Chapter IX: Asiatic Cholera (6)

[134] Dunsford, _Historical Memorials of Tiverton_. The accounts of the great weaving towns of the South-west are not unpleasing until we come to the time when they were overtaken by decay of work and distress, from about 1720 onwards. The district, says Defoe, was “a rich enclosed country, full of rivers and towns, and infinitely populous, in so much that some of the market towns are equal to cities in bigness, and superior to many of them in numbers of people.” Taunton had 1100 looms. Tiverton in the seven years 1700-1706 had 331 marriages, 1116 baptisms, 1175 burials (a slight excess), and an estimated population of 8693, which kept nearly at that level for about twenty years longer (from 1720 to 1726 the marriages were 284, the baptisms 1070 and the burials 1175).

[135] _Gent. Magaz._ XI. (1742), p. 704.

[136] Blomefield, _History of Norfolk_ III. 449.

[137] Arnot, _History of Edinburgh_, 1779, p. 211.

[138] _Gent. Magaz._ 1741, p. 705.

[139] _Edin. Med. Essays and Obs._ I. Art. 1.

[140] _Gent. Magaz._ 1742, p. 186.

[141] John Wall, M.D., _Medical Tracts_, Oxford, 1780, p. 337. See also _Obs. on the Epid. Fever of 1741_, 3rd ed., by Daniel Cox, apothecary, with cases.

[142] _Edin. Med. Essays and Obs._ VI. 539.

[143] “And here I cannot but observe how many ignorant conceited coxcombs ride out, under a shew of business, with their lancet in their pocket, and make diseases instead of curing them, drawing their weapon upon every occasion, right or wrong, and upon every complaint cry out, ‘Egad! I must have some of your blood,’ give the poor wretches a disease they never might have had, drawing the blood and the purse, torment them in this world,” etc.--_An Essay on the present Epidemic Fever_, Sherborne, 1741. The practice of blood-letting in continued fevers received a check in the second half of the 18th century, but it was still kept up in inflammatory diseases or injuries. Even in the latter it was freely satirized by the laity. When the surgeon in _Tom Jones_ complained bitterly that the wounded hero would not be blooded though he was in a fever, the landlady of the inn answered: “It is an eating fever, then, for he hath devoured two swingeing buttered toasts this morning for breakfast.” “Very likely,” says the doctor, “I have known people eat in a fever; and it is very easily accounted for; because the acidity occasioned by the febrile matter may stimulate the nerves of the diaphragm, and thereby occasion a craving which will not be easily distinguishable from a natural appetite.... Indeed I think the gentleman in a very dangerous way, and, if he is not blooded, I am afraid will die.”

[144] Munk, _Roll of the College of Physicians_, II. 53.

[145] _Gentleman’s Magaz._ III. 1733, Sept., p. 492.

[146] _Effects of Air on Human Bodies_, 1733, pp. 11, 17. His excellent remarks on the need of fresh air in the treatment of fevers, two generations before Lettsom carried out the practice, are at p. 54. The curious calculation above cited was copied by Langrish, and usually passes as his.

[147] “Also without the bars both sides of the street be pestered with cottages and alleys even up to Whitechapel Church, and almost half a mile beyond it, into the common field: all which ought to be open and free for all men. But this common field, I say, being sometime the beauty of this city on that part, is so encroached upon by building of filthy cottages, and with other purprestures, enclosures and laystalls (notwithstanding all proclamations and Acts of Parliament made to the contrary) that in some places it scarce remaineth a sufficient highway for the meeting of carriages and droves of cattle. Much less is there any fair, pleasant or wholesome way for people to walk on foot, which is no small blemish to so famous a city to have so unsavoury and unseemly an entrance or passage thereunto.” Stow’s _Survey of London_, section on “Suburbs without the Walls.”

[148] The line of an old field walk can still be followed from Aldermanbury Postern to Hackney, Goldsmiths’ Row being one of the wider sections of it.

[149] Luttrell’s _Diary_ 10 June, 1684.

[150] Roger North’s “Autobiography,” in _Lives of the Norths_, new ed. 3 vols., 1890, III. 54.

