Opening…

Preface

This volume is the continuation of ‘A History of Epidemics in Britain from A.D. 664 to the Extinction of Plague’ (which was published three years ago), and is the completion of the history to the present time. The two volumes may be referred to conveniently as the first and second of a ‘History of Epidemics in Britain.’ In adhering to the plan of a systematic history instead of annals I have encountered more difficulties in the second volume than in the first. In the earlier period the predominant infection was Plague, which was not only of so uniform a type as to give no trouble, in the nosological sense, but was often so dramatic in its occasions and so enormous in its effects as to make a fitting historical theme. With its disappearance after 1666, the field is seen after a time to be occupied by a numerous brood of fevers, anginas and other infections, which are not always easy to identify according to modern definitions, and were recorded by writers of the time, for example Wintringham, in so dry or abstract a manner and with so little of human interest as to make but tedious reading in an almost obsolete phraseology. Descriptions of the fevers of those times, under the various names of synochus, synocha, nervous, putrid, miliary, remittent, comatose, and the like, have been introduced into the chapter on Continued Fevers so as to show their generic as well as their differential character; but a not less important purpose of the chapter has been to illustrate the condition of the working classes, the unwholesomeness of towns, London in particular, the state of the gaols and of the navy, the seasons of dearth, the times of war-prices or of depressed trade, and all other vicissitudes of well-being, of which the amount of Typhus and Relapsing Fever has always been a curiously correct index. It is in this chapter that the epidemiology comes into closest contact with social and economic history. In the special chapter for Ireland the association is so close, and so uniform over a long period, that the history may seem at times to lose its distinctively medical character.

As the two first chapters are pervaded by social and economic history, so each of the others will be found to have one or more points of distinctive interest besides the strictly professional. Smallpox is perhaps the most suitable of all the subjects in this volume to be exhibited in a continuous view, from the epidemics of it in London in the first Stuart reigns to the statistics of last year. While it shares with Plague the merit, from a historical point of view, of being always the same definite item in the bills of mortality, it can be shown to have experienced, in the course of two centuries and a half, changes in its incidence upon the classes in the community, upon the several age-periods and upon town and country, as well as a very marked change relatively to measles and scarlatina among the infective scourges of infancy and childhood. For certain reasons Smallpox has been the most favoured infectious disease, having claimed an altogether disproportionate share of interest at one time with Inoculation, at another time with Vaccination. The history of the former practice, which is the precedent for, or source of, a whole new ambitious scheme of prophylaxis in the infectious diseases of men and brutes, has been given minutely. The latter practice, which is a radical innovation inasmuch as it affects to prevent one disease by the inoculation of another, has been assigned as much space in the chapter on Smallpox as it seems to me to deserve. Measles and Whooping-cough are historically interesting, in that they seem to have become relatively more prominent among the infantile causes of death in proportion as the public health has improved. Whooping-cough is now left to head the list of its class by the shrinkage of the others. It is in the statistics of Measles and Whooping-cough that the principle of population comes most into view. The scientific interest of Scarlatina and Diphtheria is mainly that of new, or at least very intermittent, species. Towards the middle of the 18th century there emerges an epidemic sickness new to that age, in which were probably contained the two modern types of Scarlet Fever and Diphtheria more or less clearly differentiated. The subsequent history of each has been remarkable: for a whole generation Scarlatina could prove itself a mild infection causing relatively few deaths, to become in the generation next following the greatest scourge of childhood; for two whole generations Diphtheria had disappeared from the observation of all but a few medical men, to emerge suddenly in its modern form about the years 1856-59.

The history of Dysentery, as told by the younger Heberden, has been a favourite instance of the steady decrease of a disease in London during the 18th century. I have shown the error in this, and at the same time have proved from the London bills of mortality of the 17th and 18th centuries that Infantile Diarrhoea, which is now one of the most important causes of death in some of the great manufacturing and shipping towns, was formerly still more deadly to the infancy of the capital in a hot summer or autumn. Asiatic Cholera brings us back, at the end of the history, to the same great problem which the Black Death of the 14th century raised near the beginning of it, namely, the importation of the seeds of pestilence from some remote country, and their dependence for vitality or effectiveness in the new soil upon certain favouring conditions, which sanitary science has now happily in its power to withhold. I have left Influenza to be mentioned last. Its place is indeed unique among epidemic diseases; it is the oldest and most obdurate of all the problems in epidemiology. The only piece of speculation in this volume will be found in the five-and-twenty pages which follow the narrative of the various historical Influenzas; it is purely tentative, exhibiting rather the disjecta membra of a theory than a compact and finished hypothesis. If there is any new light thrown upon the subject, or new point of view opened, it is in bringing forward in the same context the strangely neglected history of Epidemic Agues.

