819, p. 466. [974] Jenner to James Moore, in Baron’s Life of Jenner, II. 401: “Is not that a precious anecdote for your new work?” See also Court and Private Life of Queen Charlotte (Journals of Mrs Papendiek). Lond. 1887, I. 41, 70, 270. [975] In Baron, u. s. [976] A Conscious View, &c. u. s. [977] Earle, in Jenner’s Further Observations. 1799. [978] T. Adams to Richard Pew, M.D., of Sherborne. Lond. Med. and Phys. Journ. April, 1829. [979] John Forbes, M.D., “Some Account of the Smallpox lately prevalent in Chichester and its vicinity.” Lond. Med. Reposit. Sept. 1822, p. 218. [980] Discourse on Inoculation. Eng. Transl. 1755. [981] A Series of Experiments, &c. 1768. [982] John Haygarth, M.B., Inquiry how to prevent the Smallpox. Chester, 1784, p. 154. [983] History of Inoculation in Britain. Vol. I. London, 1796, p. 33. [984] History of Edinburgh. Edin. 1779, p. 260. [985] W. Hillary, Rational and mechanical Essay on the Smallpox. Lond. 1735. [986] J. Barker, The Nature of Inoculation explained and its Merits stated. London, 1769, p. 33. He taught that a depraved habit, by ill diet, &c., “serves for a nidus wherein the variolous matter rests.” If the variolous matter to be expelled is small, “by reason of natural health, temperance, or the power of preparation,” the disease is of the distinct kind; when large, of the confluent. “And wise indeed must he be who can find out any laws respecting the reception and expulsion of diseases superior on the whole to those which are original.” p. 9. [987] “I have taken an account in this town [Halifax], and some parts of the country, and have procured the same from several other towns hereabouts, where the smallpox has been epidemical this last year, with as much exactness as was possible.” Phil. Trans. XXXII. 211. [988] “A small neighbouring market town.” [989] “More than usually mortal.” [990] “A small market town in Lancashire, including two neighbouring villages.” [991] Account taken “by a person of credit” and sent to Dr Whitaker. Jurin says, more generally: “Taken in several places by a careful enquiry from house to house.” Account, &c. 1724, p. 7. [992] “At Uxbridge and in the neighbourhood, the smallpox having been exceedingly fatal all thereabouts.” [993] Mr Maitland’s Account of Inoculating the Smallpox vindicated. 2nd ed. Lond. 1722. [994] Phil. Trans. XXXIII. 379. “A short account of the Anomalous Epidemic Smallpox beginning at Plymouth in August, 1724, and continuing to the month of June, 1725, By the learned and ingenious Dr Huxham, physician at Plymouth.” [995] The totals are given in Jurin’s Account for 1725. The ages are in the original communication of the Rev. Mr Wasse, among the MS. papers which Jurin had deposited with the Royal Society. [996] The most singular thing in the Aynho experience is that there should have been no cases in infants under two years. It was observed, however, some two generations after this, that smallpox attacked children at the earliest ages in the great towns (Haygarth, Sketch of a Plan, &c., 1793, p. 31), and even in the worst conditions of infancy it has attacked relatively few in the first three months of life. Again, it is nearly as remarkable that there should have been only three cases at Aynho in the third year of life and only four in the fourth. However, the fewness of cases in the five first years of life must be taken as exceptional, even for a village epidemic. If Nettleton, who made the first of these censuses of smallpox epidemics and suggested to Jurin that they should be carried out elsewhere, had given the ages, he would certainly have included some in infancy, for he mentions, in the course of his inoculation experiences, particular cases at nine months, eighteen months, etc. [997] Frewen, Phil. Trans. XXXVII. 108. [998] See above, pp. 485-6 and 490-1. [999] Deering, Nottingham vetus et nova. 1751, pp. 78, 82. He says, in an essay on smallpox (Improved Method of treating Smallpox. Nottingham, 1737) that he treated fifty-one cases in the epidemic of 1736, of which only three proved fatal. [1000] Gent. Magaz. 1741, p. 704. [1001] Alex. Monro, primus, in his Report to the Dean of the Faculty of Medicine of Paris on Inoculation in Scotland, 1765. Reprinted in his Works. Edin. 1781, p. 485. He does not give ages, but an inspection of the burial registers is said to show that they were nearly all under five. [1002] Gent. Magaz. 1742, p. 704. Blomefield gives 1710 and 1731 as great smallpox years in Norwich. [1003] Ibid. 1747, p. 623. The population of Northampton in 1746 was 5136. Price, Revers. Payments. 4th ed. I. 353. [1004] Part of the account extracted from the parish registers by the Rev. Samuel Partridge, F.S.A., vicar of Boston, and sent to Dr George Pearson, who published it in the Report of the Vaccine Pock Institution for 1800-1802. London, 1803, p. 100. [1005] J. C. M’Vail, M.D. in Proc. Philos. Soc. Glasgow, XIII. 1882, p. 381, from a MS. register kept by the session clerk of Kilmarnock, now in the General Register House, Edinburgh. The baptisms and burials have not been extended from the MS. for more years than the table shows. [1006] Statist. Acct. of Scotland. [1007] Sketch of a Plan, &c. 1793, pp. 33-34. [1008] The following is the Ackworth bill given by Price, Phil. Trans. LXV. 443.
[1009] The following are some examples of rural fecundity and health: Middleton, near Manchester, 1763-72, births 1560, deaths 993, average of 4·75 children to a marriage. Tattenhall, near Chester, 1764-73, births 280, deaths 130; Waverton, same county and years, births 193, deaths 84. Stoke Damerel (now the dockyard near Plymouth), in 1733 (in part an influenza-year), births 122, deaths 62, population 3361. Landward townships of Manchester in 1772, births 401, deaths 246. Darwen, in 1774-80, births 508, deaths 233, population 1850. From Papers in Phil. Trans. by Percival and others. [1010] Statist. Acct. of Scot. I. 155. [1011] Hoare’s Wiltshire, VI. 521. There had been a general inoculation to the number of 422, from 13 August, 1751, to February, 1752, just before the epidemic. Brown to Watson, in Phil. Trans. XLVII. 570. [1012] Huxham, Ulcerous Sore-throat, 1757. [1013] Gent. Magaz. 1751, Supplement, p. 577. See also June, 1751, p. 244, and letter of “Devoniensis,” ibid. 1752, p. 159. The subject had been raised by Corbyn Morris in his Observations on the past growth and present state of London, and was discussed, from an actuary’s point of view, by Dodson in Phil. Trans. XLVII. (Jan. 1752), p. 333. [1014] The weekly average deaths for eight weeks of September and October is 30·5 from two to five years and 11·1 from five to ten, which are about half the average at each age period during the maximum prevalence of smallpox. [1015] W. Black, M.D. (Observations Medical and Political on the Smallpox, etc. London, 1781, p. 100) says: “I am induced by various considerations to believe that whatever share of smallpox mortality takes place in London amongst persons turned of twenty years of age, is almost solely confined to the new annual settlers or recruits, who are necessary to repair the waste of London, and the majority of whom arrive in the capital from twenty to forty years of age.” [1016] Maddox, bishop of Worcester, preaching a sermon in 1752 for the Smallpox and Inoculation Charity, enforced his pleading by relating the recent case of “a poor man sick of this distemper, of which his wife lay dead in the same room, with four children around her catching the dreadful infection, but destitute of all relief, till they found some in that too narrow building which now importunately begs your compassionate bounty to enlarge its dimensions.” [1017] The Gent. Magaz. Sept. 1752, p. 402, contains a long letter to refute the very prevailing notion among many people that there is very little occasion for doctors and apothecaries in smallpox, but that a good nurse is all the assistance that is usually wanted. “Whence this notion took its rise I cannot conceive, unless it was from the disease being visible, so that every one who has been at all used to it knows it when they see it.” [1018] This was an argument used in the first writings on Inoculation, so as to prove the real hazard of dying by the natural smallpox. Thus, Maitland in his Vindication of 1722, which Arbuthnot is said to have had a hand in, deducts a quarter of the annual London deaths before he begins to estimate the ratio of smallpox among them, for the reason that eight out of nine infants who die in their first year are “non-entities” qu smallpox, other causes of death having had the priority (p. 19). Jurin used the same argument for the same purpose in his Letter to Caleb Cotesworth, M.D., 1723, p. 11: “It is notorious that great numbers, especially of young children, die of other diseases without ever having the smallpox”; and again, “very young children, or at most not above one or two years of age,” including the stillborn, abortives and overlaid, chrisoms and infants, and those dead of convulsions. “It is true, indeed, that in all probability some small part of these must have gone through the smallpox, and therefore ought not to be deducted out of the account”; but he does deduct 386 in every 1000 London deaths before he estimates the ratio of smallpox deaths, which so comes out 2 in 17. [1019] Percival, Med. Obs. and Inquiries, V. 1776, p. 287; population in Phil. Trans. LXIV. 54. [1020] Haygarth, Inquiry how to prevent the Smallpox, 1784. [1021] Haygarth, Sketch of a plan to exterminate the Natural Smallpox. Lond. 1793, p. 139. [1022] John Heysham, M.D. “An Abridgement of Observations on the Bills of Mortality in Carlisle, 1779-1787,” in Hutchinson’s History of Cumberland. 2 vols. Carlisle, 1794, and separate reprint, Carlisle, 1797; also reprinted in Appendix to Joshua Milne’s Treatise on the Valuation of Annuities. London, 1815, pp. 733-752. [1023] See Loveday’s Diary of a Tour, 1732, p. 120. [1024] Gent. Magaz. 1755, p. 595. In a parish near Glasgow, Eaglesham, eighty children are said to have died of smallpox in 1713. Chambers, Domest. Annals, III. 387. [1025] Robert Watt, M.D., Treatise on the History, Nature and Treatment of Chincough ... to which is subjoined an Inquiry into the relative mortality of the Principal Diseases of Children, and the Numbers who have died under ten years of age in Glasgow during the last thirty years. Glasgow, 1813. [1026] This high mortality was probably caused by the epidemic agues of 1780, which specially affected Lincolnshire. [1027] In 1802 the smallpox epidemic recurred, with 33 deaths. In 1801 there was one death. [1028] Barker and Cheyne, u. s. [1029] James Sims, M.D., Observations on Epidemic Disorders. London, 1773. [1030] Two papers on Fever and Infection, 1763, p. 112. [1031] Medicina Nautica. [1032] Haygarth, Sketch of a Plan, &c., 1793, p. 32. [1033] Gaol at Bury St Edmunds: In the winter of 1773, five died of the smallpox. No apothecary then. Leicester County Gaol: In 1774 three debtors and one felon died of the smallpox. “Of that disease, I was informed, few ever recover in this gaol.” Oxford Castle: In 1773 eleven died of the smallpox. In 1774 that distemper still in the gaol. In 1775 one debtor died of it in May, three debtors and a petty offender in June; three recovered. No infirmary, no straw to lie on. State of the Prisons. [1034] I append Haygarth’s full table of the Chester smallpox epidemic, 1774:
[1035] Isaac Massey, Remarks on Dr Jurin’s last yearly Account of the Success of Inoculation. Lond. 1727, p. 6. Huxham held that children might be “prepared” for the natural smallpox, as it was then the custom to prepare them for the inoculated disease, so that few of them need have it severely: “I am persuaded, if persons regularly prepared were to receive the variolous contagion in a natural way, far the greater part would have them in a mild manner.” On Fevers. 2nd ed. 1750, p. 133. [1036] C. Deering, M.D., Account of an improved Method of treating the Smallpocks. Nottingham, 1737. [1037] John Lamport alias Lampard, u. s. [1038] Obs. on Ship Fever, &c. New ed. Lond. 1789, p. 448. [1039] Thomas Phillips, “Journal of a Voyage,” &c. in Churchill’s Collection of Voyages, VI. 173. [1040] Berkeley’s claim for tar-water in smallpox was a double one, as a preventive or modifier, and as a cure. Of the former he says: “Another reason which recommends tar-water, particularly to infants and children, is the great security it brings against the smallpox to those that drink it, who are observed, either never to take that distemper, or to have it in the gentlest manner.” Further Thoughts on Tar-water, 1752. In his Second Letter to Thomas Prior, Esq. 1746 (in Works. 4 vols. Oxford, 1871, III. 476) he gives the famous case of curing by it:—“the wonderful fact attested by a solemn affidavit of Captain Drape at Liverpool, whereby it appears that, of 170 negroes seized at once by the smallpox on the coast of Guinea one only died, who refused to drink tar-water; and the remaining 169 all recovered, by drinking it, without any other medicine, notwithstanding the heat of the climate and the incommodities of the vessel. A fact so well vouched must, with all unbiassed men, outweigh, &c.” [1041] Prince, Gent. Magaz. Sept. 1753, p. 414. [1042] Walter Lynn, u. s. 1715, ad init. [1043] Reports, &c. 1819. [1044] Whytt, Med. Obs. and Inquiries, II. (1762), p. 187. [1045] Cleghorn, Diseases of Minorca. London (under the years). [1046] Hillary, Changes of the Air, and Epidemical Diseases of Barbados. [1047] Muret, MÉm. par la SociÉtÉ Économique de Berne, 1766. “Population dans le pays de Vaud”: p. 102, “J’ai vu À Veney, la petite vÉrole Être gÉnÉrale dans toute la ville, des centaines d’enfans attaquÉs de cette maladie, et qu’À peine il en mouroit sept ou huit.” [1048] Gent. Magaz. 1753, p. 114. Letter from Sam. Pegge, rector, 17 Feb. 1753. [1049] Haygarth, Phil. Trans. LXV. 87. [1050] Morton, Pyreologia, II. 338: “Et quidem omnes haereditario quasi jure benignis istis variolis tentabantur, quae (Deo favente) eventum secundum habuerunt; nunquam enim quemquam me vel conjugis meae stirpe ortum hoc morbo periisse memini.” The case of hereditary tendency to fatal smallpox is No. 53, p. 470: “Domina Theodosia Tytherleigh, virgo elegans ac formosa, stirpe celeberrima (sed cui hic morbus jure quasi haereditario funestus esse solebat)” &c. She died in a late stage of the disease. [1051] Cal. Coke MSS. (Hist. MSS. Commis.) II. 429. [1052] Rutty, Chronological History of the Weather and Seasons, and prevailing Diseases in Dublin during forty years. London, 1770, under the dates. [1053] Short (Comparative History of the Increase and Decrease of Mankind in England, &c. Lond. 1767) has found somewhere a statement that in 1717 there was “a most fatal continual fever in the West of Scotland, in January and February, and not less fatal confluent smallpox in March and April.” [1054] Lond. Med. Journ. VII. 163. [1055] W. Watson, in Medical Observations and Inquiries by a Society of Physicians in London, IV. (1771), p. 153. Whether the epidemic that preceded the smallpox was measles or scarlatina is a question that was raised by Willan, and is referred to in the chapter on “Scarlatina and Diphtheria.” [1056] Annals of the Lords of Warrington and Bewsey from 1587. By W. Beamont. Manchester, 1873, p. xix. [1057] John Aikin, M.D., Descriptions of the Country from thirty to forty Miles around Manchester. London, 1795, p. 302. [1058] Taken out of the register by Aikin at the request of Dr Richard Price, and published by the latter in the 4th ed. of his Obs. on Reversionary Payments. Lond. 1783, II. 5, 100. [1059] Arthur Young, Six Months Tour through the North of England. 4 vols. London, 1770-71, III. 163. [1060] Percival, Phil. Trans. LXV. 328. [1061] Beamont, u. s. p. 116-17. [1062] Ferriar, Med. Obs. and Reflections. [1063] Price, Reversionary Payments. 4th ed. II. [1064] Aikin, Phil. Trans. LXIV. (1774), p. 438; Haygarth, ibid. LXVIII. 131. [1065] “Almost ended at the winter solstice, only 19 remaining ill in January, 1775.” [1066] Percival, for Warrington, Med. Obs. and Inquiries, V. (1776), p. 272 (information from Arkin); Haygarth, for Chester, Phil. Trans. LXVIII. 150. Haygarth (Sketch of a Plan, &c. p. 141) gives the following table of the smallpox deaths and the deaths from all causes at several ages of children up to ten years at Chester from 1772 to 1777 inclusive:
