INDEX. (continued 4)

[923] Thomas Frewen, M.D., The Practice and Theory of Inoculation. London, 1749.

[924] J. Kirkpatrick, M.D., Analysis of Inoculation, with a consideration of the most remarkable appearances in the Small Pocks. Lond. 1754.

[925] Kirkpatrick, Analysis.

[926] La Condamine, Mémoires pour servir, &c. (Deuxième Discours), 1768, p. 91. It matters little what Lobb may or may not have done. But it does not appear that Boerhaave ever tried to get rid of the eruption of smallpox by means of drugs. In the chapter of his Aphorisms, “De Variolis” (§ 1392) he says that he imagines a specific might be found, in the class of antidotes, to correct and destroy the variolous virus, indicating antimony and mercury as likely agents for the purpose owing to certain physical properties of the medicinal preparations of them. Ruston (An Essay on Inoculation, 3rd ed. 1768) says that Boerhaave, who died in 1738, “never practised it himself; nor seems to have understood the manner in which these medicines operate to produce their salutary effects.” However they were known as the Boerhaavian antidotes to smallpox, and were used in Rhode Island, it is said with great success and as a secret. Ruston used them in England, and discovered by an analysis that Sutton’s secret powders were the same. They seem also to have been used by Cheyne to prevent the development of smallpox in persons who had been exposed to contagion and had presumably taken the contagion. Frewen, in 1759, published a pamphlet to show the improbability of antimony and mercury having any such action, and the fallacy of the claims made for their success.

[927] The Duchess gave the following account of her own case (Gent. Magaz. Nov. 1765, p. 495, sent by Gatti to a friend in London): “On the 12th of March, 1763, I was inoculated for the smallpox, and about four or five days afterwards a redness appeared round the orifice, which Mons. Gatti called an inflammation, and assured me was a sign that the smallpox had taken effect: these were the very terms he used. The redness or inflammation increased every day, and about the seventh or eighth day, the wound began to suppurate. There appeared also about the wound six small risings, or pimples, which successively suppurated and disappeared the next day. Mons. Gatti, upon their appearance, again assured me that the smallpox had taken effect. In the afternoon of the eleventh or twelfth day of my inoculation I felt a general uneasiness and emotion, a pain in my head and my back, and about my heart, in consequence of which I went to bed sooner than ordinary. I slept well, however, and rose without any disorder in the morning. These symptoms Mons. Gatti assured me were the forerunners of the eruption. The next day a pretty large rising or pimple appeared in my forehead, turned white, and then died away, leaving a mark which continued many days.

“The wound in my arm continued to suppurate seven or eight days, and Mons. Gatti now assured me that I had nothing to fear from the smallpox; and upon this assurance I relied without the least doubt, and continued in perfect confidence of my security till the natural smallpox appeared. I continued very well during the whole time of my inoculation, except one day, as mentioned above, and I went out every day.

“Monmorency, D. de Boufflers.”

[928] Gibbon’s Autobiography. It was to Dr Maty that Gibbon, in 1759, submitted his French essay on the Study of Literature, having had a fair copy of it transcribed by one of the French prisoners at Petersfield. Of Maty he says: “His reputation was justly founded on the eighteen volumes of the Journal Britannique, which he had supported almost alone, with perseverance and success. This humble though useful labour, which had once been dignified by the genius of Bayle and the learning of Le Clerc, was not disgraced by the taste, the knowledge and the judgment of Maty.”

[929] Angelo Gatti, M.D., New Observations on Inoculation. Translated from the French by M. Maty. Lond. 1768. The French edition was published at Brussels in 1767.

[930] John Andrew, M.D., The Practice of Inoculation impartially considered. Dated 17 June, 1765, Exeter, p. 61.

[931] La Pratique de l’Inoculation. Paris, An. VII. (1798), p 51.

[932] Andrew, u. s. p. 53.

[933] “I am sorry to have found that this operation has not always secured the patient from having the smallpox afterwards, if the eruptions have been imperfect without maturation. I attended one in a very full smallpox, which ran through all its stages in the usual manner; yet this patient had been inoculated ten years before, and, on the 5th day after inoculation, began to be feverish, with a headache, followed by a slight eruption, which eruption soon went off without coming to suppuration; the place of inoculation had inflamed and remained open ten days, leaving a deep scar, which I saw.” William Heberden, Senr., M.D., Commentaries on Disease (p. 436). This was published in 1802, after the author’s death; but as he was in the height of his practice from 1760 onwards, the case, which is undated, may be taken as illustrating Heberden’s position in the Suttonian controversy.

[934] Benj. Chandler, M.D., An Essay on the Present Method of Inoculation. Lond. 1767.

[935] Method of Inoculating the Smallpox. Lond. 1766. Baker thought he was “an enemy of improvement and no philosopher,” who stood upon the antecedent improbability of securing the patient by a minimal inoculation such as Sutton used.

[936] Giles Watts, M.D., Vindication of the Method of Inoculating. London, 1767.

[937] William Bromfeild, Thoughts on the Method of treating Persons Inoculated for the Smallpox. Lond. 1767. He was a Court surgeon and a man of some eminence. Morgagni dedicated one of the books of his De Sedibus et Causis Morborum to him as representing the Royal Society.

[938] W. Langton, M.D., Address to the Public on the present Method of Inoculation. London and Salisbury, 1767. Dr Thomas Glass, of Exeter, replied in 1767 to Bromfeild and Langton, in A Letter to Dr Baker on the Means of procuring a Distinct and Favourable Kind of Smallpox. Lond. 1767, and in a Second Letter to Dr Baker, 1767.

[939] W. Watson, M.D., An Account of a Series of Experiments instituted with a view of ascertaining the most successful Method of Inoculating the Smallpox. London, 1768.

[940] John Mudge, Surgeon at Plymouth, A Dissertation on the Inoculated Smallpox. London, 1777. A copy of this essay was found in the library of Dr Samuel Johnson. The Doctor was a friend of the author’s father, the Rev. Archdeacon Mudge, whose published sermons he has characterized in one of his most amusing balanced sentences of praise qualified with blame. Johnson stood godfather to one of John Mudge’s children. Notes on “Dr Johnson’s Library,” by A. W. Hutton.

[941] Edward Jenner, M.D., Inquiry into the Causes and Effects of the Variolae Vaccinae, or Cowpox. Lond. 1798, p. 56. See also his Further Observations on the Cowpox. 1799.

[942] Langton cites the following advertisement put out on 18 June, 1767, in his own district by Messrs Slatter and Duke, surgeons, of Ringwood, Hants: “The first objection I shall take notice of is that the disorder being in general so light, it is imagined there is danger of a second infection [i.e. a natural attack]. Whenever this has been supposed to have happened, I am certain the operation has failed, which not being discovered by the operator, proves to me that he was not experienced in the practice; for it may always be determined in four, five, or six days, sometimes sooner; and if there is the least reason to doubt, it is very easy to inoculate a second, third or fourth time, which may be done without the least inconvenience. I have inoculated several patients three or four times for their own satisfaction, having very little or perhaps no eruption.”

[943] Mem. Med. Soc. Lond. IV. 114.

[944] John Covey, of Basingstoke, 8 May, 1786, in London Medical Journal, VII. p. 180.

[945] Address to the Inhabitants of Liverpool on the subject of a General Inoculation for the Smallpox. 1 September, 1781.

[946] The account of the London charity is taken from the History of Inoculation in Great Britain (1796) by Woodville, who became physician to it in 1791.

[947] Med. Obs. and Inquiries, III. (1767), p. 287. The passage quoted (p. 306, note) is almost exactly in the words of Hufeland long after, with reference to the probable extinction of smallpox by cowpox. See his Journal, X. pt. 2, p. 189.

[948] J. C. Lettsom, A Letter to Sir Robert Barker, F.R.S. and G. Stacpoole, Esq. upon General Inoculation. London, 1778.

[949] A Plan of the General Inoculating Dispensary, &c. Lond. (no date).

[950] T. Dimsdale, Thoughts on General and Partial Inoculation. Lond. 1776. An Introduction to the Plan of the Inoculation Dispensary. 1778. Remarks on Dr Lettsom’s letter to Barker and Stacpoole. 1779.

[951] Lettsom, Obs. on Baron Dimsdale’s Remarks, &c. 1779; and other pamphlets on both sides.

[952] Clark, Report of the Newcastle Dispensary. 1789.

[953] Currie to Haygarth, 28 Nov. 1791, in Sketch of a Plan, etc., pp. 451, 207.

[954] J. C. Jenner, “An Account of a General Inoculation at Painswick.” Lond. Med. Journ. VII. 163-8.

[955] Gent. Magaz. April, 1788, reported by the Hon. and Rev. Mr Stuart, who was a grandson of Lady Mary Wortley Montagu.

[956] Monro, Account of Inoculation in Scotland, 1765; in his Works. Edin. 1781, p. 693.

[957] Statistical Account of Scotland. 1791-99, III. 376.

[958] Ibid. IV. 130. It was about the year 1782 that the College of Physicians of Edinburgh appointed a committee to inquire into the mode of conducting the gratis inoculations of the poor, which had been tried at Chester, Leeds, Liverpool, &c. in 1781-82. Haygarth, u. s. 1784, p. 207.

[959] Ibid. III. 582.

[960] Ibid. XX. 502-7.

[961] Ibid. XX. 348. Account by Rev. Abercromby Gordon, who gives in a note (p. 349) the following instance of professional zeal: “A surgeon in the north, presuming that self-interest has a stronger hold on man than superstition, has lately opened a policy of insurance for the smallpox! If a subscriber gives him two guineas for inoculating his child, the surgeon in the event of the child’s death pays ten guineas to the parent; for every guinea subscribed, four guineas, for half a guinea, two guineas, and for a crown one guinea.”

[962] James Lucas, Lond. Med. Journ. X. 269.

[963] Currie to Haygarth, 28 Nov. 1791, in the latter’s Sketch of a Plan, &c. p. 453.

[964] A Conscious View of Circumstances and Proceedings respecting Vaccine Inoculation. Bath, 1800. The author was probably James Nooth, senior surgeon to the Bath Hospital, who removed to London and practised in Queen Anne Street, holding the appointment of surgeon to the Duke of Kent. He wrote on cancer of the breast.

[965] Tracts on Inoculation. London, 1781.

[966] R. Pulteney, M.D., in a letter of 21 June, 1766, to Dr G. Baker, given in his Inquiry into the Merits of a Method of Inoculating the Smallpox. Lond. 1766.

[967] Pulteney, “Births, Deaths and Marriages of Blandford Forum, 1733-1772.” Phil. Trans. LXVIII. 615.

[968] Pulteney to Baker, App. to Inquiry into the method of Inoculating. 1766; Hutchins, Dorsetshire, I. 217.

[969] On 23 July, 1785, the apothecary makes a note in his book: “Some inspectors are not sufficiently careful to send information to the Hospital when children have had the smallpox.” MS. Records.

[970] Experiments, &c. 1768.

[971] Sir W. Watson, M.D., F.R.S., “On the Putrid Measles of London, 1763 and 1768.” Med. Obs. and Inquiries, IV. 153.

[972] Charles Kite, surgeon, Gravesend, “An Account of some anomalous Appearances consequent to Inoculation of Smallpox.” Memoirs Med. Soc. Lond. IV. (1794), p. 114.

[973] Fosbroke, Lond. Med. Repository. June, 1819, p. 466.

[974] Jenner to James Moore, in Baron’s Life of Jenner, II. 401: “Is not that a precious anecdote for your new work?” See also Court and Private Life of Queen Charlotte (Journals of Mrs Papendiek). Lond. 1887, I. 41, 70, 270.

[975] In Baron, u. s.

[976] A Conscious View, &c. u. s.

[977] Earle, in Jenner’s Further Observations. 1799.

[978] T. Adams to Richard Pew, M.D., of Sherborne. Lond. Med. and Phys. Journ. April, 1829.

