INDEX. (continued 2)

[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:

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.”

Outward voyages Homeward voyages

Crew Military Crew Invalids

Number of men 2657 3919 2701 1075 —

Sick 1253 1751 1058 282 1533

Dead 28 50 51 27 96

[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:

[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”:

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.

[284]

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:

Cost of same in 1801

£ s. d.

5s. { { { A bushel of wheat 0 16 0

A bushel of malt 0 9 0

A pound of butter 0 1 0

A pound of cheese 0 0 4

Tobacco, one penny 0 0 1

£1 6 5

Weekly wage in 1801, 9s.

Parish bonus6s. 15 0

0 11 5 deficiency

[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.

[427] Bde. Berlin, 1879, II. 193.

[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.

Union of Loughrea, Co. Galway.

1841 65,636

1851 38,698

Union of Clonakilty, Co. Cork.

1841 52,185

1851 31,473

Union of Kanturk, Co. Cork.

1841 61,238

1851 41,801

Parish of Kanturk.

1841 4,096

1851 6,754

Union of Portumna, Co. Galway.

1841 30,714

1851 19,747

Union of Skibbereen, Co. Cork.

1841 57,439

1851 37,283

Parish of Skibbereen.

1841 9,557

1851 8,931

Union of Skull, Co. Cork.

1841 26,620

1851 16,866

Parish of Skull.

1841 2,895

1851 3,226

[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.