[151] Willan, 1801: “The passage filled with putrid excremental or other abominable effluvia from a vault at the bottom of the staircase.” See also Clutterbuck, _Epid. Fever at present prevailing_. Lond. 1819, p. 60. Ferriar, of Manchester, writing of the class of houses most apt to harbour the contagion of typhus, says, “Of the new buildings I have found those most apt to nurse it which are added in a slight manner to the back part of a row, and exposed to the effluvia of the privies.”

[152] C. Davenant to T. Coke, London, 14 Dec. 1700. _Cal. Coke MSS._, II. 411, “I heartily commiserate your sad condition to be in the country these bad weeks; but I fancy you will find Derbyshire more pleasant even in winter than the House of Commons will be in a summer season. For, though it be now sixteen years ago [1685], I still bear in memory the evil smells descending from the small apartments adjoining to the Speaker’s Chamber, which came down into the House with irresistible force when the weather is hot.”

[153] _Report on the Diseases in London, 1796-1800._ Lond. 1801.

[154] John Ferriar, M.D., _Medical Histories and Reflections_. London 1810, II. 217.

[155] Heysham, _Jail Fever at Carlisle in 1781_. Lond. 1782, p. 33.

[156] John Howard, _State of the Prisons_.

[157] _Notes and Queries_, 4th ser. XII. 346. Jenkinson, who was a Minister under George II., was reputed to have set an example of stopping up windows in his mansion near Croydon:

You e’en shut out the light of day
To save a paltry shilling.

Others had boards painted to look like brickwork, which could be used to cover up windows at pleasure.

[158] Petition, undated, but placed in a collection in the British Museum among broadsides of the years 1696-1700. In 1725 the imprisoned debtors at Liverpool petitioned Parliament for relief, alleging that they were reduced to a starving condition, having only straw and water at the courtesy of the serjeant. _Commons’ Journals_, XX. 375.

[159] _Commons’ Journals_, 20 March, 1728/29, 14 May, 1729, 24 March, 1729/30.

“Mrs Mary Trapps was prisoner in the Marshalsea and was put to lie in the same bed with two other women, each of which paid 2_s._ 6_d._ per week chamber rent; she fell ill and languished for a considerable time; and the last three weeks grew so offensive that the others were hardly able to bear the room; they frequently complained to the turnkeys and officers, and desired to be removed; but all in vain. At last she smelt so strong that the turnkey himself could not bear to come into the room to hear the complaints of her bedfellows; and they were forced to lie with her on the boards, till she died.”

[160] _Political State of Great Britain_, XXXIX. April, 1730, pp. 430-431, 448.

[161] _Gent. Magaz._, XX. 235. This authority is twenty years after the event, the incident having been recalled in 1750, on the occasion of the Old Bailey catastrophe.

[162] Huxham.

[163] See the former volume of this History, pp. 375-386.

[164] _A Report &c. and of other Crown Cases._ By Sir Michael Foster, Knt., some time one of the Judges of the Court of King’s Bench. 2nd ed. London, 1776, p. 74.

[165] The _Gentleman’s Magazine_ however says (1750, p. 235): “There being a very cold and piercing east wind to attack the sweating persons when they came out of court.”

[166] See Bancroft, _Essay on the Yellow Fever, with observations concerning febrile contagion etc._ Lond. 1811.

[167] _Gent. Magaz._ 1750, p. 274: “Many families are retired into the country, and near 12,000 houses empty”--an impossible number.

[168] Sir John Pringle, _Observations on the Nature and Cure of the Hospital and Jayl Fever_. Letter to Mead, May 24. London, 1750.

[169] One of the cases was that of an apprentice: “Some of the journeymen working in Newgate had forced him to go down into the great trunk of the ventilator in order to bring up a wig which one of them had thrown into it. As the machine was then working, he had been almost suffocated with the stench before they could get him up.” Pringle, “Ventilation of Newgate,” _Phil. Trans._ 1753, p. 42.

[170] Thomas Stibbs to Sir John Pringle, Jan. 25, 1753. _Ibid._ p. 54.

[171] “Ventilators some years since when first introduced, it was thought, would prove an effectual remedy for and preservative against this infection in jails; great expectations were formed of their benefit, but several years’ experience must now have fully shewn that ventilators will not remove infection from a jail.” Lind, _Means of Preserving the Health of Seamen in the Royal Navy_. New ed. Lond. 1774, p. 29.