[979] John Forbes, M.D., “Some Account of the Smallpox lately prevalent in Chichester and its vicinity.” Lond. Med. Reposit. Sept. 1822, p. 218.

[980] Discourse on Inoculation. Eng. Transl. 1755.

[981] A Series of Experiments, &c. 1768.

[982] John Haygarth, M.B., Inquiry how to prevent the Smallpox. Chester, 1784, p. 154.

[983] History of Inoculation in Britain. Vol. I. London, 1796, p. 33.

[984] History of Edinburgh. Edin. 1779, p. 260.

[985] W. Hillary, Rational and mechanical Essay on the Smallpox. Lond. 1735.

[986] J. Barker, The Nature of Inoculation explained and its Merits stated. London, 1769, p. 33. He taught that a depraved habit, by ill diet, &c., “serves for a nidus wherein the variolous matter rests.” If the variolous matter to be expelled is small, “by reason of natural health, temperance, or the power of preparation,” the disease is of the distinct kind; when large, of the confluent. “And wise indeed must he be who can find out any laws respecting the reception and expulsion of diseases superior on the whole to those which are original.” p. 9.

[987] “I have taken an account in this town [Halifax], and some parts of the country, and have procured the same from several other towns hereabouts, where the smallpox has been epidemical this last year, with as much exactness as was possible.” Phil. Trans. XXXII. 211.

[988] “A small neighbouring market town.”

[989] “More than usually mortal.”

[990] “A small market town in Lancashire, including two neighbouring villages.”

[991] Account taken “by a person of credit” and sent to Dr Whitaker. Jurin says, more generally: “Taken in several places by a careful enquiry from house to house.” Account, &c. 1724, p. 7.

[992] “At Uxbridge and in the neighbourhood, the smallpox having been exceedingly fatal all thereabouts.”

[993] Mr Maitland’s Account of Inoculating the Smallpox vindicated. 2nd ed. Lond. 1722.

[994] Phil. Trans. XXXIII. 379. “A short account of the Anomalous Epidemic Smallpox beginning at Plymouth in August, 1724, and continuing to the month of June, 1725, By the learned and ingenious Dr Huxham, physician at Plymouth.”

[995] The totals are given in Jurin’s Account for 1725. The ages are in the original communication of the Rev. Mr Wasse, among the MS. papers which Jurin had deposited with the Royal Society.

[996] The most singular thing in the Aynho experience is that there should have been no cases in infants under two years. It was observed, however, some two generations after this, that smallpox attacked children at the earliest ages in the great towns (Haygarth, Sketch of a Plan, &c., 1793, p. 31), and even in the worst conditions of infancy it has attacked relatively few in the first three months of life. Again, it is nearly as remarkable that there should have been only three cases at Aynho in the third year of life and only four in the fourth. However, the fewness of cases in the five first years of life must be taken as exceptional, even for a village epidemic. If Nettleton, who made the first of these censuses of smallpox epidemics and suggested to Jurin that they should be carried out elsewhere, had given the ages, he would certainly have included some in infancy, for he mentions, in the course of his inoculation experiences, particular cases at nine months, eighteen months, etc.

[997] Frewen, Phil. Trans. XXXVII. 108.

[998] See above, pp. 485-6 and 490-1.

[999] Deering, Nottingham vetus et nova. 1751, pp. 78, 82. He says, in an essay on smallpox (Improved Method of treating Smallpox. Nottingham, 1737) that he treated fifty-one cases in the epidemic of 1736, of which only three proved fatal.

[1000] Gent. Magaz. 1741, p. 704.

[1001] Alex. Monro, primus, in his Report to the Dean of the Faculty of Medicine of Paris on Inoculation in Scotland, 1765. Reprinted in his Works. Edin. 1781, p. 485. He does not give ages, but an inspection of the burial registers is said to show that they were nearly all under five.

[1002] Gent. Magaz. 1742, p. 704. Blomefield gives 1710 and 1731 as great smallpox years in Norwich.

[1003] Ibid. 1747, p. 623. The population of Northampton in 1746 was 5136. Price, Revers. Payments. 4th ed. I. 353.

[1004] Part of the account extracted from the parish registers by the Rev. Samuel Partridge, F.S.A., vicar of Boston, and sent to Dr George Pearson, who published it in the Report of the Vaccine Pock Institution for 1800-1802. London, 1803, p. 100.

[1005] J. C. M’Vail, M.D. in Proc. Philos. Soc. Glasgow, XIII. 1882, p. 381, from a MS. register kept by the session clerk of Kilmarnock, now in the General Register House, Edinburgh. The baptisms and burials have not been extended from the MS. for more years than the table shows.

[1006] Statist. Acct. of Scotland.

[1007] Sketch of a Plan, &c. 1793, pp. 33-34.

[1008] The following is the Ackworth bill given by Price, Phil. Trans. LXV. 443.

1747-57 1757-67

Christened 127 212

Buried 107 156

Consumption 23 38

Dropsy 5 3

Fevers 35 23

Infancy 13 13

Old age 24 30

Smallpox 1 13

Chincough — 2

Convulsions — 6

Dysentery — 2

Measles — 2

Sundries 6 24

Total deaths in ten years 107 156

[1009] The following are some examples of rural fecundity and health: Middleton, near Manchester, 1763-72, births 1560, deaths 993, average of 4·75 children to a marriage. Tattenhall, near Chester, 1764-73, births 280, deaths 130; Waverton, same county and years, births 193, deaths 84. Stoke Damerel (now the dockyard near Plymouth), in 1733 (in part an influenza-year), births 122, deaths 62, population 3361. Landward townships of Manchester in 1772, births 401, deaths 246. Darwen, in 1774-80, births 508, deaths 233, population 1850. From Papers in Phil. Trans. by Percival and others.

[1010] Statist. Acct. of Scot. I. 155.

[1011] Hoare’s Wiltshire, VI. 521. There had been a general inoculation to the number of 422, from 13 August, 1751, to February, 1752, just before the epidemic. Brown to Watson, in Phil. Trans. XLVII. 570.

[1012] Huxham, Ulcerous Sore-throat, 1757.

[1013] Gent. Magaz. 1751, Supplement, p. 577. See also June, 1751, p. 244, and letter of “Devoniensis,” ibid. 1752, p. 159. The subject had been raised by Corbyn Morris in his Observations on the past growth and present state of London, and was discussed, from an actuary’s point of view, by Dodson in Phil. Trans. XLVII. (Jan. 1752), p. 333.

[1014] The weekly average deaths for eight weeks of September and October is 30·5 from two to five years and 11·1 from five to ten, which are about half the average at each age period during the maximum prevalence of smallpox.

[1015] W. Black, M.D. (Observations Medical and Political on the Smallpox, etc. London, 1781, p. 100) says: “I am induced by various considerations to believe that whatever share of smallpox mortality takes place in London amongst persons turned of twenty years of age, is almost solely confined to the new annual settlers or recruits, who are necessary to repair the waste of London, and the majority of whom arrive in the capital from twenty to forty years of age.”

[1016] Maddox, bishop of Worcester, preaching a sermon in 1752 for the Smallpox and Inoculation Charity, enforced his pleading by relating the recent case of “a poor man sick of this distemper, of which his wife lay dead in the same room, with four children around her catching the dreadful infection, but destitute of all relief, till they found some in that too narrow building which now importunately begs your compassionate bounty to enlarge its dimensions.”

[1017] The Gent. Magaz. Sept. 1752, p. 402, contains a long letter to refute the very prevailing notion among many people that there is very little occasion for doctors and apothecaries in smallpox, but that a good nurse is all the assistance that is usually wanted. “Whence this notion took its rise I cannot conceive, unless it was from the disease being visible, so that every one who has been at all used to it knows it when they see it.”

[1018] This was an argument used in the first writings on Inoculation, so as to prove the real hazard of dying by the natural smallpox. Thus, Maitland in his Vindication of 1722, which Arbuthnot is said to have had a hand in, deducts a quarter of the annual London deaths before he begins to estimate the ratio of smallpox among them, for the reason that eight out of nine infants who die in their first year are “non-entities” quâ smallpox, other causes of death having had the priority (p. 19). Jurin used the same argument for the same purpose in his Letter to Caleb Cotesworth, M.D., 1723, p. 11: “It is notorious that great numbers, especially of young children, die of other diseases without ever having the smallpox”; and again, “very young children, or at most not above one or two years of age,” including the stillborn, abortives and overlaid, chrisoms and infants, and those dead of convulsions. “It is true, indeed, that in all probability some small part of these must have gone through the smallpox, and therefore ought not to be deducted out of the account”; but he does deduct 386 in every 1000 London deaths before he estimates the ratio of smallpox deaths, which so comes out 2 in 17.

[1019] Percival, Med. Obs. and Inquiries, V. 1776, p. 287; population in Phil. Trans. LXIV. 54.

[1020] Haygarth, Inquiry how to prevent the Smallpox, 1784.

[1021] Haygarth, Sketch of a plan to exterminate the Natural Smallpox. Lond. 1793, p. 139.

[1022] John Heysham, M.D. “An Abridgement of Observations on the Bills of Mortality in Carlisle, 1779-1787,” in Hutchinson’s History of Cumberland. 2 vols. Carlisle, 1794, and separate reprint, Carlisle, 1797; also reprinted in Appendix to Joshua Milne’s Treatise on the Valuation of Annuities. London, 1815, pp. 733-752.

[1023] See Loveday’s Diary of a Tour, 1732, p. 120.

[1024] Gent. Magaz. 1755, p. 595. In a parish near Glasgow, Eaglesham, eighty children are said to have died of smallpox in 1713. Chambers, Domest. Annals, III. 387.

[1025] Robert Watt, M.D., Treatise on the History, Nature and Treatment of Chincough ... to which is subjoined an Inquiry into the relative mortality of the Principal Diseases of Children, and the Numbers who have died under ten years of age in Glasgow during the last thirty years. Glasgow, 1813.

[1026] This high mortality was probably caused by the epidemic agues of 1780, which specially affected Lincolnshire.

[1027] In 1802 the smallpox epidemic recurred, with 33 deaths. In 1801 there was one death.

[1028] Barker and Cheyne, u. s.

[1029] James Sims, M.D., Observations on Epidemic Disorders. London, 1773.

[1030] Two papers on Fever and Infection, 1763, p. 112.

[1031] Medicina Nautica.

[1032] Haygarth, Sketch of a Plan, &c., 1793, p. 32.

[1033] Gaol at Bury St Edmunds: In the winter of 1773, five died of the smallpox. No apothecary then. Leicester County Gaol: In 1774 three debtors and one felon died of the smallpox. “Of that disease, I was informed, few ever recover in this gaol.” Oxford Castle: In 1773 eleven died of the smallpox. In 1774 that distemper still in the gaol. In 1775 one debtor died of it in May, three debtors and a petty offender in June; three recovered. No infirmary, no straw to lie on. State of the Prisons.

[1034] I append Haygarth’s full table of the Chester smallpox epidemic, 1774:

Parish Families Persons Recovd. from smallpox Died of smallpox Not had smallpox

Suburbs { { St Oswald 924 4027 321 40 350

St John 774 3187 284 52 218

St Mary 583 2392 240 45 205

Trinity 330 1605 127 24 97

Old Parishes { { { St Peter 193 920 52 6 39

St Bridget 154 623 52 6 35

St Martin 154 611 47 18 35

St Michael 135 575 15 2 31

St Olave 134 536 42 8 43

Cathedral 47 237 3 1 7

3428 14713 1183 202 1060

[1035] Isaac Massey, Remarks on Dr Jurin’s last yearly Account of the Success of Inoculation. Lond. 1727, p. 6. Huxham held that children might be “prepared” for the natural smallpox, as it was then the custom to prepare them for the inoculated disease, so that few of them need have it severely: “I am persuaded, if persons regularly prepared were to receive the variolous contagion in a natural way, far the greater part would have them in a mild manner.” On Fevers. 2nd ed. 1750, p. 133.