[1067] Sketch of a plan, &c. p. 31. [1068] Heysham, Obs. on Bills of Mortality in Carlisle, 1779-1787. Carlisle, 1797. Reprinted from App. Vol. II. of Hutchinson’s Cumberland. [1069] Lucas, Lond. Med. Journ. X. 260: “The number of those who were still uninfected was found on a survey to be 700.” [1070] Dr Henry, of Manchester, to Haygarth, 20 March, 1789, in the latter’s Sketch of a Plan, &c. p. 369: “In large and populous places such as Manchester, the smallpox almost always exists in some parts of the town. I have known it strongly epidemic in one part without any appearance of it in others.... At present it is prevalent and fatal in the outskirts, but very rarely occurs in the interior parts of the town.” [1071] “Most of them [Jenner’s colleagues] had met with cases in which those who were supposed to have had cowpox had subsequently been affected with smallpox.” Baron, Life of Jenner, I. 48. [1072] Haygarth to Worthington, 15 April, 1794, in Baron’s Life of Jenner, I. 134. [1073] See the cases and remarks by John Hunter, Sir W. Watson, Lettsom and others. [1074] Joseph Adams, Observations on Morbid Poisons, Phagedaena and Cancer. 1st ed. Lond. 1795. Preface, 31 March. [1075] I have collected all the scattered references in Jenner’s writings to cowpox in the cow or in infected milkers in my Natural History of Cowpox and Vaccinal Syphilis. London, 1887, pp. 53-57. [1076] G. Pearson, Inquiry concerning the History of Cowpox. Lond. 1798. [1077] Beddoes’ Contributions to Physical and Medical Knowledge. Bristol, 1799, p. 387. [1078] See my Natural History of Cowpox, &c. u. s. 1887. The most systematic descriptions, both for cows and milkers, are by Ceely, in Trans. Provinc. Med. and Surg. Assocn. VIII. (1840) and X. (1842). Professor E. M. Crookshank has reproduced these valuable memoirs, with the coloured plates, in his History and Pathology of Vaccination. 2 vols. London, 1889. The plates are in vol. I., the memoirs in vol. II. Crookshank’s volumes, which are a convenient repertory of the more important earlier writings on cowpox, contain also the author’s original observations (with plates), of cowpox in Wiltshire in 1887-88. [1079] In my essay of 1887 (u. s.) I maintained, as an original opinion, that the true affinity of cowpox was to the great pox of man, and that the occasional cases of so-called vaccinal syphilis were not due to the contamination of cowpox with venereal virus but to inherent (although mostly latent) properties of the cowpox virus itself. This opinion was at first received with incredulity, but is now looked upon with more favour. See Hutchinson, Archives of Surgery, Oct. 1889, and Jan. 1891, p. 215. The concessions hitherto made are only for cases that have arisen since my book was published, such as the case at the Leeds Infirmary in 1889. I believe that my explanation of vaccinal “syphilis” will at length be accepted for all cases, past or future. [1080] An Inquiry, &c. 1798. “Remarks on the term Variolae Vaccinae.” [1081] That Dr Jenner foresaw this line of proof, and dismissed it as irrelevant, is made clear by G. C. Jenner, Monthly Magazine, 1799, p. 671, in reply to Dr Turton, of Swansea: “It is possible that variolous virus inserted into the nipples of a cow, might produce inflammation and suppuration, and that matter from such a source might produce some local affection on the human subject by inoculation. But all this tends only to show, what was well known before, that virus taken from one ulcer is capable of producing another by its being inserted into any other part of the body.” [1082] Jenner, Further Observations on the Variolae Vaccinae, 1799. [1083] Thornton, in Beddoes’ Contributions to Physical and Medical Knowledge. Bristol, 1799. [1084] Hughes, Med. and Phys. Journ. I. (1799), p. 318. Many other tests, English and foreign, are detailed in my book, Jenner and Vaccination. London, 1889, for which see the Index under “test.” [1085] Woodville tabulated 511 cases of applicants for inoculation at the hospital in whom cowpox matter was used, giving “the number of pustules” opposite the name of each; 90 had from a thousand to a hundred pustules, 215 had less than one hundred. William Woodville, M.D., Reports of a Series of Inoculations for the Variolae Vaccinae or Cowpox; with remarks on this disease considered as a substitute for the Smallpox. London, 1799. In a subsequent letter (Med. Phys. Journ. V., Dec. 1800), he thus explained the occurrence of smallpox among those recently inoculated with cowpox: “If a person who has been exposed to the contagion of smallpox for four or five days be then inoculated for this disease, the inoculation prevents the effects of the contagion, and the inoculated smallpox is produced. But if the vaccine inoculation be employed in a case thus circumstanced, the smallpox is not prevented, although the tumour produced by the cowpox inoculation advance to maturation. It was not before the commencement of the present year [1800], that I ascertained that the cowpox had not the power of superseding the smallpox. For, though from the first trials that I made of the new inoculation it appeared that these diseases, as produced in the same subject from inoculation, did not interrupt the progress of each other; yet as the casual does not act in the same manner as the inoculated smallpox, and may be anticipated by the latter, I thought it still probable that the cowpock infection might have a similar effect. Numerous facts have, however, proved this opinion to be unfounded, and that the variolous effluvia, even after the vaccine inoculation has made a considerable progress, have in several instances occasioned an eruption resembling that of smallpox.” [1086] European Magazine, XLIII. 137. [1087] Bateman, u. s. 1819, Aug.-Nov. 1807: “In a court adjoining Shoe Lane, in the course of one month, twenty-eight persons had died of smallpox.” Autumn, 1812: “In one small court in Shoe Lane, seventeen have lately been cut off by this variolous plague.” Also in the summer of 1812, “perhaps universally through the metropolis.” [1088] Extracted from the Annual Reports of the Dispensary. [1089] Heysham to Joshua Milne, in the latter’s Treatise on the Valuation of Annuities. London, 1815. App. p. 755. [1090] Cross, 1819, u. i. p. 2. [1091] Most of these were brought to light by inquiries upon the alleged failures of cowpox to avert the epidemic. The serial numbers of the Medical Observer contain frequent references to them. [1092] Letter to Joshua Dixon, in Memoirs, III. 368. [1093] Bateman, Edin. Med. Surg. Journ. VIII. 515. [1094] C. Stuart, ibid. VIII. 380. [1095] Rigby, ibid. X. 120. [1096] Joshua Dixon, The Literary Life of William Brownrigg, M.D. Whitehaven, 1801, pp. 238-9. [1097] Haygarth says: “With us in Chester, smallpox is seldom heard of except in the bills of mortality. There its devastation appears dreadful indeed.” Sketch of a Plan, &c. 1793, p. 491. [1098] Barker and Cheyne, Account of the Fever, &c. 2 vols. 1821. I. 92. [1099] Francis Rogan, M.D., Obs. on the Condition of the Middle and Lower Classes in the North of Ireland. Lond. 1819, p. 17. He proceeds to say:—“The numerous cases, which came to my knowledge, of children in the neighbouring towns who had taken smallpox, after having been vaccinated by medical practitioners of high respectability, led me to pay particular attention to those whom I myself inoculated [with cowpox]; and, although they were numerous both in private practice and at the Dispensary, not one instance occurred among them.” It comes out however that he did not keep them long in sight; he saw them on the 7th day after vaccination, and again on the 11th; and as they were meanwhile almost daily exposed to contagion, without catching it, he concluded that his own cases never would do so. [1100] W. L. Kidd. “A concise Account of the Typhus Fever at present prevalent in Ireland, as it presented itself to the Author in one of the towns in the North of that country.” Edin. Med. and Surg. Journ. XIV. (1817), 144. He goes on: “A great number of those attacked were reported to have been formerly vaccinated. At Londonderry, in particular, great numbers who were said to have undergone vaccination were the subjects of smallpox; and, whether justly or not, vaccination has in that part of the country lost much of its credit as a preservative against smallpox.” [1101] Redhead (dated Ulverston, 3 July, 1816) in Med. and Phys. Journ. Jan. 1817, p. 3. [1102] James Black, “On Anomalous Smallpox.” Ed. Med. and Surg. Journ. Jan. 1819, p. 39. [1103] Henry Dewar, M.D., Account of an Epidemic of Smallpox which occurred in Cupar in Fife in the Spring of 1817. Lond. 1818. [1104] P. Mudie, M.D. to Thomson, 18 Oct. 1818: “Many of the cases occurring after vaccination so much resembled smallpox that, if my mind had not been prejudiced against the possibility of such an occurrence, I should have pronounced the eruption to have been of a variolous nature”—which, of course, it was. [1105] Thomson, Account of the Varioloid Epidemic in Scotland, &c. Edin. 1820. [1106] In Thomson, u. s. [1107] Thomas Bent, M.D., “Observations on an Epidemic Varioloid Disease lately witnessed in the County of Derby.” Med. and Phys. Journal, Dec. 1818, p. 457. One Jennerian, Dr Pew, of Sherborne, adopted an arrogant tone towards Bent (Ibid. April, 1819, and farther correspondence). Jenner employed Fosbroke, of Berkeley, son of his friend and neighbour the antiquary Fosbroke, to traverse the whole case of the epidemic of 1817-19, in a long paper in the Medical Repository for June, 1819. The object of the paper appears to be to confuse the issues with a view to a verdict of non liquet. The Edinburgh Review thought Thomson’s book on the epidemic of 1817-19 important enough for an article, which has been attributed to Jeffrey. The article pronounced vaccination to be a very great blessing to mankind, but not a complete protection. This was not enough for Jenner, who wrote of the article: “It will do incalculable mischief: I put it down at 100,000 deaths at least.” [1108] John Green Cross, A History of the Variolous Epidemic which occurred in Norwich in the year 1819. Lond. 1820. [1109] Cross, u. s. Appendix. [1110] W. Shearman, M.D., “Cases illustrating the Nature of Variolous Contagion and the Modifying Influence of Vaccine Inoculation.” Lond. Med. Repos. Dec. 1822. Case of a mother, with good vaccine marks, attacked with smallpox, which became dry and horny about the fifth day; case of her child, in which the eruption ran the full course of pustules, but also a mild case. [1111] Lond. Med. and Phys. Journ. May, 1818, p. 488: “By Mr Field’s report of Christ’s Hospital smallpox in a mild form has been frequent post vaccinationem.” [1112] Thomas Stone, F.R.C.S. “Table of Deaths from Smallpox in Christ’s Hospital, 1750 to 1850, with remarks,” in Appendix to Papers on the History and Practice of Vaccination: Parl. Papers, 1857. In 1761 there were four deaths from smallpox. For ten years, 1775 to 1784, there were none. In some other years of the latter half of the 18th century there were one or two deaths from that cause. There must have been some special reason for the four deaths in 1761. According to Massey (supra, p. 545), the apothecary in the beginning of the 18th century, not one death happened in forty attacks, the ages from five to eighteen being the most favourable of all for smallpox to fall in. In the present century scarlatina has displaced smallpox as an infectious cause of death in that school as in others. The deaths from scarlatina at Christ’s Hospital during the six years 1851-56 were nine. [1113] John Forbes, M.D., “Some Account of the Smallpox lately prevalent in Chichester and its Vicinity.” Lond. Med. Repos. Sept. 1822, p. 208. [1114] H. W. Carter, M.D., in Lond. Med. Repos. Oct. 1824, p. 267: “The cases which came to light of smallpox after vaccination were unfortunately numerous; some, it must be confessed, were exceedingly severe; others were exaggerated.” [1115] The vaccinations are given in Cleland’s Rise and Progress of the City of Glasgow. Glasgow, 1820. The smallpox deaths from 1813 to 1819 are given, on Cleland’s authority, in the Edin. Med. and Surg. Journal, XXVI. p. 177. [1116] R. Watt, M.D., Appendix to Treatise on Chincough. [1117] John Roberton, Obs. on the Mortality, &c. of Children. Lond. 1827, p. 59, note. [1118] Gregory, Report of the London Smallpox Hospital for the year 1825. Cited in the Med. and Phys. Journ. Feb. 1826, p. 176. [1119] Cross, u. s. [1120] Carter, u. s. [1121] T. Proudfoot, M.D., Ed. Med. and Surg. Journ. July, 1822. [1122] C. Stuart, u. s. [1123] Dr Stokes, of Chesterfield, Med. and Phys. Journ. v. 17. [1124] Benjamin Moseley, M.D., A Review of the Report of the Royal College of Physicians on Vaccination. 1808, p. 11. Jenner writing to James Moore, 18 Nov. 1812 (in Baron, II. 383), enumerates his various grievances against Pearson, “and finally, finding all tricking useless, his insinuations that vaccination is good for nothing.” [1125] The equality of the two methods in this respect comes out incidentally in two reports of the Whitehaven Dispensary. In the report for 1796, when smallpox matter was in use, it is said that “173 were inoculated, all of whom, soliciting little medical assistance, recovered.” In 1801, when cowpox matter had been substituted in every case, the same phrase is used: “We seldom find any medical assistance required in this disease.” [1126] The Beneficial Effects of Inoculation. Oxford University Prize Poem. Oxford, 1807. It seems probable that this was the “Oxford copy of verses on the two Suttons” that Coleridge (Biographia Literaria (1817), Pickering’s ed. II. 89) professed to quote from in the following passage; at least it would be remarkable if there had been printed another Oxford poem on the same subject and in the same manner: “As little difficulty do we find in excluding from the honours of unaffected warmth and elevation the madness prepense of pseudopoesy, or the startling hysteric of weakness over-exerting itself, which bursts on the unprepared reader in sundry odes and apostrophes to abstract terms. Such are the Odes to Jealousy, to Hope, to Oblivion, and the like, in Dodsley’s collection and the magazines of the day, which seldom fail to remind me of an Oxford copy of verses on the two Suttons, commencing with ‘Inoculation, heavenly maid! descend!’” It appears that Coleridge himself contemplated a poem on Cowpox Inoculation, which was to have exemplified what poetry should be, just as the 18th century Oxford poem on Smallpox Inoculation exemplified what poetry should not be. It was clearly more than the difference ’twixt tweedle-dum and tweedle-dee. Writing to Dr Jenner on 27 Sept. 1811, from 7, Portland-place, Hammersmith, he said: “Dear Sir, I take the liberty of intruding on your time, first, to ask you where and in what publication I shall find the best and fullest history of the vaccine matter as the preventive of the smallpox. I mean the year in which the thought first suggested itself to you (and surely no honest heart would suspect me of the baseness of flattery if I had said, inspired into you by the All-preserver, as a counterpoise to the crushing weight of this unexampled