[172] J. C. Lettsom, M.D., _Medical Memoirs of the General Dispensary in London, 1773-4_. Lond. 1774.

[173] _Gent. Magaz._ 1776, April 22. p. 187.

[174] Lind, _Two Papers on Fevers and Infection_. Lond. 1763. pp. 90, 106. Many cases had buboes both in the groins and the armpits.

[175] Carmichael Smyth, _Description of the Jail Distemper among Spanish Prisoners at Winchester_ in 1780. Lond. 1795.

[176] _Cal. Coke MSS._ Hist. MSS. Commiss. i. 218.

[177] _Med. Hist. and Reflect._ ut infra.

[178] The following case, which happened five or six years ago, shows disparity of conditions in a twofold aspect. A lady from a city in the north of Scotland travelled direct to Switzerland to reside for a few weeks at one of the hotels in the High Alps. Within an hour or two of the end of her journey she began to feel ill, and was confined to her room from the time she entered the hotel. An English physician diagnosed the effects of the sun; the German doctor of the place, from his reading only, diagnosed typhus fever, which proved to be right, the patient dying with the most pronounced signs of malignant typhus. An explanation of the mystery was soon forthcoming. The lady had been a district visitor in an old and poor part of the Scotch city; she had, in particular, visited in a certain tenement-house in a court, from which half-a-dozen persons had been admitted to the Infirmary with typhus (an unusual event) at the very time when she was ill of it on the Swiss mountain.

[179] Blane, _Select Dissertations_. London, 1822, p. 1.

[180] Mather’s _Magnalia_. 2 vols. Hartford, 1853, i. 226 “Life of Sir William Phipps.” “Whereof there died, ere they could reach Boston, as I was told by Sir Francis Wheeler himself [‘but a few months ago’], no less than 1300 sailors out of 21, and no less than 1800 soldiers out of 24.” He had brought 1800 troops with him from England to Barbados in transports.

[181] Churchill’s Collection, VI. 173.

[182] W. Cockburn, M.D. _An Account of the Nature, Causes, Symptoms and Cure of the Distempers that are incident to Seafaring People._ 3 Parts. London, 1696-97.

[183] J. White, M.D. _De recta Sanguinis Missione, or, New and Exact Observations of Fevers, in which Letting of Blood is shew’d to be the true and solid Basis of their Cure, &c._ London, 1712. His chief point, that the strongest and lustiest were most obnoxious to malignant fevers, had been urged by Cockburn in 1696.

[184] Lind (_Two Papers on Fevers and Infection_, London, 1763, p. 113) gives an instance where the poisonous effluvia of the ship’s well did not spread through the ’tween decks: “The following accident happened lately [written in 1761] in the Bay of Biscay. In a ship of 60 guns, by the carpenter’s neglecting to turn the cock that freshens the bilge-water, which had not been pumped out for some time, a large scum, as is usual, or a thick tough film was collected a-top of it. The first man who went down to break this scum in order to pump out the bilge-water was immediately suffocated. The second suffered an instantaneous death in like manner. And three others, who successively attempted the same business, narrowly escaped with life: one of whom has never since perfectly recovered his health. Yet that ship was at all times, both before and after this accident, remarkably healthy.” It was the contention of Renwick, a naval surgeon who wrote in 1794, that it was the stirring of the bilge-water in being discharged from the ship’s well, or the adding of fresh water to the foul, that caused the offensive emanations. “Hence the first cause of febrile sickness in all ships recently commissioned.” Renwick made so much of the foul bilge-water as a cause that he thought the fevers ought to be termed “bilge-fevers.” _Letter to the Critical Reviewer_, p. 42.

[185] These particulars are not given in Freind’s special work on Peterborough’s campaign, which deals only with the military and political history, but in his _Nine Commentaries on Fever_ (Engl. ed. by Dale, London, 1730), and in a Latin letter to Cockburn, dated Barcelona, 9 Sept. 1706, which was first printed in _Several Cases in Physic_. By Pierce Dod, M.D. London, 1746.