[1036] C. Deering, M.D., Account of an improved Method of treating the Smallpocks. Nottingham, 1737.

[1037] John Lamport alias Lampard, u. s.

[1038] Obs. on Ship Fever, &c. New ed. Lond. 1789, p. 448.

[1039] Thomas Phillips, “Journal of a Voyage,” &c. in Churchill’s Collection of Voyages, VI. 173.

[1040] Berkeley’s claim for tar-water in smallpox was a double one, as a preventive or modifier, and as a cure. Of the former he says: “Another reason which recommends tar-water, particularly to infants and children, is the great security it brings against the smallpox to those that drink it, who are observed, either never to take that distemper, or to have it in the gentlest manner.” Further Thoughts on Tar-water, 1752. In his Second Letter to Thomas Prior, Esq. 1746 (in Works. 4 vols. Oxford, 1871, III. 476) he gives the famous case of curing by it:—“the wonderful fact attested by a solemn affidavit of Captain Drape at Liverpool, whereby it appears that, of 170 negroes seized at once by the smallpox on the coast of Guinea one only died, who refused to drink tar-water; and the remaining 169 all recovered, by drinking it, without any other medicine, notwithstanding the heat of the climate and the incommodities of the vessel. A fact so well vouched must, with all unbiassed men, outweigh, &c.”

[1041] Prince, Gent. Magaz. Sept. 1753, p. 414.

[1042] Walter Lynn, u. s. 1715, ad init.

[1043] Reports, &c. 1819.

[1044] Whytt, Med. Obs. and Inquiries, II. (1762), p. 187.

[1045] Cleghorn, Diseases of Minorca. London (under the years).

[1046] Hillary, Changes of the Air, and Epidemical Diseases of Barbados.

[1047] Muret, Mém. par la Société Économique de Berne, 1766. “Population dans le pays de Vaud”: p. 102, “J’ai vu à Veney, la petite vérole être générale dans toute la ville, des centaines d’enfans attaqués de cette maladie, et qu’à peine il en mouroit sept ou huit.”

[1048] Gent. Magaz. 1753, p. 114. Letter from Sam. Pegge, rector, 17 Feb. 1753.

[1049] Haygarth, Phil. Trans. LXV. 87.

[1050] Morton, Pyreologia, II. 338: “Et quidem omnes haereditario quasi jure benignis istis variolis tentabantur, quae (Deo favente) eventum secundum habuerunt; nunquam enim quemquam meâ vel conjugis meae stirpe ortum hoc morbo periisse memini.” The case of hereditary tendency to fatal smallpox is No. 53, p. 470: “Domina Theodosia Tytherleigh, virgo elegans ac formosa, stirpe celeberrima (sed cui hic morbus jure quasi haereditario funestus esse solebat)” &c. She died in a late stage of the disease.

[1051] Cal. Coke MSS. (Hist. MSS. Commis.) II. 429.

[1052] Rutty, Chronological History of the Weather and Seasons, and prevailing Diseases in Dublin during forty years. London, 1770, under the dates.

[1053] Short (Comparative History of the Increase and Decrease of Mankind in England, &c. Lond. 1767) has found somewhere a statement that in 1717 there was “a most fatal continual fever in the West of Scotland, in January and February, and not less fatal confluent smallpox in March and April.”

[1054] Lond. Med. Journ. VII. 163.

[1055] W. Watson, in Medical Observations and Inquiries by a Society of Physicians in London, IV. (1771), p. 153. Whether the epidemic that preceded the smallpox was measles or scarlatina is a question that was raised by Willan, and is referred to in the chapter on “Scarlatina and Diphtheria.”

[1056] Annals of the Lords of Warrington and Bewsey from 1587. By W. Beamont. Manchester, 1873, p. xix.

[1057] John Aikin, M.D., Descriptions of the Country from thirty to forty Miles around Manchester. London, 1795, p. 302.

[1058] Taken out of the register by Aikin at the request of Dr Richard Price, and published by the latter in the 4th ed. of his Obs. on Reversionary Payments. Lond. 1783, II. 5, 100.

[1059] Arthur Young, Six Months Tour through the North of England. 4 vols. London, 1770-71, III. 163.

[1060] Percival, Phil. Trans. LXV. 328.

[1061] Beamont, u. s. p. 116-17.

[1062] Ferriar, Med. Obs. and Reflections.

[1063] Price, Reversionary Payments. 4th ed. II.

[1064] Aikin, Phil. Trans. LXIV. (1774), p. 438; Haygarth, ibid. LXVIII. 131.

[1065] “Almost ended at the winter solstice, only 19 remaining ill in January, 1775.”

[1066] Percival, for Warrington, Med. Obs. and Inquiries, V. (1776), p. 272 (information from Arkin); Haygarth, for Chester, Phil. Trans. LXVIII. 150. Haygarth (Sketch of a Plan, &c. p. 141) gives the following table of the smallpox deaths and the deaths from all causes at several ages of children up to ten years at Chester from 1772 to 1777 inclusive:

Under one 1-2 2-3 3-5 5-10 Total

Smallpox deaths 91 75 83 86 34 369

All other deaths 392 155 68 68 53 736

[1067] Sketch of a plan, &c. p. 31.

[1068] Heysham, Obs. on Bills of Mortality in Carlisle, 1779-1787. Carlisle, 1797. Reprinted from App. Vol. II. of Hutchinson’s Cumberland.

[1069] Lucas, Lond. Med. Journ. X. 260: “The number of those who were still uninfected was found on a survey to be 700.”

[1070] Dr Henry, of Manchester, to Haygarth, 20 March, 1789, in the latter’s Sketch of a Plan, &c. p. 369: “In large and populous places such as Manchester, the smallpox almost always exists in some parts of the town. I have known it strongly epidemic in one part without any appearance of it in others.... At present it is prevalent and fatal in the outskirts, but very rarely occurs in the interior parts of the town.”

[1071] “Most of them [Jenner’s colleagues] had met with cases in which those who were supposed to have had cowpox had subsequently been affected with smallpox.” Baron, Life of Jenner, I. 48.

[1072] Haygarth to Worthington, 15 April, 1794, in Baron’s Life of Jenner, I. 134.

[1073] See the cases and remarks by John Hunter, Sir W. Watson, Lettsom and others.

[1074] Joseph Adams, Observations on Morbid Poisons, Phagedaena and Cancer. 1st ed. Lond. 1795. Preface, 31 March.

[1075] I have collected all the scattered references in Jenner’s writings to cowpox in the cow or in infected milkers in my Natural History of Cowpox and Vaccinal Syphilis. London, 1887, pp. 53-57.

[1076] G. Pearson, Inquiry concerning the History of Cowpox. Lond. 1798.

[1077] Beddoes’ Contributions to Physical and Medical Knowledge. Bristol, 1799, p. 387.

[1078] See my Natural History of Cowpox, &c. u. s. 1887. The most systematic descriptions, both for cows and milkers, are by Ceely, in Trans. Provinc. Med. and Surg. Assocn. VIII. (1840) and X. (1842). Professor E. M. Crookshank has reproduced these valuable memoirs, with the coloured plates, in his History and Pathology of Vaccination. 2 vols. London, 1889. The plates are in vol. I., the memoirs in vol. II. Crookshank’s volumes, which are a convenient repertory of the more important earlier writings on cowpox, contain also the author’s original observations (with plates), of cowpox in Wiltshire in 1887-88.

[1079] In my essay of 1887 (u. s.) I maintained, as an original opinion, that the true affinity of cowpox was to the great pox of man, and that the occasional cases of so-called vaccinal syphilis were not due to the contamination of cowpox with venereal virus but to inherent (although mostly latent) properties of the cowpox virus itself. This opinion was at first received with incredulity, but is now looked upon with more favour. See Hutchinson, Archives of Surgery, Oct. 1889, and Jan. 1891, p. 215. The concessions hitherto made are only for cases that have arisen since my book was published, such as the case at the Leeds Infirmary in 1889. I believe that my explanation of vaccinal “syphilis” will at length be accepted for all cases, past or future.

[1080] An Inquiry, &c. 1798. “Remarks on the term Variolae Vaccinae.”

[1081] That Dr Jenner foresaw this line of proof, and dismissed it as irrelevant, is made clear by G. C. Jenner, Monthly Magazine, 1799, p. 671, in reply to Dr Turton, of Swansea: “It is possible that variolous virus inserted into the nipples of a cow, might produce inflammation and suppuration, and that matter from such a source might produce some local affection on the human subject by inoculation. But all this tends only to show, what was well known before, that virus taken from one ulcer is capable of producing another by its being inserted into any other part of the body.”

[1082] Jenner, Further Observations on the Variolae Vaccinae, 1799.

[1083] Thornton, in Beddoes’ Contributions to Physical and Medical Knowledge. Bristol, 1799.

[1084] Hughes, Med. and Phys. Journ. I. (1799), p. 318. Many other tests, English and foreign, are detailed in my book, Jenner and Vaccination. London, 1889, for which see the Index under “test.”

[1085] Woodville tabulated 511 cases of applicants for inoculation at the hospital in whom cowpox matter was used, giving “the number of pustules” opposite the name of each; 90 had from a thousand to a hundred pustules, 215 had less than one hundred. William Woodville, M.D., Reports of a Series of Inoculations for the Variolae Vaccinae or Cowpox; with remarks on this disease considered as a substitute for the Smallpox. London, 1799. In a subsequent letter (Med. Phys. Journ. V., Dec. 1800), he thus explained the occurrence of smallpox among those recently inoculated with cowpox: “If a person who has been exposed to the contagion of smallpox for four or five days be then inoculated for this disease, the inoculation prevents the effects of the contagion, and the inoculated smallpox is produced. But if the vaccine inoculation be employed in a case thus circumstanced, the smallpox is not prevented, although the tumour produced by the cowpox inoculation advance to maturation. It was not before the commencement of the present year [1800], that I ascertained that the cowpox had not the power of superseding the smallpox. For, though from the first trials that I made of the new inoculation it appeared that these diseases, as produced in the same subject from inoculation, did not interrupt the progress of each other; yet as the casual does not act in the same manner as the inoculated smallpox, and may be anticipated by the latter, I thought it still probable that the cowpock infection might have a similar effect. Numerous facts have, however, proved this opinion to be unfounded, and that the variolous effluvia, even after the vaccine inoculation has made a considerable progress, have in several instances occasioned an eruption resembling that of smallpox.”

[1086] European Magazine, XLIII. 137.

[1087] Bateman, u. s. 1819, Aug.-Nov. 1807: “In a court adjoining Shoe Lane, in the course of one month, twenty-eight persons had died of smallpox.” Autumn, 1812: “In one small court in Shoe Lane, seventeen have lately been cut off by this variolous plague.” Also in the summer of 1812, “perhaps universally through the metropolis.”

[1088] Extracted from the Annual Reports of the Dispensary.

[1089] Heysham to Joshua Milne, in the latter’s Treatise on the Valuation of Annuities. London, 1815. App. p. 755.

[1090] Cross, 1819, u. i. p. 2.

[1091] Most of these were brought to light by inquiries upon the alleged failures of cowpox to avert the epidemic. The serial numbers of the Medical Observer contain frequent references to them.

[1092] Letter to Joshua Dixon, in Memoirs, III. 368.

[1093] Bateman, Edin. Med. Surg. Journ. VIII. 515.

[1094] C. Stuart, ibid. VIII. 380.

[1095] Rigby, ibid. X. 120.

[1096] Joshua Dixon, The Literary Life of William Brownrigg, M.D. Whitehaven, 1801, pp. 238-9.

[1097] Haygarth says: “With us in Chester, smallpox is seldom heard of except in the bills of mortality. There its devastation appears dreadful indeed.” Sketch of a Plan, &c. 1793, p. 491.