Other subjects than those which occupy the nine chapters of this volume might have been brought into a history of epidemics, such as Mumps, Chickenpox and German Measles, Sibbens and Button Scurvy, together with certain ordinary maladies which become epidemical at times, such as Pneumonia, Erysipelas, Quinsy, Jaundice, Boils and some skin-diseases. While none of these are without pathological interest, they do not lend themselves readily to the plan of this book; they could hardly have been included except in an appendix of miscellanea curiosa, and I have preferred to leave them out altogether. It has been found necessary, also, to discontinue the history of Yellow Fever in the West Indian and North American colonies, which was begun in the former volume.

I have, unfortunately for my own labour, very few acknowledgements to make of help from the writings of earlier workers in the same field. My chief obligation is to the late Dr Murchison’s historical introduction to his ‘Continued Fevers of Great Britain.’ I ought also to mention Dr Robert Willan’s summary of the throat-distempers of the 18th century, in his ‘Cutaneous Diseases’ of 1808, and the miscellaneous extracts relating to Irish epidemics which are appended in a chronological table to Sir W. R. Wilde’s report as Census Commissioner for Ireland. For the more recent history, much use has naturally been made of the medical reports compiled for the public service, especially the statistical.

September, 1894.

I. TYPHUS AND OTHER CONTINUED FEVERS

The Epidemic Fever of 1661, according to Willis 4

Sydenham’s epidemic Constitutions 9

Typhus Fever perennial in London 13

The Epidemic Constitutions following the Great Plague 17

The Epidemic Fever of 1685-86 22

Retrospect of the great Fever of 1623-25 30

The extinction of Plague in Britain 34

Fevers to the end of the 17th Century 43

Fevers of the seven ill years in Scotland 47

The London Fever of 1709-10 54

Prosperity of Britain, 1715-65 60

The Epidemic Fevers of 1718-19 63

The Epidemic Fevers of 1726-29: evidence of Relapsing Fever 66

The Epidemic Fever of 1741-42 78

Sanitary Condition of London under George II. 84

The Window-Tax 88

Gaol-Fever 90

Circumstances of severe and mild Typhus 98

Ship-Fever 102

Fever and Dysentery of Campaigns: War Typhus, 1742-63 107

Ship-Fever in the Seven Years’ War and American War 111

The “Putrid Constitution” of Fevers in the middle third of the 18th Century 120

Miliary Fever 128

Typhus Fever in London, 1770-1800 133

Typhus in Liverpool, Newcastle and Chester in the last quarter of the 18th century 140

Fever in the Northern Manufacturing Towns, 1770-1800 144

Typhus in England and Scotland generally, in the end of the 18th century 151

Fevers in the Dearth of 1799-1802 159

Comparative immunity from Fevers during the War and high prices of 1803-15 162

The Distress and Epidemic Fever (Relapsing) following the Peace of 1815 and the fall of wages 167

The Epidemic of 1817-19 in Scotland: Relapsing Fever 174

The Relapsing Fever of 1827-28 181

Typhoid or Enteric Fever in London, 1826 183

Return of Spotted Typhus after 1831: “Change of Type.” Distress of the Working Class 188