[186] Smollett joined the ‘Cumberland’ as surgeon’s mate in 1740, before she sailed with the fleet sent out under Vernon and others to Carthagena. His account in _Roderick Random_ of the sick-bay of the ‘Thunder’ as she lay at the Nore is doubtless veracious: “When I observed the situation of the patients, I was much less surprised that people should die on board, than that any sick person should recover. Here I saw about fifty miserable distempered wretches, suspended in rows, so huddled one upon another that not more than fourteen inches space was allowed for each with his bed and bedding; and deprived of the light of the day, as well as of fresh air; breathing nothing but a noisome atmosphere of the morbid steams exhaling from their own excrements and diseased bodies, devoured with vermin hatched in the filth that surrounded them, and destitute of every convenience necessary for people in that helpless condition.” Chap. XXV. He wrote a separate account of the fatal Carthagena expedition in a compendium of voyages.

[187] Coxe’s _Life of Marlborough_. Bohn’s ed. I. 183.

[188] Grainger’s essay, _Historia febris anomalae Bataviae annorum, 1746, 1747, 1748, etc._ Edin. 1753, is chiefly occupied with an anomalous “intermittent” or “remittent” fever with miliary eruption, and with dysentery.

[189] For a full discussion of the relation of dysentery to typhus, see Virchow, “Kriegstypus und Ruhr.” _Virchow’s Archiv_, Bd. LII. (1871), p. 1.

[190] Sir John Pringle, _Obs. on the Nature and Cure of Hospital and Jayl Fever_, Lond. 1750 (Letter to Mead); and his _Obs. on Diseases of the Army_, Lond. 1752 (fullest account).

[191] Pringle, _Diseases of the Army_, pp. 40-45.

[192] _Ibid._ p. 68.

[193] Donald Monro, M.D. _Diseases of British Military Hospitals in Germany, from Jan. 1761 to the Return of the Troops to England in 1763._ Lond. 1764. The same campaign called forth also Dr Richard Brocklesby’s _Œconomical and Medical Observations from 1758 to 1763 on Military Hospitals and Camp Diseases etc._ London, 1764.

[194] _Essay on Preserving the Health of Seamen_, Lond. 1757; _Two papers etc._ u. s.

[195] In 1755 a pestilential sickness raged in the North American fleet, the ‘Torbay’ and ‘Munich’ being obliged to land their sick at Halifax.

[196] The _Gentleman’s Magazine_ for December, 1772 (p. 589), records the following: “The bodies of two Dutchmen who were thrown overboard from a Dutch East Indiaman, where a malignant fever raged, were cast up near the Sally Port at Portsmouth; they were so offensive that it was with difficulty that anyone could be got to bury them.”

[197] W. Brownrigg, M.D. _Considerations on preventing Pestilential Contagion._ London, 1771, p. 36.

[198] Lind writes in his book on the Health of Seamen, “The sources of infection to our armies and fleets are undoubtedly the jails: we can often trace the importers of it directly from them. It often proves fatal in impressing men on the hasty equipment of a fleet. The first English fleet sent last war to America lost by it alone two thousand men.”

[199] R. Robertson, M.D. _Observations on Jail, Hospital or Ship Fever from the 4th April, 1776, to the 30th April, 1789, made in various parts of Europe and America and on the Intermediate Seas._ London, 1789. New edition.

[200] Given by Blane in a Postscript to his paper “On the Comparative Health of the British Navy, 1779-1814” in _Select Dissertations_, London, 1822, p. 62.

[201] Blane, u. s. p. 47, from information supplied by Dr John Lind, of Haslar Hospital.

[202] _Diseases incident to Seamen_, p. 18.

[203] _Ibid._ p. 34.

[204] Trotter, _Medicina Nautica_, I. 61. His general abstracts of the health of the fleet in the first years of the French War, 1794-96, give many instances of ship-typhus.

[205] John Clark, M.D. _Observations on the Diseases which prevail in Long Voyages to Hot Countries, &c._ London, 1773. 2nd ed. 2 vols., 1792.

John Lorimer, M.D., published in _Med. Facts and Observations_, VI. 211, a “Return of the ships’ companies and military on board the ships of the H. E. I. C. for the years 1792 and 1793.”