[1098] Barker and Cheyne, Account of the Fever, &c. 2 vols. 1821. I. 92.

[1099] Francis Rogan, M.D., Obs. on the Condition of the Middle and Lower Classes in the North of Ireland. Lond. 1819, p. 17. He proceeds to say:—“The numerous cases, which came to my knowledge, of children in the neighbouring towns who had taken smallpox, after having been vaccinated by medical practitioners of high respectability, led me to pay particular attention to those whom I myself inoculated [with cowpox]; and, although they were numerous both in private practice and at the Dispensary, not one instance occurred among them.” It comes out however that he did not keep them long in sight; he saw them on the 7th day after vaccination, and again on the 11th; and as they were meanwhile almost daily exposed to contagion, without catching it, he concluded that his own cases never would do so.

[1100] W. L. Kidd. “A concise Account of the Typhus Fever at present prevalent in Ireland, as it presented itself to the Author in one of the towns in the North of that country.” Edin. Med. and Surg. Journ. XIV. (1817), 144. He goes on: “A great number of those attacked were reported to have been formerly vaccinated. At Londonderry, in particular, great numbers who were said to have undergone vaccination were the subjects of smallpox; and, whether justly or not, vaccination has in that part of the country lost much of its credit as a preservative against smallpox.”

[1101] Redhead (dated Ulverston, 3 July, 1816) in Med. and Phys. Journ. Jan. 1817, p. 3.

[1102] James Black, “On Anomalous Smallpox.” Ed. Med. and Surg. Journ. Jan. 1819, p. 39.

[1103] Henry Dewar, M.D., Account of an Epidemic of Smallpox which occurred in Cupar in Fife in the Spring of 1817. Lond. 1818.

[1104] P. Mudie, M.D. to Thomson, 18 Oct. 1818: “Many of the cases occurring after vaccination so much resembled smallpox that, if my mind had not been prejudiced against the possibility of such an occurrence, I should have pronounced the eruption to have been of a variolous nature”—which, of course, it was.

[1105] Thomson, Account of the Varioloid Epidemic in Scotland, &c. Edin. 1820.

[1106] In Thomson, u. s.

[1107] Thomas Bent, M.D., “Observations on an Epidemic Varioloid Disease lately witnessed in the County of Derby.” Med. and Phys. Journal, Dec. 1818, p. 457. One Jennerian, Dr Pew, of Sherborne, adopted an arrogant tone towards Bent (Ibid. April, 1819, and farther correspondence). Jenner employed Fosbroke, of Berkeley, son of his friend and neighbour the antiquary Fosbroke, to traverse the whole case of the epidemic of 1817-19, in a long paper in the Medical Repository for June, 1819. The object of the paper appears to be to confuse the issues with a view to a verdict of non liquet. The Edinburgh Review thought Thomson’s book on the epidemic of 1817-19 important enough for an article, which has been attributed to Jeffrey. The article pronounced vaccination to be a very great blessing to mankind, but not a complete protection. This was not enough for Jenner, who wrote of the article: “It will do incalculable mischief: I put it down at 100,000 deaths at least.”

[1108] John Green Cross, A History of the Variolous Epidemic which occurred in Norwich in the year 1819. Lond. 1820.

[1109] Cross, u. s. Appendix.

[1110] W. Shearman, M.D., “Cases illustrating the Nature of Variolous Contagion and the Modifying Influence of Vaccine Inoculation.” Lond. Med. Repos. Dec. 1822. Case of a mother, with good vaccine marks, attacked with smallpox, which became dry and horny about the fifth day; case of her child, in which the eruption ran the full course of pustules, but also a mild case.

[1111] Lond. Med. and Phys. Journ. May, 1818, p. 488: “By Mr Field’s report of Christ’s Hospital smallpox in a mild form has been frequent post vaccinationem.”

[1112] Thomas Stone, F.R.C.S. “Table of Deaths from Smallpox in Christ’s Hospital, 1750 to 1850, with remarks,” in Appendix to Papers on the History and Practice of Vaccination: Parl. Papers, 1857. In 1761 there were four deaths from smallpox. For ten years, 1775 to 1784, there were none. In some other years of the latter half of the 18th century there were one or two deaths from that cause. There must have been some special reason for the four deaths in 1761. According to Massey (supra, p. 545), the apothecary in the beginning of the 18th century, not one death happened in forty attacks, the ages from five to eighteen being the most favourable of all for smallpox to fall in. In the present century scarlatina has displaced smallpox as an infectious cause of death in that school as in others. The deaths from scarlatina at Christ’s Hospital during the six years 1851-56 were nine.

[1113] John Forbes, M.D., “Some Account of the Smallpox lately prevalent in Chichester and its Vicinity.” Lond. Med. Repos. Sept. 1822, p. 208.

[1114] H. W. Carter, M.D., in Lond. Med. Repos. Oct. 1824, p. 267: “The cases which came to light of smallpox after vaccination were unfortunately numerous; some, it must be confessed, were exceedingly severe; others were exaggerated.”

[1115] The vaccinations are given in Cleland’s Rise and Progress of the City of Glasgow. Glasgow, 1820. The smallpox deaths from 1813 to 1819 are given, on Cleland’s authority, in the Edin. Med. and Surg. Journal, XXVI. p. 177.

[1116] R. Watt, M.D., Appendix to Treatise on Chincough.

[1117] John Roberton, Obs. on the Mortality, &c. of Children. Lond. 1827, p. 59, note.

[1118] Gregory, Report of the London Smallpox Hospital for the year 1825. Cited in the Med. and Phys. Journ. Feb. 1826, p. 176.

[1119] Cross, u. s.

[1120] Carter, u. s.

[1121] T. Proudfoot, M.D., Ed. Med. and Surg. Journ. July, 1822.

[1122] C. Stuart, u. s.

[1123] Dr Stokes, of Chesterfield, Med. and Phys. Journ. v. 17.

[1124] Benjamin Moseley, M.D., A Review of the Report of the Royal College of Physicians on Vaccination. 1808, p. 11. Jenner writing to James Moore, 18 Nov. 1812 (in Baron, II. 383), enumerates his various grievances against Pearson, “and finally, finding all tricking useless, his insinuations that vaccination is good for nothing.”

[1125] The equality of the two methods in this respect comes out incidentally in two reports of the Whitehaven Dispensary. In the report for 1796, when smallpox matter was in use, it is said that “173 were inoculated, all of whom, soliciting little medical assistance, recovered.” In 1801, when cowpox matter had been substituted in every case, the same phrase is used: “We seldom find any medical assistance required in this disease.”

[1126] The Beneficial Effects of Inoculation. Oxford University Prize Poem. Oxford, 1807. It seems probable that this was the “Oxford copy of verses on the two Suttons” that Coleridge (Biographia Literaria (1817), Pickering’s ed. II. 89) professed to quote from in the following passage; at least it would be remarkable if there had been printed another Oxford poem on the same subject and in the same manner: “As little difficulty do we find in excluding from the honours of unaffected warmth and elevation the madness prepense of pseudopoesy, or the startling hysteric of weakness over-exerting itself, which bursts on the unprepared reader in sundry odes and apostrophes to abstract terms. Such are the Odes to Jealousy, to Hope, to Oblivion, and the like, in Dodsley’s collection and the magazines of the day, which seldom fail to remind me of an Oxford copy of verses on the two Suttons, commencing with

It appears that Coleridge himself contemplated a poem on Cowpox Inoculation, which was to have exemplified what poetry should be, just as the 18th century Oxford poem on Smallpox Inoculation exemplified what poetry should not be. It was clearly more than the difference ’twixt tweedle-dum and tweedle-dee. Writing to Dr Jenner on 27 Sept. 1811, from 7, Portland-place, Hammersmith, he said: “Dear Sir, I take the liberty of intruding on your time, first, to ask you where and in what publication I shall find the best and fullest history of the vaccine matter as the preventive of the smallpox. I mean the year in which the thought first suggested itself to you (and surely no honest heart would suspect me of the baseness of flattery if I had said, inspired into you by the All-preserver, as a counterpoise to the crushing weight of this unexampled war), and the progress of its realization to the present day. My motives are twofold: first and principally, the time is now come when the ‘Courier’ ... is open and prepared for a series of essays on this subject; and the only painful thought that will mingle with the pleasure with which I shall write them is, that it should be at this day, and in this the native country of the discoverer and the discovery, be even expedient to write at all on the subject. My second motive is more selfish. I have planned a poem on this theme, which after long deliberation, I have convinced myself is capable in the highest degree of being poetically treated, according to our divine bard’s [Milton’s] own definition of poetry, as ‘simple, sensuous, (i.e. appealing to the senses by imagery, sweetness of sound, &c.) and impassioned, &c.’” The Life of Edward Jenner, M.D. By John Baron, M.D. 2 vols. II. 175.

[1127] Edin. Med. and Surg. Journ. I. 507.

[1128] Jenner to James Moore, 26 Feb. 1810, in Baron, II. 367.

[1129] Walker to Lettsom, 1 Sept. 1813, in Pettigrew’s Memoirs of Lettsom. Lond. 1817, III. 350.

[1130] Dr Smith to Dr Monro, Dunse, 2 June, 1818, in Monro’s Obs. on the different kinds of Smallpox, 1818. There appears to have been some reluctance to face the facts. “Though I have seen,” says Smith, “a multitude of cases in which smallpox has in every possible shape taken place after vaccination, I feel myself placed in the painful situation [why painful?] of bringing forward many facts to which gentlemen of the first eminence in the profession will probably give little or no credit.”

[1131] Lond. Med. Repository. Sept. 1822.

[1132] J. J. Cribb, Smallpox and Cowpox. Cambridge, 1825.

[1133] Ibid. Letter of Rev. R. Marks, of Great Missenden, 6 May, 1824: “The summer I came here the smallpox was introduced, and as the weather was very hot, and the confluent sort was what appeared, the people began to die almost as fast as they took the plague. Great prejudice prevailed against vaccination, in consequence of the parish having some years ago been vaccinated by a gentleman who knew nothing of the matter, and contaminated the people with decomposed virus, when it was good for nothing but to make ulcers and produced very wretched arms, and left them all liable to smallpox, which they were all inoculated for the same year.” This clergyman subsequently vaccinated 500 cases, and the parish surgeon 300: “and here,” says the former, “I had the happiness of seeing the plague and destruction of a most horrid smallpox completely stopped.”

[1134] Robert Ferguson, M.D. A Letter to Sir Henry Halford, proposing a method of Inoculating the Smallpox, which deprives it of all its Danger, but preserves all its Power of Preventing a Second Attack. London, 1825.

[1135] John Roberton, Observations on the Mortality and Physical Management of Children. London, 1827, p. 59, note.

[1136] J. Dalton, “Smallpox as it prevailed at Bury St Edmunds in 1825.” Lond. Med. and Phys. Journ. May, 1827, p. 406.

[1137] Cribb, u. s.

[1138] “Observation on Smallpox as it has occurred in London in 1825.” Med. and Phys. Journ. Feb. 1826, p. 117.

[1139] Med. and Phys. Journ. 1826, p. 122. “The general voice of the public satisfactorily showed that the upper ranks of society suffered during the past year from smallpox much less than the lower.”

[1140] Gregory, Report on the Smallpox Hospital, 4 Dec. 1825.

[1141] Farr, in the First Report of the Registrar-General (1839, p. 100), said: “It may be safely asserted that the parish clerks registered little more than half the deaths that occurred within the limits of the London bills of mortality.” Outside the limits of the bills there were large parishes, such as St Pancras, Marylebone, Kensington and Chelsea, which had large mortalities from smallpox in the first years of registration.

[1142] Tables in Murchison’s Continued Fevers of Great Britain.

[1143] Med. Chir. Trans, XXIV. 15. His other papers are: “Cursory Remarks on Smallpox as it occurs subsequent to Vaccination,” ibid. XII. 324; and “Notices of the Occurrences at the Smallpox Hospital during the year 1838,” ibid. XXII. 95. He contributed the treatise on Smallpox to Tweedie’s Library of Medicine, I. 1840, and indicated his final opinions (which are interesting) in his Lectures on the Eruptive Fevers, 1843.