war), and the progress of its realization to the present day. My motives are twofold: first and principally, the time is now come when the ‘Courier’ ... is open and prepared for a series of essays on this subject; and the only painful thought that will mingle with the pleasure with which I shall write them is, that it should be at this day, and in this the native country of the discoverer and the discovery, be even expedient to write at all on the subject. My second motive is more selfish. I have planned a poem on this theme, which after long deliberation, I have convinced myself is capable in the highest degree of being poetically treated, according to our divine bard’s [Milton’s] own definition of poetry, as ‘simple, sensuous, (i.e. appealing to the senses by imagery, sweetness of sound, &c.) and impassioned, &c.’” The Life of Edward Jenner, M.D. By John Baron, M.D. 2 vols. II. 175. [1127] Edin. Med. and Surg. Journ. I. 507. [1128] Jenner to James Moore, 26 Feb. 1810, in Baron, II. 367. [1129] Walker to Lettsom, 1 Sept. 1813, in Pettigrew’s Memoirs of Lettsom. Lond. 1817, III. 350. [1130] Dr Smith to Dr Monro, Dunse, 2 June, 1818, in Monro’s Obs. on the different kinds of Smallpox, 1818. There appears to have been some reluctance to face the facts. “Though I have seen,” says Smith, “a multitude of cases in which smallpox has in every possible shape taken place after vaccination, I feel myself placed in the painful situation [why painful?] of bringing forward many facts to which gentlemen of the first eminence in the profession will probably give little or no credit.” [1131] Lond. Med. Repository. Sept. 1822. [1132] J. J. Cribb, Smallpox and Cowpox. Cambridge, 1825. [1133] Ibid. Letter of Rev. R. Marks, of Great Missenden, 6 May, 1824: “The summer I came here the smallpox was introduced, and as the weather was very hot, and the confluent sort was what appeared, the people began to die almost as fast as they took the plague. Great prejudice prevailed against vaccination, in consequence of the parish having some years ago been vaccinated by a gentleman who knew nothing of the matter, and contaminated the people with decomposed virus, when it was good for nothing but to make ulcers and produced very wretched arms, and left them all liable to smallpox, which they were all inoculated for the same year.” This clergyman subsequently vaccinated 500 cases, and the parish surgeon 300: “and here,” says the former, “I had the happiness of seeing the plague and destruction of a most horrid smallpox completely stopped.” [1134] Robert Ferguson, M.D. A Letter to Sir Henry Halford, proposing a method of Inoculating the Smallpox, which deprives it of all its Danger, but preserves all its Power of Preventing a Second Attack. London, 1825. [1135] John Roberton, Observations on the Mortality and Physical Management of Children. London, 1827, p. 59, note. [1136] J. Dalton, “Smallpox as it prevailed at Bury St Edmunds in 1825.” Lond. Med. and Phys. Journ. May, 1827, p. 406. [1137] Cribb, u. s. [1138] “Observation on Smallpox as it has occurred in London in 1825.” Med. and Phys. Journ. Feb. 1826, p. 117. [1139] Med. and Phys. Journ. 1826, p. 122. “The general voice of the public satisfactorily showed that the upper ranks of society suffered during the past year from smallpox much less than the lower.” [1140] Gregory, Report on the Smallpox Hospital, 4 Dec. 1825. [1141] Farr, in the First Report of the Registrar-General (1839, p. 100), said: “It may be safely asserted that the parish clerks registered little more than half the deaths that occurred within the limits of the London bills of mortality.” Outside the limits of the bills there were large parishes, such as St Pancras, Marylebone, Kensington and Chelsea, which had large mortalities from smallpox in the first years of registration. [1142] Tables in Murchison’s Continued Fevers of Great Britain. [1143] Med. Chir. Trans, XXIV. 15. His other papers are: “Cursory Remarks on Smallpox as it occurs subsequent to Vaccination,” ibid. XII. 324; and “Notices of the Occurrences at the Smallpox Hospital during the year 1838,” ibid. XXII. 95. He contributed the treatise on Smallpox to Tweedie’s Library of Medicine, I. 1840, and indicated his final opinions (which are interesting) in his Lectures on the Eruptive Fevers, 1843. [1144] Kenrick Watson, “Medical Topography of Stourport and Kidderminster.” Trans. Prov. Med. and Surg. Assoc. II. 195. [1145] John Roberton, “On the Increasing Prevalence of Smallpox after Vaccination.” Lond. Med. Gaz. 9 Feb. 1839, p. 711. Roberton had been a warm supporter of the Jennerian method from as early a date as 1808, when he was resident in Edinburgh, and again in his book on The Mortality of Children, in 1827. The above cited paper is somewhat satirical, the disappointing facts of it being referred to the Island of Barataria. His conclusions are (p. 713): (1) “It is not fact, but conjecture, that the protective power of cowpox gradually ceases in the human system. (2) It is not fact, but conjecture, that a person successfully re-vaccinated is less liable to smallpox than he was before. (3) To affirm that, when re-vaccination fails in individuals, they are thereby proven to be secure from smallpox, is conjecture.” [1146] Cowan, “On the Mortality of Children in Glasgow,” Glas. Med. Journ. V. (1831), p. 358, does not give Cleland’s figures, but says: “No bills of mortality except those for the Royalty in the Glasgow Courier are in existence for the period from 1812 to 1821”; and again: “Finding that the suburbs were excluded, and the Calton being the burying-place in which the greatest number of children are interred, I thought it needless to insert any tabular view of the deaths by measles since the date of Dr Watt’s tables.” Watt could have made no tables if he had not gone direct to the sixteen MS. volumes of burial registers, including those of the Calton. [1147] J. C. Steele, Glas. Med. Journ. N. S. I. 60: “From 1812 to 1835 it is much to be regretted that no record of the deaths from smallpox has been kept for even a limited period.” [1148] Glas. Med. Journ. I. 105: “There exists at present among the poorer classes an increasing carelessness and aversion to vaccination, from a belief that it does not afford adequate protection from the varioloid disease.” [1149] Andrew Buchanan, M.D. “Present Condition of the Poor in Glasgow.” Glasg. Med. Journ. III. (1830), 437. [1150] Chalmers had been urging the repeal of the Corn Law since 1819. In a letter to Wilberforce, Glasgow, 15 Dec. 1819, he says: “From my extensive mingling with the people, I am quite confident in affirming the power of another expedient to be such that it would operate with all the quickness and effect of a charm in lulling their agitated spirits—I mean the repeal of the Corn Bill.” Hanna’s Memoirs of Dr Chalmers, 1850, II. 250. [1151] J. Orgill, “Obs. on the Measles and Smallpox that prevailed epidemically in Stranraer, in the autumn of 1829.” Glasg. Med. Journ. IV. 351. [1152] McDerment, ibid. IV. 201. [1153] Howison, ibid. V. 256-7. [1154] J. C. Steele, Glasg. Med. Journ. N. S. I. 59. [1155] Eleventh detailed Report of the Regr.-Genl. for Scotland, 1865, p. xxxix. The Report says that vaccination was general during the above period, although there was no Vaccination Act for Scotland (until 1864). This was familiar knowledge in Scotland, so much so that the necessity for a compulsory law, on the English model, was not quite obvious in the medical circles of Edinburgh. See Christison’s address to the Social Science Association at Edinburgh in 1863 (p. 106). In my own recollection of Aberdeenshire, the vaccination of infants was as little neglected as their baptism; the law made no real difference. [1156] “An Enquiry into the Mortality among the Poor in the City of Limerick.” Journ. Statist. Soc. Jan. 1841, III. 316. [1157] The Census of Ireland, 1841. Parl. Papers, 1843. Report on the Tables of Deaths, by W. R. Wilde. [1158] From the Second Report of the Registrar-General, Lond. 1840, p. 180. [1159] 1840.
[1160] Douglass to Colden, 1 May, 1722, in Massach. Hist. Soc. Collect. Series 4, vol. II. p. 169. [1161] Philip Rose, M.D., Essays on the Smallpox. London, 1724, p. 76. [1162] Rev. R. Houlton, App. to A Sermon in Defence of Inoculation, Chelmsford, 1767, p. 59: “For, had the indictment been found, he would have assuredly nonsuited his enemies, and have proved beyond a possibility of doubt that he never brought into Chelmsford a patient who was capable of infecting a bystander, notwithstanding such person would convey infection by inoculation. However paradoxical this may seem, it is truth, and would have been proved to a demonstration.” [1163] Darwin, Animals and Plants under Domestication, II. 356: “From these facts we clearly see that the quantity of the peculiar formative matter which is contained within the spermatozoa and pollen-grains is an all-important element in the act of fertilization, not only for the full development of the seed, but for the vigour of the plant produced from such seed.” [1164] J. C. Lettsom, M.D., A Letter to Sir Robert Barker, F.R.S. and G. Stackpoole, Esq. upon General Inoculation. London, 1778, p. 8. [1165] W. Black, M.D., Observations Medical and Political on the Smallpox, etc. London, 1781, p. 103. [1166] “But, in the cowpox, no pustules appear, nor does it seem possible for the contagious matter to produce the disease from effluvia, or by any other means than contact, and that probably not simply between the virus and the cuticle; so that a single individual in a family might at any time receive it without the risk of infecting the rest, or of spreading a distemper that fills a country with terror.” [1167] Parliamentary Papers, 1807, 8th July. [1168] Bateman, Reports etc. 1819, p. 102. The principle of the Common Law on which the judgment rested was, “Sic utere tuo ut alienum non laedas.” [1169] Joseph Adams, An Inquiry into the Laws of Epidemics, with Remarks on the Plans lately proposed for Exterminating the Smallpox. London, 1809. The Edin. Med. and Surg. Journal (VI. 231), in a long review of this essay, declared that Adams was inconsistent in reaffirming his old faith in cowpox and at the same time demanding liberty for the inoculators. [1170] J. C. Steele, M.D., “Increase of Smallpox in Glasgow.” Glas. Med. Journ. N. S. I. 59. The Paris figures are cited from the Annuaire pour l’an 1852-53. [1171] I do not, of course, answer for the correctness of Gregory’s statements. [1172] Lancet, 12 Dec. 1838. [1173] 409 of these in Sheffield. [1174] There are two notable exceptions, marked †, Lancashire and Yorkshire; but, in regard to their higher mortality from smallpox in 1837-40, it should be kept in mind that they were the chief scenes of the great distress among the working class in those years, the same causes which produced an enormous mortality from typhus fever in adults having tended to increase the fatality of smallpox among the children. [1175] In the first universal and very fatal epidemic of measles, that of 1808, a good many adults, who had not had measles before, were attacked. See the chapter on Measles. [1176] The accounts by Fothergill, Wall and others, of the malignant sore-throat with scarlet rash about 1740 give prominence to cases in early manhood or womanhood. [1177] Supplement (Decennial) to the 45th Report of the Regr.-Genl. 1885, p. cxii. [1178] The figures for 1721 are cited above (p. 485) from Douglass and others. Those for 1752 are given in the Gent. Magaz. 1753, Sept., p. 413, as “collected from the Accounts of the Overseers in the Twelve several Wards,” and sent by the Rev. T. Prince. [1179] Supplementary Report of the Registrar-General, 1883. The mean death rate per 1000 living, for the period 1838-82, has been 71·0 males, and 61·2 females under five years of age; but as late as 1878 the annual average was the mean of the period, namely 71·2 males and 61·1 females. [1180] Lettsom (Gent. Magaz. 1804, Aug. p. 701), in a preface to Neild’s papers on the state of the prisons, estimated that 40,000 lives might be saved every year in England by preventing infectious fevers, “for in this metropolis my respectable friend Thomas Bernard, Esq., whose caution and accuracy no person will doubt, calculates the number of victims at 3000 each year [doubtless from the London Bills of Mortality].... If to this pleasing view we add the preservation of 48,000 victims to the smallpox, which may now be preferred by the cowpox, we have in our power to possess the sublime contemplation of forming a saving fund of human life of nearly 88,000 persons annually in this empire, by the exercise of reason, philanthropy and judicious policy.” [1181] Duvillard, Tableaux etc. Paris, 1806. [1182] Essay on the Principle of Population. Bk. IV. chap. 5. [1183] Robert Watt, M.D. Treatise on Chincough, with Inquiry into the Relative Mortality of the Diseases of Children in Glasgow. Glasgow, 1813. [1184] John Graunt, Natural and Political Observations upon the Bills of Mortality, London, 1662, says: “The original entries in the Hall books were as exact in the very first year [he probably means 1629, which is the first year of his own extracts from them, but the classification of deaths began in 1604] as to all particulars, as now; and the specifying of casualties and diseases was probably more.” The searchers, he explains, were in many cases able to report the opinions of the physicians, receiving the same from the friends of the deceased; while for certain causes of death, among which he includes smallpox, “their own senses are sufficient.” [1185] Cal. Coke MSS. (Hist. MSS. Commis.) I. 21 June, 1628. [1186] Sutherland Letters, in Rep. Hist. MSS. Com. V. 152. [1187] Cal. State Papers, Domestic. Charles II. s. d. It appears from the Pyretologia by Drage, of Hitchin (1665), that the natural history of measles must have been familiar, for he mentions that its incubation period was from fourteen to fifteen days: p. 20. [1188] Obs. Med. 3rd ed. (1675), Bk. IV. chap. 5. [1189] Sydenham, Obs. Med. 1675, v. 3. “Morbilli anni 1674.” It entered almost every household, as on the last occasion, attacking infants more especially. It had some points of difference from the measles of 1670. The rash was less uniformly on the fourth day, now sooner, now later; it would come on the arms or trunk before the face; nor was it followed by the branny powdering which was as obvious in the measles of 1670 as it was usual to see it after scarlatina. Along with these anomalies of the rash, the consecutive fever and peripneumonia were also more severe, and a more frequent cause of death. But in the principal characters of measles the disease of 1674 was the same as that of 1670, and called for no fresh description. Among Sydenham’s patients were the children of the Countess of Salisbury, who all took measles in turn, and all passed through the attack and its sequelae without danger, under a particular regimen which is detailed. It is of great interest to see how this season of anomalous measles looks in the weekly bills, as in the above table. [1190] Richard Morton, M.D. Pyretologia. 