+---------------------------------------------------------------+
| | Outward voyages | Homeward voyages | |
| |-----------------|------------------| In port |
| | Crew | Military | Crew | Invalids | |
|----------------|------|----------|-------|----------|---------|
| Number of men | 2657 | 3919 | 2701 | 1075 | -- |
| Sick | 1253 | 1751 | 1058 | 282 | 1533 |
| Dead | 28 | 50 | 51 | 27 | 96 |

[206] _Reflections and Resolutions for the Gentlemen of Ireland_, p. 28. Cited by Lecky.

[207] Sutton, “Changing Air in Ships,” _Phil. Trans._ XLII. 42; W. Watson, M.D. _ibid._ p. 62; H. Ellis, _ibid._ XLVII. 211.

[208] _Ibid._ XLIX. 332, “Ventilation of a Transport.”

[209] _Ibid._ pp. 333, 339.

[210] Lind, _Essay on the Most Effectual Means of Preserving the Health of Seamen in the Royal Navy_. New Ed. London, 1774, p. 29.

[211] Blane, _Diseases incident to Seamen_, 1785, p. 243.

[212] _Id._ “On the Comparative Health of the British Navy from the year 1799 to the year 1814, with Proposals for its farther Improvement.” _Select Dissertations_, 1822, p. 1.

[213] Le Cat, _Phil. Trans._ XLIX. 49.

[214] “Its cause seemed to be something contagious mixed with the contents of the stomach and intestines, especially the bile and alvine faeces, which absorbed thence contaminates the whole body and affects especially the cerebral functions.” _Gent. Magaz._, Article signed “S,” 1755, p. 151.

[215] James Johnstone, M.D., senior, _Malignant Epidemic Fever of 1756_. London, 1758.

[216] Nash, _Hist. of Worcestershire_, II. 39, found evidence in the Kidderminster registers that the fevers of 1727, 1728 and 1729 had “very much thinned the people, and terrified the inhabitants.” Watson, “On the Medical Topography of Stourport,” _Trans. Proc. Med. Assoc._, II., had heard or read somewhere that fever was so bad in Kidderminster in the first part of the 18th century that farmers were afraid to come to market.

[217] Huxham, _Dissertation on the Malignant Ulcerous Sore-Throat_. Lond. 1757, p. 60.

[218] Tooke, _History of Prices_. Introduction.

[219] In Shrewsbury gaol, in 1756, thirty-seven colliers were confined for rioting during the dearth. Four of them died in gaol, ten were condemned to death, of whom two were executed. Phillips, _History of Shrewsbury_, 1779, p. 213.

[220] Johnstone, u. s. Short says: “a slow, malignant, putrid fever in some parts of Yorkshire, Cheshire, Worcestershire and the low parts of Leicestershire, which carried off very many.” In October, 1757, it set in at Sheffield and raged all the winter.

[221] Short, _Increase and Decrease of Mankind in England, etc._ London, 1767, p. 109.

[222] Charles Bisset, _Essay on the Medical Constitution of Great Britain_, 1 Jan. 1758, to Midsummer, 1760. Together with a narrative of the Throat-Distemper and the Miliary Fever which were epidemical in the Duchy of Cleveland in 1760. London, 1762, pp. 265, 270, &c.

[223] James Sims, M.D., _Obs. on Epid. Disorders_. Lond. 1773, p. 181.

[224] W. Hillary, M.D., _Changes of the Air and Concomitant Epid. Disorders in Barbadoes_. 2nd ed., Lond. 1766.

[225] _Tractatus duplex de Praxeos Regulis et de Febre Miliari_, Lond. 1710. Engl. transl. of the latter, Lond. 1737.

[226] Ormerod, _Clin. Obs. on Continued Fever_. London, 1848.

[227] _Historia Febris Miliaris, et de Hemicrania Dissertatio._ Auctore Joanne Fordyce, M.D., Londini, 1758. Symptoms at p. 16. In an Appendix Dr Balguy makes the following curious division of the miliary vesicles: the white in malignant continued fever, the dull red in remittent fever, the “almost efflorescent” in intermittent. Fordyce makes them to appear as early as the third day, and to begin to disappear in four or six days in favourable cases.