[1144] Kenrick Watson, “Medical Topography of Stourport and Kidderminster.” Trans. Prov. Med. and Surg. Assoc. II. 195.

[1145] John Roberton, “On the Increasing Prevalence of Smallpox after Vaccination.” Lond. Med. Gaz. 9 Feb. 1839, p. 711. Roberton had been a warm supporter of the Jennerian method from as early a date as 1808, when he was resident in Edinburgh, and again in his book on The Mortality of Children, in 1827. The above cited paper is somewhat satirical, the disappointing facts of it being referred to the Island of Barataria. His conclusions are (p. 713): (1) “It is not fact, but conjecture, that the protective power of cowpox gradually ceases in the human system. (2) It is not fact, but conjecture, that a person successfully re-vaccinated is less liable to smallpox than he was before. (3) To affirm that, when re-vaccination fails in individuals, they are thereby proven to be secure from smallpox, is conjecture.”

[1146] Cowan, “On the Mortality of Children in Glasgow,” Glas. Med. Journ. V. (1831), p. 358, does not give Cleland’s figures, but says: “No bills of mortality except those for the Royalty in the Glasgow Courier are in existence for the period from 1812 to 1821”; and again: “Finding that the suburbs were excluded, and the Calton being the burying-place in which the greatest number of children are interred, I thought it needless to insert any tabular view of the deaths by measles since the date of Dr Watt’s tables.” Watt could have made no tables if he had not gone direct to the sixteen MS. volumes of burial registers, including those of the Calton.

[1147] J. C. Steele, Glas. Med. Journ. N. S. I. 60: “From 1812 to 1835 it is much to be regretted that no record of the deaths from smallpox has been kept for even a limited period.”

[1148] Glas. Med. Journ. I. 105: “There exists at present among the poorer classes an increasing carelessness and aversion to vaccination, from a belief that it does not afford adequate protection from the varioloid disease.”

[1149] Andrew Buchanan, M.D. “Present Condition of the Poor in Glasgow.” Glasg. Med. Journ. III. (1830), 437.

[1150] Chalmers had been urging the repeal of the Corn Law since 1819. In a letter to Wilberforce, Glasgow, 15 Dec. 1819, he says: “From my extensive mingling with the people, I am quite confident in affirming the power of another expedient to be such that it would operate with all the quickness and effect of a charm in lulling their agitated spirits—I mean the repeal of the Corn Bill.” Hanna’s Memoirs of Dr Chalmers, 1850, II. 250.

[1151] J. Orgill, “Obs. on the Measles and Smallpox that prevailed epidemically in Stranraer, in the autumn of 1829.” Glasg. Med. Journ. IV. 351.

[1152] McDerment, ibid. IV. 201.

[1153] Howison, ibid. V. 256-7.

[1154] J. C. Steele, Glasg. Med. Journ. N. S. I. 59.

[1155] Eleventh detailed Report of the Regr.-Genl. for Scotland, 1865, p. xxxix. The Report says that vaccination was general during the above period, although there was no Vaccination Act for Scotland (until 1864). This was familiar knowledge in Scotland, so much so that the necessity for a compulsory law, on the English model, was not quite obvious in the medical circles of Edinburgh. See Christison’s address to the Social Science Association at Edinburgh in 1863 (p. 106). In my own recollection of Aberdeenshire, the vaccination of infants was as little neglected as their baptism; the law made no real difference.

[1156] “An Enquiry into the Mortality among the Poor in the City of Limerick.” Journ. Statist. Soc. Jan. 1841, III. 316.

[1157] The Census of Ireland, 1841. Parl. Papers, 1843. Report on the Tables of Deaths, by W. R. Wilde.

[1158] From the Second Report of the Registrar-General, Lond. 1840, p. 180.

[1159] 1840.

1st qr. 2nd qr. 3rd qr. 4th qr.

Liverpool 172 184 90 85

Bath 25 42 22 8

Exeter — — 1 1

Bristol 6 54 49 76

Clifton 11 28 22 42

[1160] Douglass to Colden, 1 May, 1722, in Massach. Hist. Soc. Collect. Series 4, vol. II. p. 169.

[1161] Philip Rose, M.D., Essays on the Smallpox. London, 1724, p. 76.

[1162] Rev. R. Houlton, App. to A Sermon in Defence of Inoculation, Chelmsford, 1767, p. 59: “For, had the indictment been found, he would have assuredly nonsuited his enemies, and have proved beyond a possibility of doubt that he never brought into Chelmsford a patient who was capable of infecting a bystander, notwithstanding such person would convey infection by inoculation. However paradoxical this may seem, it is truth, and would have been proved to a demonstration.”

[1163] Darwin, Animals and Plants under Domestication, II. 356: “From these facts we clearly see that the quantity of the peculiar formative matter which is contained within the spermatozoa and pollen-grains is an all-important element in the act of fertilization, not only for the full development of the seed, but for the vigour of the plant produced from such seed.”

[1164] J. C. Lettsom, M.D., A Letter to Sir Robert Barker, F.R.S. and G. Stackpoole, Esq. upon General Inoculation. London, 1778, p. 8.

[1165] W. Black, M.D., Observations Medical and Political on the Smallpox, etc. London, 1781, p. 103.

[1166] “But, in the cowpox, no pustules appear, nor does it seem possible for the contagious matter to produce the disease from effluvia, or by any other means than contact, and that probably not simply between the virus and the cuticle; so that a single individual in a family might at any time receive it without the risk of infecting the rest, or of spreading a distemper that fills a country with terror.”

[1167] Parliamentary Papers, 1807, 8th July.

[1168] Bateman, Reports etc. 1819, p. 102. The principle of the Common Law on which the judgment rested was, “Sic utere tuo ut alienum non laedas.”

[1169] Joseph Adams, An Inquiry into the Laws of Epidemics, with Remarks on the Plans lately proposed for Exterminating the Smallpox. London, 1809. The Edin. Med. and Surg. Journal (VI. 231), in a long review of this essay, declared that Adams was inconsistent in reaffirming his old faith in cowpox and at the same time demanding liberty for the inoculators.

[1170] J. C. Steele, M.D., “Increase of Smallpox in Glasgow.” Glas. Med. Journ. N. S. I. 59. The Paris figures are cited from the Annuaire pour l’an 1852-53.

[1171] I do not, of course, answer for the correctness of Gregory’s statements.

[1172] Lancet, 12 Dec. 1838.

[1173] 409 of these in Sheffield.

[1174] There are two notable exceptions, marked †, Lancashire and Yorkshire; but, in regard to their higher mortality from smallpox in 1837-40, it should be kept in mind that they were the chief scenes of the great distress among the working class in those years, the same causes which produced an enormous mortality from typhus fever in adults having tended to increase the fatality of smallpox among the children.

[1175] In the first universal and very fatal epidemic of measles, that of 1808, a good many adults, who had not had measles before, were attacked. See the chapter on Measles.

[1176] The accounts by Fothergill, Wall and others, of the malignant sore-throat with scarlet rash about 1740 give prominence to cases in early manhood or womanhood.

[1177] Supplement (Decennial) to the 45th Report of the Regr.-Genl. 1885, p. cxii.

[1178] The figures for 1721 are cited above (p. 485) from Douglass and others. Those for 1752 are given in the Gent. Magaz. 1753, Sept., p. 413, as “collected from the Accounts of the Overseers in the Twelve several Wards,” and sent by the Rev. T. Prince.

[1179] Supplementary Report of the Registrar-General, 1883. The mean death rate per 1000 living, for the period 1838-82, has been 71·0 males, and 61·2 females under five years of age; but as late as 1878 the annual average was the mean of the period, namely 71·2 males and 61·1 females.

[1180] Lettsom (Gent. Magaz. 1804, Aug. p. 701), in a preface to Neild’s papers on the state of the prisons, estimated that 40,000 lives might be saved every year in England by preventing infectious fevers, “for in this metropolis my respectable friend Thomas Bernard, Esq., whose caution and accuracy no person will doubt, calculates the number of victims at 3000 each year [doubtless from the London Bills of Mortality].... If to this pleasing view we add the preservation of 48,000 victims to the smallpox, which may now be preferred by the cowpox, we have in our power to possess the sublime contemplation of forming a saving fund of human life of nearly 88,000 persons annually in this empire, by the exercise of reason, philanthropy and judicious policy.”

[1181] Duvillard, Tableaux etc. Paris, 1806.

[1182] Essay on the Principle of Population. Bk. IV. chap. 5.

[1183] Robert Watt, M.D. Treatise on Chincough, with Inquiry into the Relative Mortality of the Diseases of Children in Glasgow. Glasgow, 1813.

[1184] John Graunt, Natural and Political Observations upon the Bills of Mortality, London, 1662, says: “The original entries in the Hall books were as exact in the very first year [he probably means 1629, which is the first year of his own extracts from them, but the classification of deaths began in 1604] as to all particulars, as now; and the specifying of casualties and diseases was probably more.” The searchers, he explains, were in many cases able to report the opinions of the physicians, receiving the same from the friends of the deceased; while for certain causes of death, among which he includes smallpox, “their own senses are sufficient.”

[1185] Cal. Coke MSS. (Hist. MSS. Commis.) I. 21 June, 1628.

[1186] Sutherland Letters, in Rep. Hist. MSS. Com. V. 152.

[1187] Cal. State Papers, Domestic. Charles II. s. d. It appears from the Pyretologia by Drage, of Hitchin (1665), that the natural history of measles must have been familiar, for he mentions that its incubation period was from fourteen to fifteen days: p. 20.

[1188] Obs. Med. 3rd ed. (1675), Bk. IV. chap. 5.

[1189] Sydenham, Obs. Med. 1675, v. 3. “Morbilli anni 1674.” It entered almost every household, as on the last occasion, attacking infants more especially. It had some points of difference from the measles of 1670. The rash was less uniformly on the fourth day, now sooner, now later; it would come on the arms or trunk before the face; nor was it followed by the branny powdering which was as obvious in the measles of 1670 as it was usual to see it after scarlatina. Along with these anomalies of the rash, the consecutive fever and peripneumonia were also more severe, and a more frequent cause of death. But in the principal characters of measles the disease of 1674 was the same as that of 1670, and called for no fresh description. Among Sydenham’s patients were the children of the Countess of Salisbury, who all took measles in turn, and all passed through the attack and its sequelae without danger, under a particular regimen which is detailed. It is of great interest to see how this season of anomalous measles looks in the weekly bills, as in the above table.

[1190] Richard Morton, M.D. Pyretologia. 2 vols. Lond. 1692-94, I. 427. He places it in the year 1672 and in the six months of autumn and winter; and in another place (II. 71), where he cites clinical cases, he again gives the year 1672 as that in which measles “epidemice Londini publice grassabantur.” He compares the epidemic to a pestis mitior, and says that the disease had never been epidemic again to the date of his writing (1692-94). It is tolerably clear that, in writing twenty years after, he had forgotten the year and even the season—not the only error in dates in his work. Sydenham’s account of the great measles epidemic of spring and summer, 1674, was published the year after, and is exactly borne out by the weekly bills of mortality. Morton’s obvious mistake of the date is the subject of a refutation four pages long by Thomas Dickson, M.D., F.R.S., physician to the London Hospital, in Med. Obs. and Inquiries, IV. (1771), p. 266.

[1191] Fothergill (Gentleman’s Magazine, Dec. 1751) says, in a criticism of the Bills of Mortality: “If the body is emaciated, which may happen even from an acute fever, ’tis enough for them to place it to the article of consumption.” And of course they would do so the more readily if the acute fever, say measles, were past, and its sequelae had been the cause of death. Referring to Kidderminster in 1756, Johnstone says: “Measles at this time went through our town and neighbourhood: vast numbers of children died tabid.” It is to be remarked that the fever column is augmented but little during the measles of 1674, a fact which shows that the inflammatory causes of death, such as capillary bronchitis and pneumonia (specially recorded by Sydenham for this epidemic), were more apt to be entered under “consumption” than under “fevers.”