2 vols. Lond. 1692-94, I. 427. He places it in the year 1672 and in the six months of autumn and winter; and in another place (II. 71), where he cites clinical cases, he again gives the year 1672 as that in which measles “epidemice Londini publice grassabantur.” He compares the epidemic to a pestis mitior, and says that the disease had never been epidemic again to the date of his writing (1692-94). It is tolerably clear that, in writing twenty years after, he had forgotten the year and even the season—not the only error in dates in his work. Sydenham’s account of the great measles epidemic of spring and summer, 1674, was published the year after, and is exactly borne out by the weekly bills of mortality. Morton’s obvious mistake of the date is the subject of a refutation four pages long by Thomas Dickson, M.D., F.R.S., physician to the London Hospital, in Med. Obs. and Inquiries, IV. (1771), p. 266. [1191] Fothergill (Gentleman’s Magazine, Dec. 1751) says, in a criticism of the Bills of Mortality: “If the body is emaciated, which may happen even from an acute fever, ’tis enough for them to place it to the article of consumption.” And of course they would do so the more readily if the acute fever, say measles, were past, and its sequelae had been the cause of death. Referring to Kidderminster in 1756, Johnstone says: “Measles at this time went through our town and neighbourhood: vast numbers of children died tabid.” It is to be remarked that the fever column is augmented but little during the measles of 1674, a fact which shows that the inflammatory causes of death, such as capillary bronchitis and pneumonia (specially recorded by Sydenham for this epidemic), were more apt to be entered under “consumption” than under “fevers.” [1192] See Watson’s account of smallpox following measles at the Foundling Hospital, supra, p. 550. [1193] It may have been this high mortality that Dover had in mind when he wrote, in 1733: “I do not remember I ever heard of anyone’s dying of this disease [measles] till about twenty-five years since; but of late, by the help of Gascoin’s powder and bezoartic bolusses, together with blisters and a hot regimen, the blood is so highly inflamed and the fever encreased to that degree that it is become equally mortal with the smallpox.” Physician’s Legacy, 1733, p. 116. [1194] Memorial to the House of Commons, supra, p. 84. [1195] Edin. Med. Essays and Obs. V. 26. [1196] Pronounced by Sims to have been wholly scarlatina, and by Willan to have been in part that disease. [1197] Monthly reports in the Gentleman’s Magazine, under the dates. [1198] Heberden’s paper on measles in Trans. Col. Phys. III. (1785), pp. 389, 395. [1199] W. Black, M.D., Obs. Med. and Political on the Smallpox, &c. London, 1781, p. 207: “Few escape measles in infancy or childhood, and as we find one-tenth fewer to die of measles than of smallpox, etc.... In their future consequences, measles, especially in cities, are not without hazard, and are not unfrequently followed by hecticks.” [1200] Percival, in Med. Obs. and Inquiries, V. (1776), p. 282. [1201] Omitting the year 1760. [1202] Compiled from the tables in the Gentleman’s Magazine, 1742-57. All Saints parish contained more than half the population. [1203] Pearce, writing from St Croix, West Indies, 12 Oct. 1782, to Lettsom (Memoirs, III. 429), says the measles had been “very rife and fatal” there. [1204] MS. Apothecary’s Books at the Foundling Hospital. [1205] R. Willan, M.D., On Cutaneous Diseases. Vol. I. 1808, p. 244. [1206] Heysham, u. s., p. 538. [1207] James Lucas, “On Measles.” Lond. Med. Journ. XI. 325, dated 22 Aug. 1790. [1208] Reports on the Diseases of London, 1796-1800. Lond. 1801, pp. 2, 13, 18, 32, 229. [1209] John Roberton, in Med. and Phys. Journ. XIX. 185. Measles seems to have been more usual than scarlatina in Scotland as well as in Ireland. In the accounts of the several parishes written for the Statistical Account, about 1791-99, measles is often mentioned (and would appear at that time to have been more usual in country districts than smallpox), while hardly anything is said of scarlatina under that name, and not much of sore-throat. [1210] Med. and Phys. Journ. VII. (1802), p. 316. [1211] “Observations on Measles.” By Mr Edlin, surgeon, Uxbridge. Med. and Phys. Journ. VIII. (July-Dec. 1802), p. 28. An earlier epidemic of anomalous eruptive fever (“dark coloured eruption of the neck and breast which spread at length over the whole body”) was described for Uxbridge and its vicinity in the summer and autumn of 1799, in an essay reviewed in British Critic, XV. 435. [1212] T. Bateman, M.D., Report on the Diseases of London, 1804-16. Lond. 1819, p. 90-91. [1213] Samuel Fothergill, M.D., and others, in Med. and Phys. Journ. XVIII. (Dec. 1807), pp. 569, 572; XIX. 91, 185. [1214] “The Epidemic Measles of 1808.” By Dr Ferguson. Med. and Phys. Journ. XXI. 359. [1215] John Roberton, Med. and Phys. Journ. XIX. 182, 272, 278, 471. [1216] Roberton, loc. cit. XIX. 471. [1217] In the earlier period, according to Grainger, Lind and others, numerous cases of measles sometimes occurred on board ships of war. [1218] Published as an Appendix to his Treatise on the History, Nature and Treatment of Chincough. Glasgow, 1813. Reprinted by John Thomson, Glasgow, 1888. Dr Watt is best known by his Bibliotheca Britannica (Edinburgh, 1819. 4 vols. 4to.), a wonderfully complete bibliography under the dual arrangement of subjects and authors, which is still indispensable for research in every branch of knowledge. Perhaps the many who use it are not all aware that it was the labour of a physician in Glasgow (originally a surgeon at Paisley), who died (in 1819) at the age of forty-five, having reached such professional distinction in his own city as to be elected President of the Faculty of Physicians and Surgeons. [1219] De Febribus, 1659. Cap. XV. [1220] Sketch of a Plan to exterminate the Casual Smallpox, &c. London, 1793, p. 152. [1221] It was believed that smallpox left ill effects in some constitutions. William III. is said to have had the dregs of smallpox in his lungs. Roberton (u. s.) cites Saunders as teaching that smallpox caused scrofula, and he is himself doubtful whether an attack of it ever improved the constitution. Dr Moses Younghusband, of New Lebanon Springs, Med. Phys. Journ. XI. (1804), 317, wrote: “I see no more of the glandular suppurations formerly so frequent and unavoidable” after smallpox. [1222] Johnstone, Malignant Epidemic Fever of 1756, London, 1757, says of Kidderminster during a season of high mortality from fever and other diseases: “The measles at this time went through our town and neighbourhood. The children commonly got over the usual course of this distemper; but vast numbers died tabid of its consequences. The chincough succeeded the measles.” [1223] The Edin. Med. and Surg. Journ. XXVI. 177, cites from Cleland, with a reference which I have not succeeded in verifying, the following Glasgow figures for the period 1813-19: all deaths 22,060, smallpox 236 (1·07 per cent.), measles 614 (3·69 per cent.). But see Cowan, Glas. Med. Journ. V. 358, supra, p. 597. [1224] Cowan, Journ. Statist. Soc. III. [1225] Griffin, ibid. III. [1226] Macmichael, in an essay on scarlatina and other contagions, 1822, says: “Parents considering the measles as a disease almost inevitable have wisely chosen to expose their children to the contagion at such auspicious times [summer season]; so that the disorder may be once well over, and all further anxiety at an end.” p. 30. [1227] P. Macgregor, Med. Chir. Trans. V. 436, obtained from Henry, of Manchester, the burials from measles at the Collegiate Church and St John’s Church for two years, 1812-13, which when compared with those abstracted by Percival from the former register for twenty years, 1754-74, showed a higher ratio of measles to the burials from all causes. [1228] Cross, u. s. [1229] Delagarde, Med. Chir. Trans. XIII. 163. [1230] A. Campbell Monro, M.D., “Measles: an Epidemiological Study.” Chiefly from the Jarrow statistics. Trans. Epid. Soc. N. S. X. (1890-91), p. 94. The author connects the recent increase with the greater concourse of children to infant and elementary schools under the Education Act. [1231] Rep. Reg.-Genl. LIV. p. xviii, and LV. p. xi. The explanation given is as follows: “When a county or other area has been visited by a severe epidemic [of measles] there is for several succeeding years scarcely sufficient material, in the shape of unprotected children, for another considerable outbreak, unless it be in very populous areas such as London or Liverpool; and in such places the disease is endemic.” [1232] Buchan and Mitchell, Journ. Scot. Meteor. Soc. July, 1874, p. 194. [1233] Ogle, in the 47th Report of the Registrar-General (for 1884), p. xv. [1234] Cited by Hirsch, Geogr. and Histor. Pathology. Eng. transl. III. 28. [1235] Harl. MSS. No. 2378. Moulton’s This is the Myrour or Glasse of Health, circa 1540, is in the main a printed reproduction of this manuscript prescription-book. The same receipt which is “for ye kink” in the one, is “for the chyncough” in the other (formula LXXIX.). [1236] “Sycknesses happenynge to children:—When they be new borne, there do happen to them sores of the mouth called aphte, vometyng, coughes, watchinge, fearefulness, inflamations of the nauelle, moysture of the eares. When they brede tethe, ytchinge of the gummes, fevers, crampes and laskes. When they waxe elder, than be they greved with kernelles, opennesse of the mould of the head, shortnesse of wynde, the stone of the bladder, wormes of the bealy, waters, swellynges under the chynne, and in Englande commonly purpyles, measels and small pockes.” [1237] Obs. Med. 3rd ed. Bk. IV. chap. V. § 8; Epist. Respons. I. § 42. [1238] Mary Barker at Hambleton, to Abel Barker at the Dog and Ball in Fleet Street. Hist. MSS. Commis. V. 398. [1239] Tractatus de morbis acutis infantum. Lond. 1689. Englished by W. Cockburn, M.D. London, 1693, pp. 38, 78, 87. [1240] Gent. Magaz. 1751, pp. 195, 578. [1241] Treatise on Chincough. Glasgow, 1813. [1242] Vierordt, Physiologie des Kindesalters, TÜbingen, 1877, p. 82, without adducing evidence that the larynx is congenitally different in the two sexes (a matter of very nice measurements which even Beneke does not appear to have attempted), says that the development of the posterior glottidean space has advanced before puberty much more in boys than in girls. Stark, a former Superintendent of Statistics for Scotland (Rep. Reg. Gen. Scot. for 1856, p. xxxviii), has raised the question thus: “The causes of this greater liability of the female sex to death while suffering from whooping-cough are worthy of being investigated. So far as one’s own limited experience goes, it would appear to be produced by the greater tendency which the female sex exhibits to have fits or convulsions when attacked by a paroxysm or fit of coughing in that disease.” [1243] Changes in the Air, &c. ... in Barbadoes. Lond. 1760. [1244] In the Irish Decennial Summary for 1871-80 (Suppl. to 17th Report of Reg.-Gen. Ireland, 1884) it is said: “A general relation has been noticed by many observers between the prevalence of whooping-cough and measles, and there is no doubt that in many localities an epidemic of measles is frequently accompanied by or followed by a prevalence of whooping-cough. A comparison of the figures in Table XV. does not point to any very close relationship. Whooping-cough was a much more fatal disease than measles, but it is more than probable that measles was equally prevalent.” [1245] Illustrations of Unconscious Memory in Disease. London, 1886 [1885]. Chapter VI. pp. 64-83. [1246] Med. Times and Gaz. 1885, II. p. 6. [1247] Preface to 3rd ed. of Obs. Med., Greenhill’s ed. p. 16. [1248] Sydenhami Opera, ed. Greenhill, 1844, p. 243. [1249] Maton, Med. Trans. Col. Phys. V., having seen an extensive epidemic attended by a red rash in one of the great public schools, was disposed to erect it into a new type of roseola, owing to its mildness, while he admitted that it was the same as Sydenham’s scarlatina simplex. Macmichael (New View of the Infection of Scarlet Fever, 1822, p. 78) thought that this was “rather a proof of extreme refinement,” and that there was no need to give it a new designation. Gee, Brit. Med. Journ., 1883, II. 236, cites this “refinement” of Maton’s as one of the noteworthy things in the history of the diseases of children in this country. [1250] Sir Robert Sibbald, M.D., Scotia Illustrata, sive Prodromus Historiae Naturalis. Edin. 1684. Lib. II. cap. 5, p. 55. [1251] Richard Morton, M.D. Pyretologia. 2 vols. London, 1692-94, II. 69. [1252] Engl. transl. 1737, p. 80. The reference by Dover (Ancient Physician’s Legacy, 1732, p. 117), is almost in the words of Sydenham, his master: “This is a fever of a milder kind than the measles [of which latter he did not remember anyone’s dying till about twenty-five years since], and does not want the assistance of a doctor. The skin seems to be universally inflamed, but the inflammation goes off in forty-eight hours.” [1253] Edin. Med. Essays and Obs. III. 26. [1254] Obs. de aere et morb. epid. [1255] H. Warren, M.D., On the Malignant Fever in Barbados. London, 1740, p. 73. [1256] Le Cat, in Phil. Trans. XLIX. 49: In 1736 and 1737, a prevalence of gangrenous sore-throats which chiefly attacked children. They reappeared in 1748 in young persons of the first distinction, not only at Rouen, but also at St Cyr, near Versailles, and at Paris. [1257] Webster, Brief History of Epidemick and Pestilential Diseases. Hartford, 1799, II. 253: “Away, then, with crowded cities—the thirty feet lots and alleys, the artificial reservoirs of filth, the hot-beds of atmospheric poison! Such are our cities—they are great prisons, built with immense labour to breed infection and hurrying mankind prematurely to the grave.” [1258] W. Douglass, M.D., The Practical History of a New Epidemical Eruptive Miliary Fever, with an Angina Ulcusculosa, which prevailed in New England in the years 1735 and 1736. Boston, N.E. 1736. This rare essay was reprinted in the New England Journ. of Med. and Surg. XIV. 1 (Jan. 1825). [1259] In Belknap’s History of New Hampshire. Boston, 1791. [1260] Gent. Magaz. Feb. 1752, p. 73. [1261] The account by Kearsley, of Philadelphia, written about 1769 (Gent. Magaz. XXXIX. 251), refers to a great epidemic of throat-disease in New England in the spring, summer and autumn of 1746; but the date is almost certainly a mistake for 1736, as no such epidemic is known on contemporary authority. [1262] Cadwallader Colden, M.D. “Letter to Dr Fothergill on the Throat Distemper,” dated New York, 1 Oct. 1753, in Med. Obs. and Inquiries, I. 211. [1263] Belknap, III. 421. [1264] Samuel Bard, M.D. “An Inquiry into the Nature, Cause and Cure of the Angina Suffocativa, or Sore throat Distemper, as it is commonly called by the inhabitants of this city and colony.” Trans. Amer. Philos. Soc. I. (1769-1771). Philad. 