Enteric Fever mixed with the prevailing Typhus, 1831-42 198

Relapsing Fever in Scotland, 1842-44 203

The “Irish Fever” of 1847 in England and Scotland 205

Subsequent Epidemics of Typhus and Relapsing Fevers 208

Relative prevalence of Typhus and Enteric Fevers since 1869 211

Circumstances of Enteric Fever 216

II. FEVER AND DYSENTERY IN IRELAND

Dysentery and Fever at Londonderry and Dundalk, 1689 229

A generation of Fevers in Cork 234

Famine and Fevers in Ireland in 1718 and 1728 236

The Famine and Fever of 1740-41 240

The Epidemic Fevers of 1799-1801 248

The Growth of Population in Ireland 250

The Famine and Fevers of 1817-18 256

Famine and Fever in the West of Ireland, 1821-22 268

Dysentery and Relapsing Fever, 1826-27 271

Perennial Distress and Fever 274

The Great Famine and Epidemic Sicknesses of 1846-49 279

Decrease of Typhus and Dysentery after 1849 295

III. INFLUENZAS AND EPIDEMIC AGUES

Retrospect of Influenzas and Epidemic Agues in the 16th and 17th centuries 306

The Ague-Curers of the 17th Century 315

The Peruvian Bark Controversy 320

The Influenza of 1675 326

The Influenza of 1679 328

The Epidemic Agues of 1678-80 329

The Influenza of 1688 335

The Influenza of 1693 337

The Influenza of 1712 339

Epidemic Agues and Influenzas, 1727-29 341

The Influenza of 1733 346

The Influenza of 1737 348

The Influenza of 1743 349

Some Localized Influenzas and Horse-colds 352

The Influenza of 1762 356

The Influenza of 1767 358

The Influenza of 1775 359

The Influenza of 1782 362

The Epidemic Agues of 1780-85 366

The Influenza of 1788 370

The Influenza of 1803 374

The Influenza of 1831 379

The Influenza of 1833 380

The Influenza of 1837 383

The Influenza of 1847-48 389

The Influenzas of 1889-94 393

The Theory of Influenza 398

Influenza at Sea 425

The Influenzas of Remote Islands 431

IV. SMALLPOX

Retrospect of earlier epidemics 434

Smallpox after the Restoration 437

Sydenham’s Practice in Smallpox 445

Causes of Mild or Severe Smallpox 450

Pockmarked Faces in the 17th Century 453

The Epidemiology continued to the end of the 17th century 456

Smallpox in London in 1694: the death of the Queen 458

Circumstances of the great Epidemic in 1710 461

Inoculation brought into England 463

The popular Origins of Inoculation 471

Results of the first Inoculations; the Controversy in England 477

Revival of Inoculation in 1740: a New Method 489

The Suttonian Inoculation 495

Extent of Inoculation in Britain to the end of the 18th Century 504

The Epidemiology continued from 1721 517

Smallpox in London in the middle of the 18th century 529

The Epidemiology continued to the end of the 18th century 535

The range of severity in Smallpox, and its circumstances 544

Cowpox 557

Chronology of epidemics resumed from 1801 567

The Smallpox Epidemic of 1817-19 571

Extent of Inoculation with Cowpox or Smallpox, 1801-1825 582

The Smallpox Epidemic of 1825-26 593

A generation of Smallpox in Glasgow 597

Smallpox in Ireland, 1830-40 601

The Epidemic of 1837-40 in England 604

Legislation for Smallpox after the Epidemic of 1837-40 606

Other effects of the epidemic of 1837-40 on medical opinion 610

The age-incidence of Smallpox in various periods of history 622

V. MEASLES

Derivation and early uses of the name 632

Sydenham’s description of Measles in London, 1670 and 1674 635

Measles in the 18th century 641

Increasing mortality from Measles at the end of the 18th century 647

Measles in Glasgow in 1808 and 1811-12: Researches of Watt 652

Measles in the Period of Statistics 660

VI. WHOOPING-COUGH

Earliest references to whooping-cough 666

Whooping-cough in Modern Times 671

Whooping-cough as a Sequel of other Maladies 674

VII. SCARLATINA AND DIPHTHERIA

Nosological difficulties in the earlier history 678

The Throat-distemper of New England, 1735-36 685

Angina maligna in England from 1739 691

An epidemic of Throat-disease in Ireland, 1743 693

Malignant Sore-throat in Cornwall, 1748 694

Fothergill’s Sore-throat with Ulcers, 1746-48 696

“Scarlet Fever” at St Albans, 1748 698

Epidemics of Sore-throat with Scarlet rash in the period between Fothergill and Withering 699

Scarlatina anginosa in its modern form, 1777-78 708

History of Scarlatina after the Epidemic of 1778 713

Scarlatina (1788) and Diphtheria (1793-94) described by the same observer 715

Scarlatinal Epidemics, 1796-1805 719

Scarlatina since the beginning of Registration, 1837 726

Reappearance of Diphtheria in 1856-59 736

Conditions favouring Diphtheria 744

VIII. INFANTILE DIARRHOEA, CHOLERA NOSTRAS, AND DYSENTERY

Summer Diarrhoea of Infants in London, 17th century 748

Summer Diarrhoea of Infants, 18th century 754

Modern Statistics of Infantile Diarrhoea 758

Causes of the high Death-rates from Infantile Diarrhoea 763

Cholera Nostras 768

Dysentery in the 17th and 18th centuries 774

Dysentery in the 19th century 785

IX. ASIATIC CHOLERA

Asiatic Cholera at Sunderland in October, 1831 796

Extension of Cholera to the Tyne, December, 1831 802

The Cholera of 1832 in Scotland 805

The Cholera of 1832 in Ireland 816

The Cholera of 1832 in England 820

The Cholera of 1848-49 in Scotland 835

The Cholera of 1849 Ireland 839

The Cholera of 1849 in England 840

The Cholera of 1853 at Newcastle and Gateshead 849

The Cholera of 1854 in England 851

The Cholera of 1853-54 in Scotland and Ireland 855

The Cholera of 1865-66 856

The Antecedents of Epidemic Cholera in India 860

Note on Cerebro-Spinal Fever 863