[1192] See Watson’s account of smallpox following measles at the Foundling Hospital, supra, p. 550.

[1193] It may have been this high mortality that Dover had in mind when he wrote, in 1733: “I do not remember I ever heard of anyone’s dying of this disease [measles] till about twenty-five years since; but of late, by the help of Gascoin’s powder and bezoartic bolusses, together with blisters and a hot regimen, the blood is so highly inflamed and the fever encreased to that degree that it is become equally mortal with the smallpox.” Physician’s Legacy, 1733, p. 116.

[1194] Memorial to the House of Commons, supra, p. 84.

[1195] Edin. Med. Essays and Obs. V. 26.

[1196] Pronounced by Sims to have been wholly scarlatina, and by Willan to have been in part that disease.

[1197] Monthly reports in the Gentleman’s Magazine, under the dates.

[1198] Heberden’s paper on measles in Trans. Col. Phys. III. (1785), pp. 389, 395.

[1199] W. Black, M.D., Obs. Med. and Political on the Smallpox, &c. London, 1781, p. 207: “Few escape measles in infancy or childhood, and as we find one-tenth fewer to die of measles than of smallpox, etc.... In their future consequences, measles, especially in cities, are not without hazard, and are not unfrequently followed by hecticks.”

[1200] Percival, in Med. Obs. and Inquiries, V. (1776), p. 282.

[1201] Omitting the year 1760.

[1202] Compiled from the tables in the Gentleman’s Magazine, 1742-57. All Saints parish contained more than half the population.

[1203] Pearce, writing from St Croix, West Indies, 12 Oct. 1782, to Lettsom (Memoirs, III. 429), says the measles had been “very rife and fatal” there.

[1204] MS. Apothecary’s Books at the Foundling Hospital.

[1205] R. Willan, M.D., On Cutaneous Diseases. Vol. I. 1808, p. 244.

[1206] Heysham, u. s., p. 538.

[1207] James Lucas, “On Measles.” Lond. Med. Journ. XI. 325, dated 22 Aug. 1790.

[1208] Reports on the Diseases of London, 1796-1800. Lond. 1801, pp. 2, 13, 18, 32, 229.

[1209] John Roberton, in Med. and Phys. Journ. XIX. 185. Measles seems to have been more usual than scarlatina in Scotland as well as in Ireland. In the accounts of the several parishes written for the Statistical Account, about 1791-99, measles is often mentioned (and would appear at that time to have been more usual in country districts than smallpox), while hardly anything is said of scarlatina under that name, and not much of sore-throat.

[1210] Med. and Phys. Journ. VII. (1802), p. 316.

[1211] “Observations on Measles.” By Mr Edlin, surgeon, Uxbridge. Med. and Phys. Journ. VIII. (July-Dec. 1802), p. 28. An earlier epidemic of anomalous eruptive fever (“dark coloured eruption of the neck and breast which spread at length over the whole body”) was described for Uxbridge and its vicinity in the summer and autumn of 1799, in an essay reviewed in British Critic, XV. 435.

[1212] T. Bateman, M.D., Report on the Diseases of London, 1804-16. Lond. 1819, p. 90-91.

[1213] Samuel Fothergill, M.D., and others, in Med. and Phys. Journ. XVIII. (Dec. 1807), pp. 569, 572; XIX. 91, 185.

[1214] “The Epidemic Measles of 1808.” By Dr Ferguson. Med. and Phys. Journ. XXI. 359.

[1215] John Roberton, Med. and Phys. Journ. XIX. 182, 272, 278, 471.

[1216] Roberton, loc. cit. XIX. 471.

[1217] In the earlier period, according to Grainger, Lind and others, numerous cases of measles sometimes occurred on board ships of war.

[1218] Published as an Appendix to his Treatise on the History, Nature and Treatment of Chincough. Glasgow, 1813. Reprinted by John Thomson, Glasgow, 1888. Dr Watt is best known by his Bibliotheca Britannica (Edinburgh, 1819. 4 vols. 4to.), a wonderfully complete bibliography under the dual arrangement of subjects and authors, which is still indispensable for research in every branch of knowledge. Perhaps the many who use it are not all aware that it was the labour of a physician in Glasgow (originally a surgeon at Paisley), who died (in 1819) at the age of forty-five, having reached such professional distinction in his own city as to be elected President of the Faculty of Physicians and Surgeons.

[1219] De Febribus, 1659. Cap. XV.

[1220] Sketch of a Plan to exterminate the Casual Smallpox, &c. London, 1793, p. 152.

[1221] It was believed that smallpox left ill effects in some constitutions. William III. is said to have had the dregs of smallpox in his lungs. Roberton (u. s.) cites Saunders as teaching that smallpox caused scrofula, and he is himself doubtful whether an attack of it ever improved the constitution. Dr Moses Younghusband, of New Lebanon Springs, Med. Phys. Journ. XI. (1804), 317, wrote: “I see no more of the glandular suppurations formerly so frequent and unavoidable” after smallpox.

[1222] Johnstone, Malignant Epidemic Fever of 1756, London, 1757, says of Kidderminster during a season of high mortality from fever and other diseases: “The measles at this time went through our town and neighbourhood. The children commonly got over the usual course of this distemper; but vast numbers died tabid of its consequences. The chincough succeeded the measles.”

[1223] The Edin. Med. and Surg. Journ. XXVI. 177, cites from Cleland, with a reference which I have not succeeded in verifying, the following Glasgow figures for the period 1813-19: all deaths 22,060, smallpox 236 (1·07 per cent.), measles 614 (3·69 per cent.). But see Cowan, Glas. Med. Journ. V. 358, supra, p. 597.

[1224] Cowan, Journ. Statist. Soc. III.

[1225] Griffin, ibid. III.

[1226] Macmichael, in an essay on scarlatina and other contagions, 1822, says: “Parents considering the measles as a disease almost inevitable have wisely chosen to expose their children to the contagion at such auspicious times [summer season]; so that the disorder may be once well over, and all further anxiety at an end.” p. 30.

[1227] P. Macgregor, Med. Chir. Trans. V. 436, obtained from Henry, of Manchester, the burials from measles at the Collegiate Church and St John’s Church for two years, 1812-13, which when compared with those abstracted by Percival from the former register for twenty years, 1754-74, showed a higher ratio of measles to the burials from all causes.

[1228] Cross, u. s.

[1229] Delagarde, Med. Chir. Trans. XIII. 163.

[1230] A. Campbell Monro, M.D., “Measles: an Epidemiological Study.” Chiefly from the Jarrow statistics. Trans. Epid. Soc. N. S. X. (1890-91), p. 94. The author connects the recent increase with the greater concourse of children to infant and elementary schools under the Education Act.

[1231] Rep. Reg.-Genl. LIV. p. xviii, and LV. p. xi. The explanation given is as follows: “When a county or other area has been visited by a severe epidemic [of measles] there is for several succeeding years scarcely sufficient material, in the shape of unprotected children, for another considerable outbreak, unless it be in very populous areas such as London or Liverpool; and in such places the disease is endemic.”

[1232] Buchan and Mitchell, Journ. Scot. Meteor. Soc. July, 1874, p. 194.

[1233] Ogle, in the 47th Report of the Registrar-General (for 1884), p. xv.

[1234] Cited by Hirsch, Geogr. and Histor. Pathology. Eng. transl. III. 28.

[1235] Harl. MSS. No. 2378. Moulton’s This is the Myrour or Glasse of Health, circa 1540, is in the main a printed reproduction of this manuscript prescription-book. The same receipt which is “for ye kink” in the one, is “for the chyncough” in the other (formula LXXIX.).

[1236] “Sycknesses happenynge to children:—When they be new borne, there do happen to them sores of the mouth called aphte, vometyng, coughes, watchinge, fearefulness, inflamations of the nauelle, moysture of the eares. When they brede tethe, ytchinge of the gummes, fevers, crampes and laskes. When they waxe elder, than be they greved with kernelles, opennesse of the mould of the head, shortnesse of wynde, the stone of the bladder, wormes of the bealy, waters, swellynges under the chynne, and in Englande commonly purpyles, measels and small pockes.”

[1237] Obs. Med. 3rd ed. Bk. IV. chap. V. § 8; Epist. Respons. I. § 42.

[1238] Mary Barker at Hambleton, to Abel Barker at the Dog and Ball in Fleet Street. Hist. MSS. Commis. V. 398.

[1239] Tractatus de morbis acutis infantum. Lond. 1689. Englished by W. Cockburn, M.D. London, 1693, pp. 38, 78, 87.

[1240] Gent. Magaz. 1751, pp. 195, 578.

[1241] Treatise on Chincough. Glasgow, 1813.

[1242] Vierordt, Physiologie des Kindesalters, Tübingen, 1877, p. 82, without adducing evidence that the larynx is congenitally different in the two sexes (a matter of very nice measurements which even Beneke does not appear to have attempted), says that the development of the posterior glottidean space has advanced before puberty much more in boys than in girls. Stark, a former Superintendent of Statistics for Scotland (Rep. Reg. Gen. Scot. for 1856, p. xxxviii), has raised the question thus: “The causes of this greater liability of the female sex to death while suffering from whooping-cough are worthy of being investigated. So far as one’s own limited experience goes, it would appear to be produced by the greater tendency which the female sex exhibits to have fits or convulsions when attacked by a paroxysm or fit of coughing in that disease.”

[1243] Changes in the Air, &c. ... in Barbadoes. Lond. 1760.

[1244] In the Irish Decennial Summary for 1871-80 (Suppl. to 17th Report of Reg.-Gen. Ireland, 1884) it is said: “A general relation has been noticed by many observers between the prevalence of whooping-cough and measles, and there is no doubt that in many localities an epidemic of measles is frequently accompanied by or followed by a prevalence of whooping-cough. A comparison of the figures in Table XV. does not point to any very close relationship. Whooping-cough was a much more fatal disease than measles, but it is more than probable that measles was equally prevalent.”

[1245] Illustrations of Unconscious Memory in Disease. London, 1886 [1885]. Chapter VI. pp. 64-83.

[1246] Med. Times and Gaz. 1885, II. p. 6.

[1247] Preface to 3rd ed. of Obs. Med., Greenhill’s ed. p. 16.

[1248] Sydenhami Opera, ed. Greenhill, 1844, p. 243.

[1249] Maton, Med. Trans. Col. Phys. V., having seen an extensive epidemic attended by a red rash in one of the great public schools, was disposed to erect it into a new type of roseola, owing to its mildness, while he admitted that it was the same as Sydenham’s scarlatina simplex. Macmichael (New View of the Infection of Scarlet Fever, 1822, p. 78) thought that this was “rather a proof of extreme refinement,” and that there was no need to give it a new designation. Gee, Brit. Med. Journ., 1883, II. 236, cites this “refinement” of Maton’s as one of the noteworthy things in the history of the diseases of children in this country.

[1250] Sir Robert Sibbald, M.D., Scotia Illustrata, sive Prodromus Historiae Naturalis. Edin. 1684. Lib. II. cap. 5, p. 55.

[1251] Richard Morton, M.D. Pyretologia. 2 vols. London, 1692-94, II. 69.

[1252] Engl. transl. 1737, p. 80. The reference by Dover (Ancient Physician’s Legacy, 1732, p. 117), is almost in the words of Sydenham, his master: “This is a fever of a milder kind than the measles [of which latter he did not remember anyone’s dying till about twenty-five years since], and does not want the assistance of a doctor. The skin seems to be universally inflamed, but the inflammation goes off in forty-eight hours.”

[1253] Edin. Med. Essays and Obs. III. 26.