1771, p. 322. What purports to be a translation of this, is given in Reutte’s Recueil d’Obs. sur le Croup (Paris, 1810), the name of “croup” being introduced into the title, and some strange liberties taken with the text. [1265] The impression made upon modern historians by these American accounts of the throat-distemper has not always been the same. Hecker finds in the malady described by Douglass the form of FrieselbrÄune, or miliary diphtheria, a somewhat rare and sporadic malady; in the account by Bard, he finds hÄutige BrandbrÄune, or membranous angina maligna; while he finds in an account by Chalmers for Charleston, S. Carolina, in 1770, a third variety, Friesel-ScharlachbrÄune, or miliary scarlet angina. Again, Jaffe finds in the account by Bard “many analogies with the diphtheria of our own day.” Hirsch identifies the throat-distemper of Douglass and Colden as “exquisite scarlet fever” and the disease described by Bard as diphtheria. HÄser identifies the epidemic described by Douglass as diphtheria. Bard himself did not doubt that the disease which he saw in New York previous to 1771 was the same that Douglass saw at Boston in 1735-36. Hecker, Geschichte der neueren Heilkunde. Bk. I. chap. 8. Max Jaffe, “Die Diphtherie in epidemiol. u. nosol. Beziehung, &c.” Original paper in Schmidt’s JahrbÜcher, CXIII. (1862), p. 97. Hirsch, 1st ed. of Handb. der histor. geogr. Pathol. I. 237, note 6; II. 125, note 4; and 2nd ed. III. 80. Eng. transl. HÄser, Geschichte, &c. III. 471. [1266] Gent. Magaz. IX. Nov. 1739, p. 606:—Died, “Nov. 27, the eldest and youngest son of Henry Pelham, Esq. of sore throats.” [1267] John Chandler, F.R.S., A Treatise of the Disease called a Cold. Also a Short Description of the Genuine nature and seat of the Putrid Sore-Throat. London, 1761, p. 55. [1268] Munk, Roll of the College of Physicians. Fothergill cites Spanish and other foreign writers on garrotillo in the historical introduction to his essay on the Sore-Throat (1748), without mentioning the fact that Letherland had been before him in that field. [1269] John Rutty, M.D., Chronological History of the Weather and Seasons, and prevailing Diseases in Dublin, during forty years. London, 1770, p. 108. [1270] John Starr, M.D., “Account of the Morbus Strangulatorius.” Phil. Trans. XLVI. 435, dated Liskeard, Jan. 10, 1749/50. [1271] John Fothergill, M.D., An Account of the Sore Throat attended with Ulcers; a Disease which hath of late years appeared in this City and the parts adjacent. London, 1748. [1272] Sir Thomas Watson (Lectures, II. 817), who mentions excoriations of the anus, carried Fothergill’s idea of an absorption of the acrid matter to an extreme length in explaining the irritation of the alimentary canal in scarlet fever. [1273] Letter to Rutty, Chronol. Hist. 1770, p. 117. [1274] Gent. Magaz. Oct. 1751, and July, 1755, p. 343. [1275] Nathaniel Cotton, M.D. Observations on a particular kind of Scarlet Fever that lately prevailed in and about St Albans. In a Letter to Dr Mead. London, 1749 (12th February). The copy in the British Museum library has a written note signed R. W. (Robert Willan, M.D.): “The only just and correct account; but was not noticed during the author’s lifetime, and it has since been consigned to oblivion.” In his work On Cutaneous Diseases (1808), Willan sarcastically contrasts the means by which Fothergill gained fame while Cotton escaped notice; of the latter he says: “But, as he gave an old appellation to a disease certainly not new, his work attracted little attention, and procured him no emolument.” [1276] John Huxham, M.D., A Dissertation on the Malignant Ulcerous Sore-Throat. London, 1757. [1277] Supra, p. 125. [1278] John Wall, M.D. “Bark in the Ulcerated Sore Throat.” Gent. Magaz. 1751, Nov. p. 497. Dated Worcester, 15 Oct. 1751. [1279] Nash, History of Worcestershire, II. 39. [1280] James Johnstone, M.D., Malignant Epidemic Fever of 1756. London, 1758. [1281] To those who explicitly distinguished the sore-throat or angina maligna from scarlatina may be added Dr Richard Russell: “In hoc quidem morbi statu mitissimo, si ad quartum vel quintum usque diem eruptiones in cute superstites sint, paulatim recedant, et desquamationes furfuraceae, perinde ut in febre scarlatina, post se reliquant, ibi crisis integra et perfectissima est.” Œconomia Naturae in Morbis Acutis et Chronicis Glandularum. Lond. 1755, p. 105 seq. [1282] Letters of Horace Walpole, ed. Cunningham, III. 280, letter to Mann, 20 Jan. 1760. [1283] Charles Bisset, Essay on the Medical Constitution of Great Britain, with obs. on the weather and diseases in 1758-60. London, 1762. [1284] Hecker (u. s.) identified Bisset’s epidemic disease in Cleveland with Douglass’s in New England. Merely because they used the term “miliary,” he erects their epidemics into an imaginary class of angina miliaris which was not scarlatina. [1285] Short to Rutty, Rotherham, 26 March, 1760, in Rutty’s Chronol. Hist. of Weather, &c. and Diseases in Dublin. London, 1770, p. 117. [1286] Sir David Hamilton, Tractatus Duplex, &c. London, 1710 (Engl. transl. 1737, p. 84), says that, in 1704, several in the “miliary fever” had “a pain in the jaws resembling that of the squinsy,” which killed many suddenly. At the other end of the century, Willan (Cutaneous Diseases, 1808, p. 333), said of fever in 1786: “The title ‘angina maligna’ would have applied with equal, if not with more propriety, to the sore-throat connected with a different species of contagion, namely, that of the typhus or malignant fever originating in the habitations of the poor where no attention is paid to cleanliness or ventilation.” [1287] Francis Penrose, A Dissertation on the Inflammatory, Gangrenous and Putrid Sore-Throat. Also on the Putrid Fever. Oxford, 1766. [1288] Some Thoughts on the Anomalous Malignant Measles lately peculiarly prevalent in the Western Parts of England. London, 1760. And to be sold at Bath and Exeter. [1289] William Watson, M.D. “An Account of the Putrid Measles as they were observed at London in the years 1763 and 1768.” Med. Obs. and Inquiries, IV. (1771), p. 132. [1290] James Clarke, M.D. “Medical Report for Nottingham from March, 1807, to March, 1808.” Edin. Med. Surg. Journ. IV. 425. [1291] These changes of the name from week to week represent probably the independent judgment of the apothecary more than the modified opinions of Watson the physician. The views which the latter expressed in his paper of 1771, are clearly reechoed in the following anonymous paragraph in the Gent. Magaz. XLII. (1772), Nov. p. 541: “The measles have lately been very rife and fatal in this metropolis. They are of a very different kind from those described by the great Doctor Sydenham, being of a malignant putrid nature, such as visited London in 1763 and 1768, where bleeding seemed of so little service, but small doses of emetic tartar, cordial medicines and blisters, were very efficacious. The above disorder was epidemic at Plymouth and parts adjacent in the years 1745 and 1750, and so long since as the year 1762 [1672] was described by Dr Morton, who says it raged so severely during the autumn of that year that it appeared like a gentle kind of plague, sparing neither sex nor age, and that 300 died weekly of it.” [1292] W. Grant, M.D., Account of a Fever and Sore Throat in London, September, 1776. London, 1777. [1293] W. Fordyce, M.D., A new Inquiry into the Causes, Symptoms and Cure of Putrid and Inflammatory Fevers; with an Appendix on the Hectic Fever, and on the Ulcerated and Malignant Sore Throat. London, 1773. The appendix on Sore-throat is pp. 209-222. [1294] Gent. Magaz. XLII. (1772), June, p. 258. [1295] G. Levison, M.D., An Account of the Epidemical Sore-Throat. 2nd ed. corrected. London, 1778 (1st ed. 1778). [1296] It might have been the third, as Grant (u. s.) says there was fever with sore-throat in London in September, 1776. [1297] “Angina and Scarlet Fever of 1778.” Mem. Med. Soc. III. 355. [1298] James Johnstone, junr. M.D., A Treatise on the Malignant Angina or Putrid and Ulcerous Sore-Throat, &c. Worcester, 1779. [1299] Robert Saunders, Observations on the Sore-Throat and Fever in the North of Scotland in 1777. London, 1778. [1300] William Withering, M.D., Account of the Scarlet Fever and Sore-Throat, particularly as it appeared at Birmingham in 1778. London, 1779; preface dated 1st January. [1301] Withering was perhaps too desirous to be thought the first in England to have described scarlatina anginosa. “The scarlet fever in its simple state,” he says, “is not a very uncommon disease in England, but its combination with a sore-throat, as described above, the violence of its attack, and the train of fatal symptoms that follow, are circumstances hitherto unnoticed by English writers.” It is probable from this that he had not seen Levison’s essay, with preface dated 11 May, 1778, his own being dated 1 January, 1779; but Cotton’s essay of 1749 actually bore the name of scarlet fever on its title-page, and described the throat-affection, glandular swellings, and the like quite correctly. The name of the elder Heberden is frequently brought into the history of the identification of scarlatina, with a reference to his Commentaries on Diseases, which were not published until 1802, some time after his death at a very advanced age. The following are among his remarks: “In the fever which has just been described there is always some degree of redness in the skin, and the throat is not without an uneasy sensation. Where it happens that the throat is full of little ulcers attended with considerable pain, there the disease, though the skin be ever so red, is not denominated from the colour, but from the soreness of the throat, and obtains the name of malignant sore-throat; and many suppose that the two disorders differ in nature as well as in name,” p. 23. “The enfeebled and disordered state of all the functions of the body evidently points out such a malignity of the fever as cannot be owing to the affection of the uvula or tonsils, which in other distempers we often see ulcerated and eaten away, without any danger of the patient’s life. These sores, therefore, like pestilential buboes, point out the nature of the disorder; but the danger arises, not from them, but from the fever,” p. 25. In 1790 an elaborate attempt was made by William Lee Perkins, M.D. (dating from Hampton Court, 1 March) to distinguish between cynanche maligna and scarlatina anginosa, in An Essay for a Nosological and Comparative View of the Cynanche Maligna or Putrid Sore-Throat, and the Scarlatina Anginosa. London, 1790. He proceeds by the nosological method of Sauvages and Cullen, erecting genera, species and varieties. The result is not clear after all; for on p. 43 (note) we read that scarlatina is frequently accompanied with inflammatory and ulcerous appearances in the fauces or throat, and that angina maligna or ulcerated sore-throat is often attended with red efflorescence on the skin; this had led to their being regarded as one and the same, and treated by the same method of cure. [1302] J. Parker, A Treatise on the Putrid Constitution of 1777 and the preceding years, and the Pestilential one of 1778. London, 1779 (of inferior value beside Withering’s). [1303] Heysham, in Hutchinson’s Hist. of Cumberland, u. s. [1304] John Clark, M.D., Obs. on Fevers, and on the Scarlet Fever with Ulcerated Sore-Throat at Newcastle in 1778. Lond. 1780; Account of the Newcastle Dispensary from its commencement in 1777 to Michaelmas, 1789. Newcastle, 1789 (also by Clark). [1305] James Sims, M.D. “Scarlatina Anginosa as it appeared in London in 1786.” Mem. Med. Soc. Lond. I. 388. Willan, however, says that measles was the epidemic in the winter and spring of 1785-86; while the epidemic at the Foundling Hospital was “measles” in March and April, 1786, “fever” in June and July, and “scarlet fever” in 1787. [1306] On Cutaneous Diseases. Vol. I. London, 1808, pp. 262, 277, 345. [1307] I Have Not Succeeded in Finding the Apothecary’s Book for the Years 1776-82, Within Which the Great London Epidemic of 1777-78 Fell; But Willan, Who May Have Had the Complete Set of Books Before Him, Says (op. cit. 1808, P. 245) “the Denomination ‘scarlet Fever and Sore-throat’ First Occurs in the Weekly Report, 1st September, 1787.” I am Indebted To the Courtesy of Mr Swift, M.R.C.S. for A Sight of the Books. [1308] J. Barker, Epidemicks, Or General Observations on the Air and Diseases From The Year 1740 To 1777 Inclusive, and Particular Ones From That Time To the Beginning Of 1795. Birmingham (no Date). [1309] Lond. Med. Journ. XI. 374. [1310] H. Rumsey, “Epidemic Sore-Throat at Chesham in 1788.” Lond. Med. Journal, X. 7, dated 14 Dec. 1788. [1311] H. Rumsey, “An Account of the Croup as it appeared in the Town and Neighbourhood of Chesham, in Buckinghamshire, in the years 1793 and 1794.” Trans. of a Soc. for Improving Med. and Chirurg. Knowledge, II. (1800), 25. Read 1 July, 1794. [1312] “Several children brought up portions of a film, or membrane of a whitish colour, resembling the coagulated matter which was found in the trachea of those children whose bodies were opened. This was thrown off by violent coughing or retching; and the efforts made to dislodge it were often so distressing that the child appeared almost in a state of strangulation.” [1313] Sinclair’s Statist. Account of Scotland, IX. 190. [1314] Ibid. II. 412. [1315] Ibid. IX. 461. [1316] Livingston to Lettsom, Aberdeen, 13 May, 1790, in Memoirs of Dr Lettsom, III. [1317] R. Willan, M.D., Reports on the Diseases in London, 1796-1800. Lond. 1801, p. 2. [1318] “Cursory Remarks on the Appearance of the Angina Scarlatina in the Spring of 1793.” Mem. Med. Soc. Lond. IV. (1795), p. 280. [1319] W. Rowley, M.D., An Essay on the Malignant ulcerated Sore-Throat, containing reflections on its causes and fatal effects in 1787, etc., London, 1788; The Causes of the Great Numbers of Deaths ... in Putrid Scarlet Fevers and Ulcerated Sore-Throats explained, etc., London, 1793. Based on the practice of the St Marylebone Infirmary. [1320] James Sims, M.D. “Sketch of a Description of a Species of Scarlatina Anginosa which occurred in the Autumn of 1798.” Mem. Med. Soc. Lond. V. (1799), p. 415. [1321] This is the source of Noah Webster’s information for London; he adds that the “cat distemper” appeared in Philadelphia in June, and was very fatal in New York and over the Northern States. [1322] E. Peart, M.D., Practical Information on the Malignant Scarlet Fever and Sore-Throat. London, 1802. See also Med. and Phys. Journ. IX. 16, report for Dec. 1802: “so very general that few of those who have continued in the same house have entirely escaped it”; and the reports, ibid. X. 76, 276. [1323] Clark, u. s. Monteith, Report of the Newcastle Dispensary from its Foundation, 1878. [1324] Polwhele’s Cornwall. Part VII. Diseases, p. 59. [1325] F. Skirmshire, Med. Phys. Journ. VI. 424. [1326] R. Freeman, ibid. IX. 157. [1327] H. Gilbert, ibid. IX. 249. [1328] Goodwin, ibid. IX. 509. [1329] Braithwaite, ibid. XI. [1330] Willan, Cutan. Dis. 1808, p. 379, particulars from Dr Binns, with full discussion of the methods of treatment. Willan was told by Dr Stanger that there were 71 cases in the Foundling Hospital from June to October, 1804, with 4 deaths. [1331] W. Blackburne, M.D., Facts and Observations concerning the Prevention and Cure of Scarlet Fever, &c. London, 1803. [1332] James Hamilton, M.D., Obs. on the Utility, &c. of Purgative Medicines. 4th ed. Edin. 1811. App. III. p. 66 (three boys in Heriot’s Hospital died of dropsy). Autenrieth, Account of the State of Medicine in Great Britain. Extracts translated by Graves, u. i. [1333] Ferriar, Med. Hist. and Reflect. III. 128. [1334] R. J. Graves, M.D., A System of Clinical Medicine. Dublin, 1843, p. 493. [1335] T. Bateman, M.D., Reports on the Diseases of London, and the State of the Weather, from 1804 to 1816. London, 1819. [1336] Clarke, Ed. Med. and Surg. Journ. XXX. [1337] Goodwin, of Earlsoham, Med. and Phys. Journ. XXIV. 465. [1338] Samuel Fothergill, M.D. Med. and Phys. Journ. XXXII. 481. [1339] N. Bruce, Med. Chir. Trans. IX. 273. [1340] Heysham to Joshua Milne, in the latter’s Treatise on the Valuation of Annuities. Lond. 1815. App. p. 755. [1341] Currie, Med. Reports, 1805, II. 458; Armstrong, Pract. Illustr. of the Scarlet Fever, Measles, &c. Lond. 1818; Lodge, of Preston, in Med. and Phys. Journ. XXXIII. (1815), p. 358. [1342] W. Macmichael, M.D., A New View of the Infection of Scarlet Fever, &c. London, 1822, pp. 30, 59, 78, 81-2. The title of another essay appears to reflect the same ideas, Caution to the Public, or hints upon the nature of Scarlet Fever, designed to show that this disease arises from a peculiar and absolute virus, and is specifically infectious in its mildest as well as in its most malignant form. By William Cooke, London, 1831. [1343] Kreysig, “Ueber das Scharlachfieber,” Hecker’s Annalen, IV. 273, 401, 1826, says that scarlatina had been “not only almost uninterrupted in all Europe since twenty-six or twenty-seven years [1799 or 1800], but also frightfully fatal.” The period in which this was written appears to have been one of fatal scarlatina in some parts of Germany; so also the years 1817-19, and the years 1799-1805 (as in Great Britain and Ireland). But the sweeping assertion as to frightful scarlatina mortality in all Europe without interruption since 1799 is clearly a flight of rhetoric, and is as nearly as possible the reverse of the truth so far as concerns Britain and Ireland. [1344] Blackmore, Lond. Med. Gaz. VI. 114. [1345] Sandwith, Edin. Med. and Surg. Journ. XL. 249. [1346] Aulsebrook, Lancet, 12 Nov. 1831, p. 217: cases of very malignant suddenly fatal scarlatina in infants and young persons up to the age of twenty-two. In the house of a canal boatman a son and two daughters, from 21 to 13 years, died in the course of two days after a very sudden and brief illness. [1347] Rumsey, Trans. Prov. Med. Assoc. III. 194. [1348] Hamilton, Edin. Med. Surg. Journ. XXXIX. 140. [1349] Cowan, Journ. Statist. Soc. III. [1350] Sidey, Stark and others in Edin. Med. and Surg. Journ. 1835-36. H. Kennedy, M.D., Account of the Epidemic of Scarlatina in Dublin from 1834 to 1842. Dublin, 1843. [1351] The principal epidemics of scarlatina which have been inquired into by inspectors of the medical department since 1870 have been the following:
[1352] William Ogle, M.D., in the 49th Report of the Registrar-General (for 1886), p. xiv. [1353] See a paper, with Tables, on “Age, Sex and Season in relation to Scarlet Fever,” by Arthur Whitelegge, M.D. in Trans. Epidemid. Soc. N. S. VII. p. 153, for Nottingham and some other towns. A paper by Dr Ballard, “On the Prevalence and Fatality of Scarlatina as influenced by Sex, Age and Season,” which was written twenty years before but left unpublished, follows Whitelegge’s in the Trans. Epidem. Soc. N. S. VII. (1887-8). [1354] A table of figures showing this will be found in Dr B. A. Whitelegge’s second lecture on “Changes of Type in Epidemic Diseases.” Brit. Med. Journ. 4 March, 1893. [1355] Longstaff, Trans. Epid. Soc. N. S. IV. (1880), 421, and Studies in Statistics. London, 1891, p. 310. D. A. Gresswell, Contribution to the Natural History of Scarlatina. Oxford, 1890, p. 193. [1356] Journ. Scot. Meteorol. Soc. July, 1874, p. 195. [1357] Cutaneous Diseases. Vol. I. 1808, p. 254. [1358] An unfortunate event that came under the writer’s notice some years ago may be illustrative of this. Two women with cancer of the breast were operated on, the one after the other, in the same operating theatre. Their beds were in the same hospital ward, but separated by the whole length of the ward. A few days after the operations, one of the women developed erysipelas, which was most extensive on the back; very soon after the other woman got the disease in a precisely similar way; they both died of it. As it seemed improbable that No. 1 had been infected in the ward, or that No. 2 had been infected from No. 1, (some dozen surgical cases between them escaping,) the suggestion arises of a common source of both infections in the operating theatre. The operating table was covered by a woollen cloth, of red colour so as not to show blood stains; it must have contained a good deal of putrid invisible blood from former operations. [1359] The first instance showing this came from a dairy at Hendon. See James Cameron, M.D. Trans. Epid. Soc. V. (1885-6), p. 104; and ibid. VIII. 40. One of the latest and most fully investigated came from a dairy near Glasgow, J. B. Russell, M.D., LL.D., and A. K. Chalmers, M.D. Glas. Med. Journ. Jan. 1893, p. 1. An outbreak at Wimbledon and Merton is described, Rep. Med. Off. Loc. Gov. Bd. for 1886, p. 327. See also ibid. for 1882, p. 63. The scarlatina caused by cream (with strawberries) is traced, ibid. for 1875, p. 72. A very clear case of scarlatinal epidemic due to contaminated milk occurred at Blackheath, both among children and adults, in April, 1894. [1360] E. M. Crookshank, Path. Trans. XXXIX. 382, in an extensive prevalence of cowpox on a dairy farm near Cricklade. No scarlatina could be traced in the neighbourhood. [1361] Alfred Carpenter, M.D. Lancet, 28 Jan. and 4 Feb. 1871. [1362] Wall, Gent. Magaz. 1751, p. 71, 501. He quotes Severinus to the effect that the great epidemic of garrotillo in the province of Naples in 1618 was preceded by a murrain. [1363] Prince A. Morrow, “Drug Eruptions,” edited for the New Sydenham Society by T. Colcott Fox, in Selected Monographs on Dermatology. London, 1893. [1364] Hirsch, III. 87. [1365] Cullen, First Lines of the Practice of Physic, Part I., Book II. chap. 5, § 2, and Book III. chap. 4. [1366] On Cutaneous Diseases, vol. I., London, 1808, pp. 319, 326, 333. He included also the garrotillo of Spain and the throat-plague of Naples (1618) among the “varieties of scarlatina,” inasmuch as they had not unfrequently a rash which was of the erysipelatous kind. Hirsch (u. s.) and Max Jaffe (“Die Diphtherie in epidemiologischer und nosologischer Beziehung vornehmlich nach FranzÖsischen und Englischen Autoren zusammengestellt,” Originalabhandlung in Schmidt’s JahrbÜcher, CXIII., 1862, pp. 97-120) do not seem to doubt the diphtheritic nature of the garrotillos of Spain and Italy in the 16th and 17th centuries, but they agree with Willan in classing most of the 18th century throat-distempers of English and American writers as scarlatinal, reserving as diphtheritic, or as more nearly allied to diphtheria, Starr’s “morbus strangulatorius” of Cornwall, some cases of infants recorded by Denman (supra, p. 714), Rumsey’s cases of “croup” (supra, p. 716), and the epidemic described by Bard, of New York (supra, p. 690). These matters of identification appear to be like matters of taste, for which the best rule is non disputandum. I have already pointed out that Bard himself did not hesitate to identify the epidemic throat-disease of his time with that which Douglass had described in New England thirty years before. [1367] P. Bretonneau, Des inflammations spÉciales du tissu muqueux et en particulier de la DiphthÉrite, Paris, 1826, with supplement in 1827. [1368] Id. Arch. gÉn. de mÉd., Jan., 1855. [1369] Mackenzie, Ed. Med. and Surg. Journ., April, 1825, p. 294, and Med. Chir. Rev., 1827, p. 289, for Glasgow in 1819. The disease which Mackenzie called croup, was generally known in Glasgow at that time as “croupy sore throat.” It was very fatal, attacking several children in the same family, was reckoned contagious, was not a modification of scarlatina, was very different from idiopathic croup as it began on the tonsils and descended to the larynx and trachea, and, lastly, was sometimes marked by gangrenous foetor. Robertson, Edin. Med. and Surg. Journ. (1826) XXV. 279, for Kelso in 1825. Bewley, Dub. Journ. of Med. Sci. VIII. 401, for Dublin in 1835-36. An outbreak observed by Brown, at Haverfordwest, in 1849-50, involving some 200 cases and 40 deaths, was identified in 1858 with diphtheria (Med. Times and Gaz., May, 1858, p. 566, see also Med. Chir. Trans. XL. 49). Outbreaks more vaguely recalled in 1858 as diphtheria occurred at Ashford in 1817, and at Leatherhead (30 deaths in the workhouse) at an uncertain date (2nd Rep. (1859) Med. Offices Privy Council, pp. 244, 320). F. Ryland, Diseases and Injuries of the Larynx and Trachea, London, 1837, pp. 161-175, described a similar disease as a complication of measles at Birmingham in 1835. [1370] Med. Times and Gazette, Lancet, British Med. Journal, &c. for 1858 and 1859. See references in Hirsch, III. 89. [1371] Second Report (for 1859) by the Medical Officer of the Privy Council, London, 1860, p. 161 seq. Dr Greenhow published an essay on Diphtheria in 1860. Lectures important for the nosological definition were published by Sir William Jenner in 1861 (reprinted in 1893). Other essays called forth by the epidemic were by W. F. Wade (1858), Ernest Hart (1859), Edward Copeman (Norwich, 1859). Christison, J. W. Begbie and others wrote upon it in Scotland. [1372] Mr Jones, of Fletching, Sussex, wrote that scores of cases (probably at least 50 or 60) have had more or less eruption. In one case it was general and bright.... It was like scarlatina ... but the whole surface was covered with minute miliary vesicles of clear fluid, ‘one mass of small vesications.’ There was a great deal of itching and no subsequent dropsy. In other cases the eruption was partial. Rep. Med. Off. Privy Council, II. (1859), p. 284. [1373] Starr’s description for 1748 is referred to supra, p. 695. Sanderson, Report, u. s. p. 263, says of the disease in 1858: “At Launceston the diphtheritic pellicle was tough, leathery, and highly elastic; and on the mucous surface of the fauces and pharynx it attained so great thickness (from one-tenth to one-eighth of an inch) that it was compared by several practitioners to the coriaceous lichens which grow on rotten bark. In the other districts this was never observed.” [1374] G. B. Longstaff, M.D., “The Geographical Distribution of Diphtheria in England and Wales,” in Supplement to the 17th Annual Report of Loc. Gov. Board, 1887-8, p. 135. See also Downes, Trans. Epid. Soc. N. S. VII. 193. Farr, Rep. Reg. Genl. for 1874, p. 219, gave the following illustration: “It is remarkable that of diphtheria, out of the same number born, more die in the healthy districts of England than in Liverpool; the proportions are 1029 in the healthy districts and 442 in Liverpool of 100,000 born. The deaths from scarlet fever are 2140 in the healthy districts to 3830 in Liverpool.” [1375] 8th Detailed Report of the Reg. Gen. Scot., p. xxxix. [1376] R. T. Thorne, M.B., Diphtheria: its Natural History and Prevention. Milroy Lectures for 1891. London, 1891. [1377] Farr, Rep. Reg.-Genl. XXIV. (1861), p. 217. [1378] Longstaff, u. s. [1379] G. Budd, M.D., “Obs. on Typhoid or Intestinal Fever.” Brit. Med Journ., 9 Nov. 1861, p. 485. [1380] Supra, pp. 210, 213. [1381] Matthew A. Adams, cited by Thorne, u. s. with diagram. [1382] M. W. Taylor, M.D., “Diphtheria in connection with Damp and Mould Fungi.” Trans. Epic. Soc. N. S. VI. (1886-7), p. 104. Thorne, u. s. gives instances in which diphtheria seemed to choose out wet and impervious soils. [1383] L. Traube, Gesammelte BeitrÄge, &c., Berlin, 1871, II. 11. [1384] Thorne, u. s. has collected and analysed very fully the instances of diphtherial epidemics traced to cows’ milk. It is commonly assumed that the epidemics are either wholly diphtherial or wholly scarlatinal, but not a mixture of the two diseases. [1385] W. N. Thursfield, Lancet, 3 Aug. 1878, p. 180, has contended for some such correlation between diphtheria and enteric fever in their respective preferences, at that time, for rural and urban districts. [1386] William Heberden, M.D. junior. Observations on the Increase and Decrease of Diseases, particularly the Plague. Lond. 1801. [1387] Among the numerous medical writers who have used it are Macmichael, Watson and Chevers. Among historians Lecky (I. 573) has thought it worthy of mention among the progressive improvements of the 18th century. [1388] Heberden (l. c. p. 42) accounted for the enormous increase of the article “convulsions” in the Bills by the inclusion under that term of most of the deaths originally entered under “chrisomes and infants,” which were infants under one month. But the latter had been mostly transferred at an early period while convulsions was still a small total; and even at the worst period of the public health in London, about 1730-40, they would not have accounted for a sixth part of the deaths under convulsions. The probability of the deaths from “griping in the guts” having been transferred to “convulsions” was pointed out in a review of Heberden’s essay in the British Critic on its appearance, without reasons given such as I adduce in the sequel. [1389] Observ. Med. IV. cap. 7, § 2. [1390] Ibid. III. cap. 2, § 54. [1391] Pathol. Cerebri. Pordage’s Transl. p. 25. [1392] Walter Harris, M.D., Tractatus de Morbis Acutis Infantum. Lond. 1689. Engl. Transl. by Cockburn, 1693, p. 39. [1393] Obs. Med. IV. cap. 2, § 7: “haud aliter ac si in aËre peculiaris mensis hujus [Augusti] lateat reconditum ac peculiare quiddam, quod specificam hujus modi alterationem, soli huic morbo adaptatam, vel cruori vel ventriculi fermento valeat imprimere.” [1394] See the reference to Simpson’s essay, supra, p. 333. [1395] W. Fordyce, M.D. A new inquiry into the Causes, Symptoms and Cure of Putrid and Inflammatory Fevers: with an Appendix on the Hectic Fever and on the Ulcerated and Malignant Sore Throat. London, 1773, p. 207. [1396] See the Representation of the College of Physicians on Drink in 1726, cited at p. 84. [1397] Joseph Clarke, M.D. “Nine-day Fits in the Lying-in Hospital of Dublin.” Trans. Royal Irish Academy (in Med. Facts and Obs. III. 1792). [1398] Moss, u. s. He makes out that the infants of the poorer class were much neglected by their drunken parents. [1399] John Ferriar, M.D., Medical Histories and Reflections. 2 vols. Lond. 1810. II. 213 seq. “On the Prevention of Fevers in Great Towns.” [1400] Watt, u. s., says that “bowel-hive” at Glasgow included, along with teething, “a promiscuous mass which may be considered nearly in the same light as the great number of deaths in the London bills of mortality ranked under the terms convulsions, gripes of the guts, &c.... If the patient dies in a state of convulsions, this, we are told, is owing to the hives having gone in about the heart, or their having seized the bowels.” [1401] Hirsch, Geographical and Historical Pathology, Engl. Transl. III. 376. [1402] Supplement to the 45th Annual Report of the Registrar-General. London, 1885, p. xiii. Ballard, following the method of Pfeiffer (1871) for Asiatic cholera, has shown that the correspondence is closest with the temperature of the ground four feet deep. [1403] Ballard, Report to the Local Government Board upon the Causation of Summer Diarrhoea, 1889, p. 32. [1404] Willis mentions an instance (Pathol. Cerebri, Pordage’s transl. p. 25) which can hardly mean anything but congenital feebleness as a cause of infantile convulsions. A neighbour of his (in St Martin’s Lane) had lost all his children by convulsions within the space of three months. Another child was born, and Willis was sent for to advise what regimen should be followed so as to save it from the same fate. [1405] This is clearly seen in comparing ages at death in Liverpool, and in Preston or Salford. Again in the ten years 1871-80, there were 4530 deaths from diarrhoea in the group of shipping towns, Yarmouth, Hull (with Sculcoates), Goole and Hartlepool, of which 70 per cent. were under one year, 19 per cent. from one to five, and 11 per cent. above five, chiefly in old age. In the group of Leicester, Worcester, Northampton and Coventry in the same period, there were 5001 deaths, of which 74 per cent. were under one year, 17 per cent. from one to five, and 9 per cent. above five, chiefly in old age. [1406] Ballard, Report, &c. u. s. says that “occupation of females from home,” which had been often assigned by medical officers of health and others as a fruitful cause of infantile fatal diarrhoea, “resolves itself mainly into the question of maternal neglect, with the substitution more or less of artificial feeding for feeding at the breast.” Tatham, Brit. Med. Journ. 1892, II. 277, is of opinion that the rate of infant mortality was considerably increased by the practice, which obtained in most manufacturing towns, of allowing women to return to work within a week or ten days after their confinement, so that the duties of the mother were necessarily delegated. The paper by Dr G. Reid, ibid. p. 275, which called forth that and similar opinions as to the kind of maternal neglect that favoured the mortality by infantile diarrhoea, bore the title, “Legal restraint upon the employment of women in factories before and after childbirth”; but the emphasis falls almost wholly upon restraint of the mother’s industrial occupation after the child is born. [1407] L. c. pp. 43-45. [1408] Ballard, u. s. Table VI. [1409] See former volume, p. 412. [1410] The Triall of Tabacco, &c. by E. G. [Edmund Gardiner], Gent. and Practicioner in Physicke. London, 1610, fol. II. [1411] Obs. Med. IV. cap. 2. [1412] Ibid. IV. cap. 7. [1413] Dr Andrew Wilson, a pupil of the Edinburgh School in the great period of the first Monro, Whytt and Rutherford, used his Newcastle experiences in 1758 and following years as the basis of two excellent essays, one on Dysentery (1761) and the other upon Autumnal Disorders of the Bowels (1765). In the latter he includes both cholera nostras and bilious colic, (as well as dry colic) as Sydenham had done, and makes the following distinction between the two forms, which “are very nearly allied in their nature”:—“The vomiting of bile in the cholera is not so early as it is in the other; neither is it so constant, nor in so large quantities. Though a purging generally attends the bilious colic, yet it does not correspond so regularly as it does in the cholera, in which there generally is a call to stool soon after every paroxysm of vomiting.... The bilious colic is not generally so quickly hazardous as the cholera is. The intervals between the sick fits are often longer, and when it is attended with danger, it does not become so so suddenly as the cholera does.” Bilious colic was not so strictly an autumnal complaint as cholera. It was not so soon relieved by medicines. It resembled cholera in the remarkable character of exciting cramps in other muscles than the abdominal. [1414] Pharmaceutice rationalis. [1415] Appendix to Essay on Smallpox, 1740. [1416] Gent. Magaz., Sept. 1751, p. 398. [1417] Two Papers on Fever and Infection, 1763, p. 35. [1418] Med. Hist. and Reflect. II. 220. [1419] Ed. Med. Surg. Journ., 1807. [1420] Charles Turner Thackrah, Cholera, its character and treatment, with remarks on the identity of the Indian and English. Leeds, 1832, p. 24. [1421] W. Horsley, Med. Phys. Journ. 24 March, 1832, p. 270. [1422] Geogr. and Histor. Path. Engl. transl. III. 315. [1423] It is probable that the association of surfeit with bowel-complaint in general and at length with dysentery in particular came from the popular belief that these maladies of the autumnal season were due to repletion with fruit. That was the popular belief from an early period, which nearly all the medical writers on autumnal diarrhoea and dysentery took occasion to combat as either inadequate or erroneous. [1424] See Vol. 1. of this History, p. 626. The following is in a letter from Charles Bertie to Viscountess Campden, London, 22 Nov. 1681: “I have safely received your choice present of four bottles, three of Plague and the other of Surfeit water, which I shall preserve against the occasion, being confident that better are not made with hands.” Cal. Belvoir MSS. (Hist. MSS. Com.) II. 60. [1425] Obs. Med. IV. cap. 3. [1426] Pharmaceutice Rationalis, lib. III. cap. 3. [1427] Supra, p. 103. [1428] Andrew Fletcher, Two Discourses, &c. No. 2. p. 2, 1698. [1429] John Jones, M.D., De Morbis Hibernorum specialim vero de Dysenteria Hibernica. Accesserunt nonnulla de Dysenteria Epidemica. Inaug. Diss. Trin. Col. Dub. Londini, 1698, p. 12. [1430] Edin. Med. Essays and Obs. I. (1733) 37, II. 30, IV. V. [1431] James Stephen, surgeon to Gen. Whetham’s regiment, in Pringle’s collection of accounts of the “Success of the vitrum Antimonii ceratum.” Ibid. V. pt. 2, p. 179, 4th ed. [1432] Professor T. Simpson, of St Andrews, Andrew Brown, of Dalkeith, John Paisley and John Gordon, of Glasgow. Ibid. [1433] Gent. Magaz., 1741, p. 705. [1434] The “epidemic constitution” of 1743 was so markedly dysenteric after the influenza in the spring that Huxham regarded the dysentery as a sequela of the influenza. [1435] Mark Akenside, M.D., De Dysenteria Commentarius, London, 1764. [1436] George Baker, M.D., De Catarrho et de Dysenteria Londinensi Epidemicis utrisque An. MDCCLXII. Libellus, Lond., 1764. [1437] William Watson, M.D., in Phil. Trans. LII. pt. 2 (1762), p. 647. [1438] Pringle also, who was well acquainted with the dysentery of campaigns, speaks of the London epidemic as an exceptional occurrence, and as having caused few deaths. [1439] Med. Obs. and Inquiries, IV. (1771), p. 153. [1440] MS. Infirmary Book of the Foundling Hospital. [1441] An Essay on the Autumnal Dysentery. By a physician (Andrew Wilson, M.D.), Lond., 1761 (Preface dated Newcastle, 25 March, 1760), pp. 1, 23. [1442] Trans. K. and Q. Col. Phys. V. (1828), p. 221. [1443] Obs. on the History and Treatment of Dysentery and its Combinations, etc., 2nd ed., Dublin, 1847. [1444] Alexandri Tralliani Medici libri duodecim. Basil, 1556, Lib. VIII. pp. 423, 432. [1445] Akenside, l. c. “Ut dysenteriam jam pro rheumatismo intestinorum habeam, et similem utriusque morbi causam et materiem esse contendimus.” [1446] Hirsch, III. 333 (Eng. transl.): “As to the influence of an extreme diurnal range of the thermometer (cold nights after very hot days) there is almost complete agreement among the observers in those parts [tropical and subtropical] of the world.” [1447] I have enunciated this view of the pathology of acute rheumatism more fully in the Article “Pathology” in the Encyclopaedia Britannica. [1448] Lond. Med. Journal. Editorial note, II. 211. The parish register of Finchley shows double the average mortality in 1780, and indicates dysentery as a fatal malady. Lysons, Environs of London. [1449] Moss, u. s. [1450] Francis Geach, F.R.S., Some Observations on the present Epidemic Dysentery, 1781. [1451] Dennis Ryan, M.D., “Remittent Fever of the West Indies.” Lond. Med. Journ. II. 253, iii. 63. [1452] Dr Livingston to Dr Lettsom, Aberdeen, 29 June, 1789, in Memoirs of Lettsom, III. [1453] Willan, Report on the Diseases etc., p. 42. The nearest approach to a fatality in dysentery, he says, happened in the case of a lady residing in Spa Fields, at whose window a brown owl, attracted by the solitary light, came flapping and hooting at midnight, to the great aggravation of the patient’s symptoms. [1454] Bateman, u. s. [1455] Glasg. Med. Journ. IV. (1831), pp. 5, 229. [1456] Cheyne, Dubl. Hosp. Reports, III. (1822), p. 3. At Limerick, from June to September, 1821, there were 47 cases among the men of the 79th regiment. [1457] Clarke, Edin. Med. and Surg. Journ. IV. 423. [1458] A. C. Hutchinson, Statement of the extraordinary sickness at the Penitentiary at Milbank, Lond. 1823; P. M. Latham, M.D., Account of the Disease lately prevalent at the General Penitentiary. Lond. 1825. [1459] James Wilson, Glasgow Med. Journ. I. (1828), p. 40. [1460] James Wilson, Glasgow Med. Journ. I. 39; James Brown, ibid.; Macfarlane, I. 99; Paterson, I. 438; Editors, IV. 1; Hume (Hamilton), IV. 14, and 229; McDerment (Ayr), IV. 19; Macnab (Callander), IV. 241. [1461] Christison, “Notice on the Dysentery which has lately prevailed in the Edinburgh Infirmary.” Edin. Med. Surg. Journ. XXXI. (Jan. 1829), p. 216, and in Life of Sir Robert Christison, “Autobiography,” I. 376. [1462] W. H. Gilby, M.D., “On the Dysentery which occurred in the Wakefield Lunatic Asylum in the years 1826, 1827, 1828 and 1829.” North of Eng. Med. and Surg. Journ. I. (1830-31), 91. [1463] Hume, “Case of the Edinburgh New Town Epidemic.” Glasgow Med. Journ. IV. 229. [1464] Ibid. IV. 7. The following is Buchanan’s reference to it: “The only epidemic fever belonging to the family of diseases we are here considering that occurred in Scotland during the dysenteric years was that of the New Town of Edinburgh, in 1828, of which we have already spoken. As our knowledge of this fever is not derived from any source on which we can certainly rely, it is possible that we may have formed an erroneous opinion respecting it; but from all we have heard of its symptoms and mode of distribution, we are disposed to consider it as totally different in nature from the common fever of this country. The latter circumstance alone, the mode of distribution of the disease, is, we think, perfectly sufficient to demonstrate our proposition. Instead of occupying the Cowgate, the Grassmarket, and the High Street, the usual haunts of typhus, this fever had its head-quarters in Heriot Row and Great King Street; and, according to our information, it extended from the last mentioned street in the direction of the Water of Leith, and from Leith, along the shore, to Musselburgh. We do not vouch for the accuracy of these minute details, but we believe the important fact to be beyond doubt that this fever prevailed chiefly, not in the districts where typhus is invariably to be met with, but in the most fashionable parts of the New Town.” [1465] James Black, M.D., Edin. Med. Surg. Journ. XLV. (1836), p. 63. “As the epidemic was ushered in and was accompanied during the half of its course with cholera, fever of a typhous character followed close in its train among the working and lower classes, and continued more or less during the first months of winter, after dysentery had totally disappeared.” The latter had not been seen again down to 1835. [1466] J. Smith, ibid. XLII. (1833), p. 342. [1467] Cleland, Trans. Glasg. and Clydesd. Statist. Soc. I. 1837. [1468] Arrott, Edin. Med. Surg. Journ., Jan. 1839, p. 121. [1469] Farr, in First Report of the Registrar-General, 1837-8, p. 103. [1470] Baly, Pathology and Treatment of Dysentery. London, 1847. [1471] Moyle, Lond. Med. Gaz. N. S. VII. Dec. 29, 1848, p. 1093. [1472] Christison, “On a local Epidemic of Dysentery.” Month. Journ. Med. Sc. XVII. (Dec. 1853), 508. [1473] T. S. Clouston, Med. Times and Gaz. 1865, I. 567. [1474] W. H. Duncan, M.D., “On the recent Introduction of Fever into Liverpool by the crew of an Egyptian frigate.” Trans. Epidemiol. Soc. vol. 1. pt. 2. p. 246. (1 July, 1861). [1475] James Boyle, surgeon to H. M. S. ‘Minden,’ Epidemic Cholera of India, London, 1821; W. B. Carter, Cholera Indica vel Spasmodica, Thesis, Glasgow, 1822; Thomas Brown, of Musselburgh, On Cholera, more especially as it has appeared in British India, Edin. 1824; Whitelaw Ainslie, M.D., The Cholera Morbus of India, Letter to the Court of Governors, H. E. I. C., Edin. 1825; A. T. Christie, M.D. (of Madras), Obs. on the Nature and Treatment of Cholera, Edin. 1828; Charles Searle (of Madras), Cholera, its Nature, Cause and Treatment, London, 1830 (dated 1st May, instigated, not by the Orenburg epidemic, but by the deaths of Sir Thomas Monro and others from cholera in Madras). [1476] See extract in Glas. Med. Journ., Feb. 1831, p. 105, from Scottish Mission. and Philan. Reg. [1477] George Hamilton Bell, Treatise on Cholera Asphyxia or Epidemic Cholera as it appeared in Asia and more recently in Europe, Edin. 1831; Reginald Orton, An Essay on the Epidemic Cholera of India, 2nd. ed. with a supplement, London, 1831 (August); 1st ed. Madras, 1820; H. Young, M.D. (of the Bengal Service), Remarks on the Cholera Morbus, 2nd ed. 1831; Alex. Smith, M.D. (Calcutta), Description of the Spasmodic Cholera (substance of an old report to the Army Medical Board); W. Macmichael, M.D., Is the Cholera Spasmodica of India a Contagious Disease? London, 1831 (Sept.); T. J. Pettigrew, Obs. on Cholera, comprising a description of the Epidemic Cholera of India, London, 1831 (13 Nov.); John Austin, Cholera Morbus, Indian and Russian Cholera, London, 1831 (July); John Goss, late H. E. I. C. S., Practical Remarks on the Disease called Cholera, London, 1831 (Nov.); Whitelaw Ainslie, Letters on the Cholera, London, 1832 (from Edinburgh, Dec. 1831); Henry Penneck, M.D., Nature and Treatment of the Indian Pestilence commonly called Cholera, London, 1831 (Penzance, 24 Nov.); A. P. Wilson Philip, Nature of Malignant Cholera, London, 1832; Official Reports made to Government by Drs Russell and Barry on Cholera Spasmodica observed during the Mission to Russia in 1831, London, 1832; John V. Thompson, Dep. Insp. Gen. of Hosps. The Pestilential Cholera unmasked, Cork, 1832 (January). [1478] Op. cit. p. 469. [1479] Lond. Med. Gaz. 1831. [1480] James Hall, “Narrative of an Epidemic English Cholera that appeared on board ships of war lying in ordinary in the River Medway during the Summer and Autumn of 1831.” Edin. Med. Surg. Journ., Feb. 1832, p. 295. [1481] John Marshall, M.D., Obs. on Cholera as it appeared at Port Glasgow in July and August, 1831. Illustrated by numerous cases. 1831. [1482] William Dixon, Lond. Med. Gaz. 4 Feb. 1832, IX. 668. [1483] Dixon, u. s. [1484] Kell, p. 22. [1485] Kell, Dixon, and others; the statements about Henry’s case are contradictory. [1486] Clanny, p. 19. [1487] A table of the daily course of the cholera at Sunderland, which I must omit for want of space, is given in the essay by Haslewood and Morbey, History and Medical Treatment of Cholera as it appeared in Sunderland in 1831, London, 1832, p. 151. [1488] Kell, however, suspected that there were many malignant cases in Monk Wearmouth after the 31st of October, which were not reported. l. c. p. 73. [1489] Clanny says (p. 42), “At first our epidemic appeared only in certain streets or lanes, namely, the Fish Landing, Long Bank, Silver Street, High Street, Burleigh Street, Mill Hill, Sailors’ Alley, Love Lane, Wood Street, Warren Street; as also in several lanes in Bishopwearmouth, the New Town, Ayre’s Quay, and on the north side of the river in Monkwearmouth, in several of the byelanes near the river.... Generally speaking the disease fixed its residence in such places as medical men could have pointed out À priori.” [1490] Besides the essay of Haslewood and Morbey, and the paper by Dixon, supra, the following were written on the Sunderland cholera: W. Ainsworth, Obs. on the Pestilential Cholera at Sunderland, London, 1832; John Butler Kell, surgeon to the 82nd Regt., Cholera at Sunderland in 1831, Edin. 1834; W. Reid Clanny, M.D., (chairman of the Local Board of Health), Hyperanthraxis, or the Cholera of Sunderland, Lond. 1832; Emile Dubuc, Rapport sur le Cholera Morbus À Sunderland, Newcastle, etc. Rouen, 1832. [1491] Ainsworth, p. 164, u. s., says: “Dennis Mc Gwin, who took the disease to North Shields, came from Sunderland. The first case in South Shields was a boy from Gateshead. A pedler woman took it to Houghton, a traveller to Morpeth, and I have no doubt its arrival could similarly be traced to Durham, Haddington and Tranent, all towns on the same high road. A wanderer also perished of the disease at Doncaster; but luckily there were no other cases.” [1492] T. M. Greenhow, M.D., Cholera as it has recently appeared in the Towns of Newcastle and Gateshead, including Cases, London, 1832; Thomas Mollison, M.D., Remarks on the epidemic Disease called Cholera, as it occurred in Newcastle, Edin. 1832. (He arrived at Newcastle from Edinburgh on the 21st Dec. and remained eleven days.) [1493] In Greenhow, u. s. [1494] Craigie, Edin. Med. Surg. Journ. XXXVII. 337. [1495] John Douglas, M.D., “History of the Epidemic Cholera of Hawick,” in Cholera Gazette, no. 6, April 7, p. 234. [1496] Chiefly from the paper by Professor George Watt, Glas. Med. Journ. v. 298, 384; see also Bryce, ibid. 262. [1497] W. Auchincloss, M.D., “Report of the Epidemic Cholera as it appeared in the Town’s Hospital of Glasgow in February and March, 1832,” Glas. Med. Journ. v. 113. [1498] James Cleland, LL.D., and James Corkindale, M.D., Edin. Med. Surg. Journ. XXXIX. 503. [1499] J. Adair Lawrie, M.D., “Report of the Albion Street Cholera Hospital.” Glas. Med. Journ. V. 309, 416. [1500] Month. Journ. Med. Sc. March, 1850, p. 302. [1501] Wood, Glas. Med. Journ. VI. 1833. [1502] Grieve, Month. Journ. Med. Sc. IX. 1849, p. 777. [1503] Scott, Edin. Med. and Surg. Journ. XXXIX. 