[1254] Obs. de aere et morb. epid.

[1255] H. Warren, M.D., On the Malignant Fever in Barbados. London, 1740, p. 73.

[1256] Le Cat, in Phil. Trans. XLIX. 49: In 1736 and 1737, a prevalence of gangrenous sore-throats which chiefly attacked children. They reappeared in 1748 in young persons of the first distinction, not only at Rouen, but also at St Cyr, near Versailles, and at Paris.

[1257] Webster, Brief History of Epidemick and Pestilential Diseases. Hartford, 1799, II. 253: “Away, then, with crowded cities—the thirty feet lots and alleys, the artificial reservoirs of filth, the hot-beds of atmospheric poison! Such are our cities—they are great prisons, built with immense labour to breed infection and hurrying mankind prematurely to the grave.”

[1258] W. Douglass, M.D., The Practical History of a New Epidemical Eruptive Miliary Fever, with an Angina Ulcusculosa, which prevailed in New England in the years 1735 and 1736. Boston, N.E. 1736. This rare essay was reprinted in the New England Journ. of Med. and Surg. XIV. 1 (Jan. 1825).

[1259] In Belknap’s History of New Hampshire. Boston, 1791.

[1260] Gent. Magaz. Feb. 1752, p. 73.

[1261] The account by Kearsley, of Philadelphia, written about 1769 (Gent. Magaz. XXXIX. 251), refers to a great epidemic of throat-disease in New England in the spring, summer and autumn of 1746; but the date is almost certainly a mistake for 1736, as no such epidemic is known on contemporary authority.

[1262] Cadwallader Colden, M.D. “Letter to Dr Fothergill on the Throat Distemper,” dated New York, 1 Oct. 1753, in Med. Obs. and Inquiries, I. 211.

[1263] Belknap, III. 421.

[1264] Samuel Bard, M.D. “An Inquiry into the Nature, Cause and Cure of the Angina Suffocativa, or Sore throat Distemper, as it is commonly called by the inhabitants of this city and colony.” Trans. Amer. Philos. Soc. I. (1769-1771). Philad. 1771, p. 322. What purports to be a translation of this, is given in Reutte’s Recueil d’Obs. sur le Croup (Paris, 1810), the name of “croup” being introduced into the title, and some strange liberties taken with the text.

[1265] The impression made upon modern historians by these American accounts of the throat-distemper has not always been the same. Hecker finds in the malady described by Douglass the form of Frieselbräune, or miliary diphtheria, a somewhat rare and sporadic malady; in the account by Bard, he finds häutige Brandbräune, or membranous angina maligna; while he finds in an account by Chalmers for Charleston, S. Carolina, in 1770, a third variety, Friesel-Scharlachbräune, or miliary scarlet angina. Again, Jaffe finds in the account by Bard “many analogies with the diphtheria of our own day.” Hirsch identifies the throat-distemper of Douglass and Colden as “exquisite scarlet fever” and the disease described by Bard as diphtheria. Häser identifies the epidemic described by Douglass as diphtheria. Bard himself did not doubt that the disease which he saw in New York previous to 1771 was the same that Douglass saw at Boston in 1735-36. Hecker, Geschichte der neueren Heilkunde. Bk. I. chap. 8. Max Jaffe, “Die Diphtherie in epidemiol. u. nosol. Beziehung, &c.” Original paper in Schmidt’s Jahrbücher, CXIII. (1862), p. 97. Hirsch, 1st ed. of Handb. der histor. geogr. Pathol. I. 237, note 6; II. 125, note 4; and 2nd ed. III. 80. Eng. transl. Häser, Geschichte, &c. III. 471.

[1266] Gent. Magaz. IX. Nov. 1739, p. 606:—Died, “Nov. 27, the eldest and youngest son of Henry Pelham, Esq. of sore throats.”

[1267] John Chandler, F.R.S., A Treatise of the Disease called a Cold. Also a Short Description of the Genuine nature and seat of the Putrid Sore-Throat. London, 1761, p. 55.

[1268] Munk, Roll of the College of Physicians. Fothergill cites Spanish and other foreign writers on garrotillo in the historical introduction to his essay on the Sore-Throat (1748), without mentioning the fact that Letherland had been before him in that field.

[1269] John Rutty, M.D., Chronological History of the Weather and Seasons, and prevailing Diseases in Dublin, during forty years. London, 1770, p. 108.

[1270] John Starr, M.D., “Account of the Morbus Strangulatorius.” Phil. Trans. XLVI. 435, dated Liskeard, Jan. 10, 1749/50.

[1271] John Fothergill, M.D., An Account of the Sore Throat attended with Ulcers; a Disease which hath of late years appeared in this City and the parts adjacent. London, 1748.

[1272] Sir Thomas Watson (Lectures, II. 817), who mentions excoriations of the anus, carried Fothergill’s idea of an absorption of the acrid matter to an extreme length in explaining the irritation of the alimentary canal in scarlet fever.

[1273] Letter to Rutty, Chronol. Hist. 1770, p. 117.

[1274] Gent. Magaz. Oct. 1751, and July, 1755, p. 343.

[1275] Nathaniel Cotton, M.D. Observations on a particular kind of Scarlet Fever that lately prevailed in and about St Albans. In a Letter to Dr Mead. London, 1749 (12th February). The copy in the British Museum library has a written note signed R. W. (Robert Willan, M.D.): “The only just and correct account; but was not noticed during the author’s lifetime, and it has since been consigned to oblivion.” In his work On Cutaneous Diseases (1808), Willan sarcastically contrasts the means by which Fothergill gained fame while Cotton escaped notice; of the latter he says: “But, as he gave an old appellation to a disease certainly not new, his work attracted little attention, and procured him no emolument.”

[1276] John Huxham, M.D., A Dissertation on the Malignant Ulcerous Sore-Throat. London, 1757.

[1277] Supra, p. 125.

[1278] John Wall, M.D. “Bark in the Ulcerated Sore Throat.” Gent. Magaz. 1751, Nov. p. 497. Dated Worcester, 15 Oct. 1751.

[1279] Nash, History of Worcestershire, II. 39.

[1280] James Johnstone, M.D., Malignant Epidemic Fever of 1756. London, 1758.

[1281] To those who explicitly distinguished the sore-throat or angina maligna from scarlatina may be added Dr Richard Russell: “In hoc quidem morbi statu mitissimo, si ad quartum vel quintum usque diem eruptiones in cute superstites sint, paulatim recedant, et desquamationes furfuraceae, perinde ut in febre scarlatina, post se reliquant, ibi crisis integra et perfectissima est.” Œconomia Naturae in Morbis Acutis et Chronicis Glandularum. Lond. 1755, p. 105 seq.

[1282] Letters of Horace Walpole, ed. Cunningham, III. 280, letter to Mann, 20 Jan. 1760.

[1283] Charles Bisset, Essay on the Medical Constitution of Great Britain, with obs. on the weather and diseases in 1758-60. London, 1762.

[1284] Hecker (u. s.) identified Bisset’s epidemic disease in Cleveland with Douglass’s in New England. Merely because they used the term “miliary,” he erects their epidemics into an imaginary class of angina miliaris which was not scarlatina.

[1285] Short to Rutty, Rotherham, 26 March, 1760, in Rutty’s Chronol. Hist. of Weather, &c. and Diseases in Dublin. London, 1770, p. 117.

[1286] Sir David Hamilton, Tractatus Duplex, &c. London, 1710 (Engl. transl. 1737, p. 84), says that, in 1704, several in the “miliary fever” had “a pain in the jaws resembling that of the squinsy,” which killed many suddenly. At the other end of the century, Willan (Cutaneous Diseases, 1808, p. 333), said of fever in 1786: “The title ‘angina maligna’ would have applied with equal, if not with more propriety, to the sore-throat connected with a different species of contagion, namely, that of the typhus or malignant fever originating in the habitations of the poor where no attention is paid to cleanliness or ventilation.”

[1287] Francis Penrose, A Dissertation on the Inflammatory, Gangrenous and Putrid Sore-Throat. Also on the Putrid Fever. Oxford, 1766.

[1288] Some Thoughts on the Anomalous Malignant Measles lately peculiarly prevalent in the Western Parts of England. London, 1760. And to be sold at Bath and Exeter.

[1289] William Watson, M.D. “An Account of the Putrid Measles as they were observed at London in the years 1763 and 1768.” Med. Obs. and Inquiries, IV. (1771), p. 132.

[1290] James Clarke, M.D. “Medical Report for Nottingham from March, 1807, to March, 1808.” Edin. Med. Surg. Journ. IV. 425.

[1291] These changes of the name from week to week represent probably the independent judgment of the apothecary more than the modified opinions of Watson the physician. The views which the latter expressed in his paper of 1771, are clearly reechoed in the following anonymous paragraph in the Gent. Magaz. XLII. (1772), Nov. p. 541: “The measles have lately been very rife and fatal in this metropolis. They are of a very different kind from those described by the great Doctor Sydenham, being of a malignant putrid nature, such as visited London in 1763 and 1768, where bleeding seemed of so little service, but small doses of emetic tartar, cordial medicines and blisters, were very efficacious. The above disorder was epidemic at Plymouth and parts adjacent in the years 1745 and 1750, and so long since as the year 1762 [1672] was described by Dr Morton, who says it raged so severely during the autumn of that year that it appeared like a gentle kind of plague, sparing neither sex nor age, and that 300 died weekly of it.”

[1292] W. Grant, M.D., Account of a Fever and Sore Throat in London, September, 1776. London, 1777.

[1293] W. Fordyce, M.D., A new Inquiry into the Causes, Symptoms and Cure of Putrid and Inflammatory Fevers; with an Appendix on the Hectic Fever, and on the Ulcerated and Malignant Sore Throat. London, 1773. The appendix on Sore-throat is pp. 209-222.

[1294] Gent. Magaz. XLII. (1772), June, p. 258.

[1295] G. Levison, M.D., An Account of the Epidemical Sore-Throat. 2nd ed. corrected. London, 1778 (1st ed. 1778).

[1296] It might have been the third, as Grant (u. s.) says there was fever with sore-throat in London in September, 1776.

[1297] “Angina and Scarlet Fever of 1778.” Mem. Med. Soc. III. 355.

[1298] James Johnstone, junr. M.D., A Treatise on the Malignant Angina or Putrid and Ulcerous Sore-Throat, &c. Worcester, 1779.

[1299] Robert Saunders, Observations on the Sore-Throat and Fever in the North of Scotland in 1777. London, 1778.

[1300] William Withering, M.D., Account of the Scarlet Fever and Sore-Throat, particularly as it appeared at Birmingham in 1778. London, 1779; preface dated 1st January.

[1301] Withering was perhaps too desirous to be thought the first in England to have described scarlatina anginosa. “The scarlet fever in its simple state,” he says, “is not a very uncommon disease in England, but its combination with a sore-throat, as described above, the violence of its attack, and the train of fatal symptoms that follow, are circumstances hitherto unnoticed by English writers.” It is probable from this that he had not seen Levison’s essay, with preface dated 11 May, 1778, his own being dated 1 January, 1779; but Cotton’s essay of 1749 actually bore the name of scarlet fever on its title-page, and described the throat-affection, glandular swellings, and the like quite correctly.

The name of the elder Heberden is frequently brought into the history of the identification of scarlatina, with a reference to his Commentaries on Diseases, which were not published until 1802, some time after his death at a very advanced age. The following are among his remarks: “In the fever which has just been described there is always some degree of redness in the skin, and the throat is not without an uneasy sensation. Where it happens that the throat is full of little ulcers attended with considerable pain, there the disease, though the skin be ever so red, is not denominated from the colour, but from the soreness of the throat, and obtains the name of malignant sore-throat; and many suppose that the two disorders differ in nature as well as in name,” p. 23. “The enfeebled and disordered state of all the functions of the body evidently points out such a malignity of the fever as cannot be owing to the affection of the uvula or tonsils, which in other distempers we often see ulcerated and eaten away, without any danger of the patient’s life. These sores, therefore, like pestilential buboes, point out the nature of the disorder; but the danger arises, not from them, but from the fever,” p. 25.