276. For a whole month it was confined to one suburb. All the earlier cases were without exception fatal. There were 130 cases and 65 deaths. [1504] It is probably to Portmahomak or Inver that Howison refers in the following (Lancet, 10 Nov. 1832, p. 203): Cholera broke out in a small village several miles from Tain, and in a few days it carried off 41 out of a population of 120 to 140. Coffins could not be made fast enough. Many were buried in sailcloth. The people fled from their houses to the fields. [1505] Hugh Miller, My Schools and Schoolmasters, Chap. XXII. [1506] The good account by Paterson, “Observations on Cholera as it appeared at Collieston and Footdee,” Edin. Med. and Surg. Journ. XLIX. (1838), p. 408, shows how much panic a mortality of nine stood for. [1507] Sir J. Y. Simpson gave to Dr Graves of Dublin a list of some places in Scotland where cholera had appeared, which contains the additional names of Helmsdale (23 July), Fort William (24 Sept.), Fort George (7 May), Islay (23 Oct.), Portpatrick (7 Aug.), Crieff (2 Oct.), and Kelso (29 Oct.). [1508] Dubl. Journ. Med. Sc. III. 74. [1509] Times, 1 July, 1832. [1510] Simon McCoy, “Notes on Malignant Cholera as it appeared in Dublin,” Dub. Journ. Med. Sc. II. 357, and III. 1. [1511] Compare Grimshaw’s observations on the admissions for fever to the Cork Street Hospital in the summer of 1864, supra, p. 298. [1512] Wilde, Census of Ireland 1841. Table of Deaths, p. xxi. [1513] Gent. Magaz. 1832, June, p. 555; Annual Register, 1832, Chronicle (June), p. 71. [1514] Graves, Dubl. Quart. Journ. Med. Sc. Feb. 1849, p. 31, from information by Dr Little of Sligo. [1515] W. Howison, M.D., of Edinburgh, Lancet, 10 Nov. 1832, p. 203. He was at Londonderry in August, and had probably heard the reports of the Sligo cholera there. [1516] John Colvan, M.D., Dubl. Journ. Med. Sc. IV. 186. These five deaths in Armagh County in 1833 do not appear in the table. [1517] Graves, u. s. 1849, VII. 246. [1518] Roupell, Croomian Lectures on Cholera, Lond. 1833, p. 33, gives the suspicious case of a man named Webster, who sailed from Sunderland on 20 Jan. and arrived in the Thames about the 30th. “The vessel immediately obtained pratique; but a few days after, this man was seized with extreme pain in the epigastrium” &c. and died suddenly after symptoms in part those of cholera. Postmortem, 20 oz. of blood were found in the peritoneum, and some blood in the lower part of the bowel. [1519] The populous parishes of the Black Country around Wolverhampton came under notice in another way in 1832 as a crucial instance in the redistribution of seats by the Reform Act. [1520] T. Ogier Ward, “Cholera in Wolverhampton in Aug.-Oct. 1832,” Trans. Prov. Med. and Surg. Assoc. II. 368. [1521] Rev. W. Leigh, An authentic narrative of the awful visitation of Bilston by Cholera in Aug.-Sept. 1832. Wolverhampton, 1833. [1522] Rev. C. Girdlestone, Seven Sermons preached during the prevalence of the Cholera in the parish of Sedgley, with a narrative of that visitation. London, 1833. [1523] T. Ogier Ward, u. s., p. 376. [1524] James Collins, M.D., Lond. Med. Gaz. 30 June, 1832, p. 412; and report by Thompson, surgeon of the ‘Brutus,’ in the Cholera Gazette, s. d. [1525] Henry Gaulter, M.D., The Origin and Progress of the Malignant Cholera in Manchester. London, 1833, p. 113. [1526] The first case was of a coach-painter, who had had frequent attacks of painter’s colic. Opposite his house was a large stable dunghill in a very foetid state. On the evening of the 16th May he had eaten a heavy supper of lambs’ fry, and had been ill thereafter, the symptoms becoming those of Asiatic cholera on the night of the 18th, death ensuing at 2 p.m. 20th. [1527] In the hamlet adjoining a cotton-mill at Hinds, near Bury, consisting of thirty cottages in a row between the mill lade and the canal, wretchedly built, without chimneys, with windows that would not open, the inmates sleeping four or five in a bed, there were 32 cases of cholera with 7 deaths, but none of these were in persons who worked in the mill. Gaulter, u. s. citing Goodlad. He cites also Flint, of Stockport, for the rarity of attacks among the mill workers in that town. See also Samuel Gaskell, “Malignant Cholera in Manchester,” Edin. Med. and Surg. Journ. XL. 52. The microbic theory, or, as it was then called by Sir Henry Holland and others, the “hypothesis of insect life,” was happily thought of by a working cotton-spinner in Manchester to explain the immunity of the mill-workers in 1832. Gaulter (u. s. p. 120) gives in correct English what would probably have been said in the vernacular as follows: “I’ve been thinkin’, Maister,” said a spinner to Mr Sowden, millowner, “as how th’ cholery comes o’ hinsecks that smo’ as we corn’d see ’em, an’ they corn’d live i’ factories for th’ ’eÄt and th’ ile. Me an’ my mates wor speakin’ o’t last neet, an’ we o’ on us thowt th’ saÄm thing.” Hahnemann, cited by the Times, 17 July, 1831, believed that the cholera insect escaped from the eye, and fastened upon the hair, skin, clothes, &c. of other persons. The common microscopic objects uniformly found in the choleraic discharges by later observers have been vibrios, of which half-a-dozen, or perhaps a dozen, varieties have been distinguished. One of these was somewhat audaciously named the “cholera germ” or “comma bacillus of cholera” by Dr R. Koch, who went to Calcutta in 1884. All vibrios, which have a corkscrew form when in motion, are apt to assume the comma form when at rest. [1528] Times, Sept. 5, 1832. [1529] John Addington Symonds, “Progress and Causes of Cholera in Bristol, 1832.” Trans. Prov. Med. Surg. Assoc. III. 170. [1530] Some cases were detailed by Edward Blackman, M.D., Lond. Med. Gaz. 1832, pp. 473, 546. [1531] Thomas Shapter, M.D., The History of the Cholera in Exeter in 1832. London, 1849, pp. 297. [1532] Besides the papers or books already cited, accounts were published for the following places: Warrington, by Mr Glazebrook, secretary to the Local Board of Health; Oxford, by Rev. V. Thomas; Hull, by James Alderson, M.D.; Kendal, by Thomas Proudfoot, M.D. (Edin. Med. and Surg. J. XXXIX. 85); various places by J. Y. Simpson, M.D. (ibid. XLIX. 358); Tynemouth, by E. H. Greenhow, M.D. (Trans. Epid. Soc. 1861); London, by Halma-Grand (Relation etc. Paris, 1832), and by Gaselee and Tweedie (Lond. 1832). There are also various minor notices: for Whittlesea (Lond. Med. Gaz. I. 1832, p. 448), Hutton, Yorkshire (ibid. II. 1832, p. 316), York (Lancet, 13 Oct. 1832, p. 72), Cheltenham, showing how it was kept free (ibid. Nov. 10, p. 210), St Heliers, Jersey (Lond. Med. Surg. J. II. 359), Derby (ibid. 11. 383). [1533] The daily mortality in Paris at the beginning of the epidemic was as follows (Annual Register, 1832, p. 318):
To the 16th of April the deaths were about 8700; before the end of the month the total was nearly doubled. As the whole cholera mortality of Paris in 1832 was about 19,000, April must have had much the greater part of it. [1534] Proudfoot, Edin. Med. and Surg. Journ. XXXIX. 99. [1535] Graves, who was a strong contagionist (l. c. 1848-49), cites the instances of nuns, nurses and porters at Tuam, and of medical men at Sligo. [1536] G. D. Dermott, lecturer in Anatomy and Surgery, Lond. Med. and Surg. Journ. 1832, p. 274. [1537] John Parkin, surgeon H.E.I.C.S., “Cause, Nature and Treatment of Cholera.” Lond. Med. and Surg. Journ. 1 Sept. 1832. [1538] Graves, Clinical Medicine, 1843, p. 700: “I could bring forward the names of many medical men in Dublin whose lives, I am happy to say, were saved by the use of this remedy.” [1539] Paterson, u. s. for the fishing village of Collieston, Aberdeenshire: “In most instances where the lancet was used at the proper period little else was required. The patient, although in an apparently hopeless state at the time of my visit, was in these instances not unfrequently in the course of twenty-four hours out of danger.” [1540] A correspondent of the Lond. Med. Gaz. Sept. 1832, p. 731, dating from Warrington, proved by a statistical arrangement of 103 cases of cholera, that the saline treatment was nearly certain recovery, that the same combined with blood-letting was certain recovery, that blood-letting alone was certain death, and that opium with stimulants, and Morison’s pill, were each uniformly followed by a fatal result.
[1541] Quarterly Review, CXVIII. 256. [1542] Reported by Brewster to J. Y. Simpson, Edin. Med. Surg. Journ. XLIX. (1838), p. 368. [1543] Glas. Med. Journ. VI. (1833), p. 366. Stark says, perhaps for Edinburgh, that cholera recurred in the end of 1833 and beginning of 1834, with a high degree of fatality. [1544] Edmond Sharkey, M.B., Dubl. J. Med. Sc. XVI. 13. Of 28 houses or cabins (nearly all in three hamlets) which together had 76 cases, 16 cabins had each two cases, 8 had each three, 1 had four, 2 had each five, and 1 had six. The type of sickness was the same as in 1832-33. [1545] R. Green, M.D., Lancet, 14 April, 1838, p. 83: true Asiatic cholera began at Youghal in the second week of December, 1837, and lasted two months, about 200 having been attacked: “two of my relatives, Miss A. —— and Mrs K. ——, died in December of cholera, one in fourteen hours, the other in ten hours.” [1546] Deaths from Cholera in the Coventry House of Industry: 1838.
Twenty-seven were males and twenty-eight females. The ages were as follow:
—Second Report of the Registrar-General, p. 98. [1547] Stark, Ed. Med. and Surg. Journ. LXXI. (1849), p. 388; W. Robertson, Month. Journ. Med. Sc. IX. (1849). The other outbreaks reported in that part of Scotland (ibid.) were slight—at Dalkeith, Haddington, Borrowstowness. [1548] Easton, Glas. Med. Journ. V. 444. [1549] Sutherland, Report of the Board of Health. [1550] Sutherland, Report, u. s.; Grieve, Month. J. Med. Sc. IX. 777. Barker, ibid. 940 (gives good account of the stormy weather). [1551] Month. Journ. Med. Sc. IX. 783, 857, 1011, X. 403. [1552] Ibid. IX. 1009. [1553] Sutherland, Report, u. s. The year 1847, in which there was no cholera, had been much more fatal in the chief towns of Scotland, than either 1848 or 1849, owing to the great prevalence of typhus (Stark): Deaths from all causes.
[1554] H. MacCormac to Graves, Dub. Journ. Med. Sc. N. S. VII. 245. [1555] Most of the information on the cholera of 1849 in England comes from two sources: (1) the Report of the General Board of Health on the Epidemic Cholera of 1848 and 1849 (Parl. papers, 1850), containing the detailed reports of Mr R. D. Grainger for London, and of Dr John Sutherland for various other towns; and (2) the Quarterly Reports of the Registrar-General for the year 1849. See also note 3, p. 846. [1556] Sutherland, Report, u. s. p. 121. At Sheffield (ibid. p. 108) a sudden outbreak of diarrhoea occurred on 26 August over the whole town; 5319 cases of it were known, with only 76 cases of cholera and 46 deaths. [1557] Henry Cooper, “On the Cholera Mortality in Hull during the epidemic of 1849,” Journ. Statist. Soc. XVI. 347. The total is higher than that in the Table. [1558] Sutherland, Report, u. s., with map. [1559] For Bristol, Sutherland (p. 126) cites Goldney: “In a certain lodging-house there were 35 attacks and 33 deaths during the epidemic of 1832.... Out of the same house in 1849, 64 people were turned, of whom 49 were sent to the House of Refuge.” Not one case of cholera occurred among these, but many attacks of diarrhoea, which was general all through the epidemic, especially along the Frome. [1560] The epidemic in the small Devonshire fishing village of Noss Mayo near Plympton St Mary, was very fully investigated by A. C. Maclaren, Journ. Statist. Soc. XIII. (1850), p. 103. The Oxford epidemic (75 deaths) was described by Greenhill and Allen in the Ashmolean Society Reports. For Tynemouth, see Greenhow, Trans. Epid. Soc. The volume by Baly and Gull, Reports on Epidemic Cholera drawn up at the desire of the Cholera Committee Roy. Col. Phys. London, 1854, is in great part a review of the epidemic of 1849, in the form of a general discussion of the whole problem of Asiatic cholera. A subcommittee of the College also published a Report on the nature of the microscopic bodies found in the intestinal discharges of Cholera, London, 1849. [1561] Farr, “Influence of elevation on the mortality of Cholera.” Journ. Statist. Soc. XV. (1852), p. 155, and in the Reports of the Registrar-General. [1562] C. Barham, M.B., “Tavistock Parish Register,” Journ. Statist. Soc. IV. 37. [1563] Middleton, “Sanitary Statistics of Salisbury,” ibid. XXVII. (1864), p. 541. [1564] Report of the Commissioners appointed to inquire into the late outbreak of Cholera in Newcastle, Gateshead and Tynemouth. Parl. papers, 1854, pp. xl and 580. [1565] The most elaborate and minute account of an epidemic on this occasion was that for Oxford, Memoir on the Cholera at Oxford in the year 1854. By H. W. Acland, M.D., in which all the points in the problem of cholera are illustrated from the easily surveyed local circumstances. [1566] The registration district of Bideford had 46 deaths in 1854, the only large total in the West country. Kingsley’s graphic picture of the cholera of 1854 in Two Years Ago may have corresponded to these naked figures in the registration tables; but no place in Cornwall, in which county the scene appears to be laid, could have furnished so considerable an epidemic as the novelist describes, a few places in it having had each some half-dozen deaths. [1567] More than half in the end of 1853. [1568] Nearly all in the end of 1853. [1569] It was reported on by three commissioners, Dr Donald Fraser and Messrs Thomas Hughes and J. M. Ludlow, in the Report of the Committee for Scientific Inquiries, Cholera Epidemic of 1854. Appendix. [1570] John Snow, M.D., On the mode of communication of Cholera. London, 1849, 2nd ed. 1855. [1571] General Board of Health, Report on Scientific Inquiries, 1854, p. 52. [1572] J. W. Begbie, Ed. Med. and Surg. Journ. April, 1855, p. 250. [1573] Glas. Med. Journ. N. S. II. 127; III. 116, 500; John Crawford, M.D., “Report of Cases in the Cholera Hosp.” ibid. III. 48. [1574] W. Alexander, M.D., Edin. Med. Journ. II. 86. The Edin. Med. Journ. I. July, 1855, p. 81, contains a few lines of abstract of a paper by W. T. Gairdner on the diffusion of cholera in the remote districts of Scotland. Information on the subject is invited, but it does not appear that any full account of the cholera of 1854 in Scotland was published. It is known to have been in Aberdeen. [1575] Census of Ireland 1861, Part III. vol. 2, p. 23. [1576] Compiled from Grainger’s report for 1849, the Registrar-General’s Reports for 1854 and 1866, a table in Lancet, I. 1867, p. 125, and, for 1866, a table by Radcliffe, in Rep. Med. Off. Priv. Council for 1866, p. 339. [1577] Radcliffe, Rep. Med. Off. Privy Council for 1866, p. 294. [1578] Scoutetten, Histoire mÉdicale et topographique du Cholera Morbus, Metz, 1831; and Histoire chronologique du Cholera, Paris, 1870. David Craigie, M.D., “Remarks on the History and Etiology of Cholera,” Edin. Med. and Surg. Journ. XXXIX. (1833), 332. John Macpherson, M.D., Annals of Cholera, London, 1872 and 1884. N. C. Macnamara, A History of Asiatic Cholera, London, 1876. Transcriber’s Note: Footnote 427 appears on page 233 of the text, but there is no corresponding marker on the page. Footnote marker 562 appears on page 312 of the text, but there is no corresponding footnote on the page. This and all associated files of various formats will be found in: Updated editions will replace the previous one--the old editions will be renamed. 1.F. 1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a defect in this electronic work within 90 days of receiving it, you can receive a refund of the money (if any) you paid for it by sending a written explanation to the person you received the work from. If you received the work on a physical medium, you must return the medium with your written explanation. 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