In 1790 an elaborate attempt was made by William Lee Perkins, M.D. (dating from Hampton Court, 1 March) to distinguish between cynanche maligna and scarlatina anginosa, in An Essay for a Nosological and Comparative View of the Cynanche Maligna or Putrid Sore-Throat, and the Scarlatina Anginosa. London, 1790. He proceeds by the nosological method of Sauvages and Cullen, erecting genera, species and varieties. The result is not clear after all; for on p. 43 (note) we read that scarlatina is frequently accompanied with inflammatory and ulcerous appearances in the fauces or throat, and that angina maligna or ulcerated sore-throat is often attended with red efflorescence on the skin; this had led to their being regarded as one and the same, and treated by the same method of cure.

[1302] J. Parker, A Treatise on the Putrid Constitution of 1777 and the preceding years, and the Pestilential one of 1778. London, 1779 (of inferior value beside Withering’s).

[1303] Heysham, in Hutchinson’s Hist. of Cumberland, u. s.

[1304] John Clark, M.D., Obs. on Fevers, and on the Scarlet Fever with Ulcerated Sore-Throat at Newcastle in 1778. Lond. 1780; Account of the Newcastle Dispensary from its commencement in 1777 to Michaelmas, 1789. Newcastle, 1789 (also by Clark).

[1305] James Sims, M.D. “Scarlatina Anginosa as it appeared in London in 1786.” Mem. Med. Soc. Lond. I. 388. Willan, however, says that measles was the epidemic in the winter and spring of 1785-86; while the epidemic at the Foundling Hospital was “measles” in March and April, 1786, “fever” in June and July, and “scarlet fever” in 1787.

[1306] On Cutaneous Diseases. Vol. I. London, 1808, pp. 262, 277, 345.

[1307] I Have Not Succeeded in Finding the Apothecary’s Book for the Years 1776-82, Within Which the Great London Epidemic of 1777-78 Fell; But Willan, Who May Have Had the Complete Set of Books Before Him, Says (op. cit. 1808, P. 245) “the Denomination ‘scarlet Fever and Sore-throat’ First Occurs in the Weekly Report, 1st September, 1787.” I am Indebted To the Courtesy of Mr Swift, M.R.C.S. for A Sight of the Books.

[1308] J. Barker, Epidemicks, Or General Observations on the Air and Diseases From The Year 1740 To 1777 Inclusive, and Particular Ones From That Time To the Beginning Of 1795. Birmingham (no Date).

[1309] Lond. Med. Journ. XI. 374.

[1310] H. Rumsey, “Epidemic Sore-Throat at Chesham in 1788.” Lond. Med. Journal, X. 7, dated 14 Dec. 1788.

[1311] H. Rumsey, “An Account of the Croup as it appeared in the Town and Neighbourhood of Chesham, in Buckinghamshire, in the years 1793 and 1794.” Trans. of a Soc. for Improving Med. and Chirurg. Knowledge, II. (1800), 25. Read 1 July, 1794.

[1312] “Several children brought up portions of a film, or membrane of a whitish colour, resembling the coagulated matter which was found in the trachea of those children whose bodies were opened. This was thrown off by violent coughing or retching; and the efforts made to dislodge it were often so distressing that the child appeared almost in a state of strangulation.”

[1313] Sinclair’s Statist. Account of Scotland, IX. 190.

[1314] Ibid. II. 412.

[1315] Ibid. IX. 461.

[1316] Livingston to Lettsom, Aberdeen, 13 May, 1790, in Memoirs of Dr Lettsom, III.

[1317] R. Willan, M.D., Reports on the Diseases in London, 1796-1800. Lond. 1801, p. 2.

[1318] “Cursory Remarks on the Appearance of the Angina Scarlatina in the Spring of 1793.” Mem. Med. Soc. Lond. IV. (1795), p. 280.

[1319] W. Rowley, M.D., An Essay on the Malignant ulcerated Sore-Throat, containing reflections on its causes and fatal effects in 1787, etc., London, 1788; The Causes of the Great Numbers of Deaths ... in Putrid Scarlet Fevers and Ulcerated Sore-Throats explained, etc., London, 1793. Based on the practice of the St Marylebone Infirmary.

[1320] James Sims, M.D. “Sketch of a Description of a Species of Scarlatina Anginosa which occurred in the Autumn of 1798.” Mem. Med. Soc. Lond. V. (1799), p. 415.

[1321] This is the source of Noah Webster’s information for London; he adds that the “cat distemper” appeared in Philadelphia in June, and was very fatal in New York and over the Northern States.

[1322] E. Peart, M.D., Practical Information on the Malignant Scarlet Fever and Sore-Throat. London, 1802. See also Med. and Phys. Journ. IX. 16, report for Dec. 1802: “so very general that few of those who have continued in the same house have entirely escaped it”; and the reports, ibid. X. 76, 276.

[1323] Clark, u. s. Monteith, Report of the Newcastle Dispensary from its Foundation, 1878.

[1324] Polwhele’s Cornwall. Part VII. Diseases, p. 59.

[1325] F. Skirmshire, Med. Phys. Journ. VI. 424.

[1326] R. Freeman, ibid. IX. 157.

[1327] H. Gilbert, ibid. IX. 249.

[1328] Goodwin, ibid. IX. 509.

[1329] Braithwaite, ibid. XI.

[1330] Willan, Cutan. Dis. 1808, p. 379, particulars from Dr Binns, with full discussion of the methods of treatment. Willan was told by Dr Stanger that there were 71 cases in the Foundling Hospital from June to October, 1804, with 4 deaths.

[1331] W. Blackburne, M.D., Facts and Observations concerning the Prevention and Cure of Scarlet Fever, &c. London, 1803.

[1332] James Hamilton, M.D., Obs. on the Utility, &c. of Purgative Medicines. 4th ed. Edin. 1811. App. III. p. 66 (three boys in Heriot’s Hospital died of dropsy). Autenrieth, Account of the State of Medicine in Great Britain. Extracts translated by Graves, u. i.

[1333] Ferriar, Med. Hist. and Reflect. III. 128.

[1334] R. J. Graves, M.D., A System of Clinical Medicine. Dublin, 1843, p. 493.

[1335] T. Bateman, M.D., Reports on the Diseases of London, and the State of the Weather, from 1804 to 1816. London, 1819.

[1336] Clarke, Ed. Med. and Surg. Journ. XXX.

[1337] Goodwin, of Earlsoham, Med. and Phys. Journ. XXIV. 465.

[1338] Samuel Fothergill, M.D. Med. and Phys. Journ. XXXII. 481.

[1339] N. Bruce, Med. Chir. Trans. IX. 273.

[1340] Heysham to Joshua Milne, in the latter’s Treatise on the Valuation of Annuities. Lond. 1815. App. p. 755.

[1341] Currie, Med. Reports, 1805, II. 458; Armstrong, Pract. Illustr. of the Scarlet Fever, Measles, &c. Lond. 1818; Lodge, of Preston, in Med. and Phys. Journ. XXXIII. (1815), p. 358.

[1342] W. Macmichael, M.D., A New View of the Infection of Scarlet Fever, &c. London, 1822, pp. 30, 59, 78, 81-2. The title of another essay appears to reflect the same ideas, Caution to the Public, or hints upon the nature of Scarlet Fever, designed to show that this disease arises from a peculiar and absolute virus, and is specifically infectious in its mildest as well as in its most malignant form. By William Cooke, London, 1831.

[1343] Kreysig, “Ueber das Scharlachfieber,” Hecker’s Annalen, IV. 273, 401, 1826, says that scarlatina had been “not only almost uninterrupted in all Europe since twenty-six or twenty-seven years [1799 or 1800], but also frightfully fatal.” The period in which this was written appears to have been one of fatal scarlatina in some parts of Germany; so also the years 1817-19, and the years 1799-1805 (as in Great Britain and Ireland). But the sweeping assertion as to frightful scarlatina mortality in all Europe without interruption since 1799 is clearly a flight of rhetoric, and is as nearly as possible the reverse of the truth so far as concerns Britain and Ireland.

[1344] Blackmore, Lond. Med. Gaz. VI. 114.

[1345] Sandwith, Edin. Med. and Surg. Journ. XL. 249.

[1346] Aulsebrook, Lancet, 12 Nov. 1831, p. 217: cases of very malignant suddenly fatal scarlatina in infants and young persons up to the age of twenty-two. In the house of a canal boatman a son and two daughters, from 21 to 13 years, died in the course of two days after a very sudden and brief illness.

[1347] Rumsey, Trans. Prov. Med. Assoc. III. 194.

[1348] Hamilton, Edin. Med. Surg. Journ. XXXIX. 140.

[1349] Cowan, Journ. Statist. Soc. III.

[1350] Sidey, Stark and others in Edin. Med. and Surg. Journ. 1835-36. H. Kennedy, M.D., Account of the Epidemic of Scarlatina in Dublin from 1834 to 1842. Dublin, 1843.

[1351] The principal epidemics of scarlatina which have been inquired into by inspectors of the medical department since 1870 have been the following:

In 1870, Camborne, Wing.

1873, Fleetwood-on-Wyre.

1874, Hetton (Durham).

1877, Massingham, Portsmouth.

1879, Pontypool, Easington (Durham), Fallowfield (near Manchester), Yeadon.

1880, Bedlington (near Morpeth), Stourbridge, Swindon, Castleford, Llanelly, Huntingdon, Barkingside (Orphans’ Home near Romford).

1881, Durham, Halifax, Thame.

1882, Bedwelty (Tredegar and Aberystruth), Potton.

1883, Sutton in Ashfield, Thorne, Donington and Moulton (Spalding).

1885, Sandal (near Wakefield).

1886, Atherton, Hayfield, Hindley, Wombwell.

1889, Spennymoor (Durham), Macclesfield, Faringdon, Brixham.

[1352] William Ogle, M.D., in the 49th Report of the Registrar-General (for 1886), p. xiv.

[1353] See a paper, with Tables, on “Age, Sex and Season in relation to Scarlet Fever,” by Arthur Whitelegge, M.D. in Trans. Epidemid. Soc. N. S. VII. p. 153, for Nottingham and some other towns. A paper by Dr Ballard, “On the Prevalence and Fatality of Scarlatina as influenced by Sex, Age and Season,” which was written twenty years before but left unpublished, follows Whitelegge’s in the Trans. Epidem. Soc. N. S. VII. (1887-8).

[1354] A table of figures showing this will be found in Dr B. A. Whitelegge’s second lecture on “Changes of Type in Epidemic Diseases.” Brit. Med. Journ. 4 March, 1893.

[1355] Longstaff, Trans. Epid. Soc. N. S. IV. (1880), 421, and Studies in Statistics. London, 1891, p. 310. D. A. Gresswell, Contribution to the Natural History of Scarlatina. Oxford, 1890, p. 193.

[1356] Journ. Scot. Meteorol. Soc. July, 1874, p. 195.

[1357] Cutaneous Diseases. Vol. I. 1808, p. 254.

[1358] An unfortunate event that came under the writer’s notice some years ago may be illustrative of this. Two women with cancer of the breast were operated on, the one after the other, in the same operating theatre. Their beds were in the same hospital ward, but separated by the whole length of the ward. A few days after the operations, one of the women developed erysipelas, which was most extensive on the back; very soon after the other woman got the disease in a precisely similar way; they both died of it. As it seemed improbable that No. 1 had been infected in the ward, or that No. 2 had been infected from No. 1, (some dozen surgical cases between them escaping,) the suggestion arises of a common source of both infections in the operating theatre. The operating table was covered by a woollen cloth, of red colour so as not to show blood stains; it must have contained a good deal of putrid invisible blood from former operations.