[228] London, 1773, p. 9. See also Sir W. Fordyce’s essay of the same year.

[229] John Moore, M.D., _Medical Sketches_, Lond. 1786. Part II. “On Fevers.” Referring to the “putrid” fever in particular, he says that certain unbelievers, of whom he was probably one, “assert that mankind are tenacious of opinions, when once adopted, in proportion as they are extraordinary, disagreeable and incredible.” Dr Moore is best known as the author of _Zeluco_.

[230] Haygarth, _Phil. Trans._ LXIV. 73.

[231] Percival, _ibid._ LXIV. 59.

[232] Hutchinson, u. s.

[233] _Annual Register_, 1766, p. 220. The King’s Speech on 11 Nov. was chiefly occupied with the dearth. The use of wheat for distilling was prohibited by an order of Council of 16 Sept. 1766. _Gent. Magaz._ p. 399. To show the hardships of the rural population at this time, Mr Gladstone, in a speech at Hawarden in 1891, read the following words copied from a stone set up in the park of Hawarden to commemorate the rebuilding of a mill: “Trust in God for bread, and to the king for protection and justice. This mill was built in the year 1767. Wheat was within this year at 9_s._, and barley at 5_s._ 6_d._ a bushel. Luxury was at a great height, and charity extensive, but the poor were starved, riotous, and hanged.”

[234] Lecky, III. 115.

[235] _Gent. Magaz._, series of letters by various hands in 1766. See also a long essay in the _Annual Register_ for 1767 (then edited by Edmund Burke), “On the Causes and Consequences of the present High Price of Provisions,” p. 165. The evidence of a rise in the standard of living, in the matter of dress and luxuries as well as of food, is equally clear from Scotland in the articles written by the parish ministers for the ‘Statistical Account.’

[236] For a judicious estimate of the value of the Parish Clerks’ bills of mortality see the elaborate paper by Dr William Ogle, _Journ. Statist. Soc._ LV. (1892), 437.

[237] _Diseases of the Army._ New ed. 1775, pp. 334-5. Pringle admitted, however, that “in some of the lowest, moistest and closest parts of the town, and among the poorer people, spotted fevers and dysenteries are still to be seen, which are seldom heard of among those of better rank living in more airy situations.”

[238] _Medical Sketches_, Lond. 1786, p. 464.

[239] Lecky, _History of England in the Eighteenth Century_, II. 636, generalizes the facts as follows: “The wealthy employer ceased to live among his people; the quarters of the rich and of the poor became more distant, and every great city soon presented those sharp divisions of classes and districts in which the political observer discovers one of the most dangerous symptoms of revolution.”

[240] “This disease, as it appears in jails and hospitals, has been well described by Sir John Pringle; and other authors have given accounts of it on board of ships, especially crowded transports and prison-ships, but I do not find that its originating in the families of the poor in great cities during the winter has been taken notice of.” _Med. Trans. Coll. Phys._ III. 345.

[241] He has been immortalised by Johnson’s verses:

“Well tried through many a varying year
See Levett to the grave descend,
Officious, innocent, sincere,
Of every friendless name the friend.
In misery’s darkest cavern known
His ready help was ever nigh;” etc.

[242] John Coakley Lettsom, M.D., _Medical Memoirs of the General Dispensary in London, April 1773 to March 1774_. London, 1774.

[243] Nothing could be clearer than Dr John Arbuthnot’s reasoning and advice on this matter half a century before.

[244] London, 1775.

[245] _Med. Trans. of the Coll. Phys. Lond._ III. (1785), 345: “Observations on the Disease commonly called the Jail or Hospital Fever.” By John Hunter, M.D., physician to the army.

[246] James Sims, M.D., “Scarlatina anginosa as it appeared in London in 1786,” _Mem. Med. Soc. Lond._ I. 414. Willan, who saw the same epidemic of scarlatinal sore-throat in London in 1786, believed that the angina was also “connected with a different species of contagion, namely, that of the typhus or malignant fever originating in the habitations of the poor, where no attention is paid to cleanliness and ventilation.” _Cutaneous Diseases_, 1808, p. 333.

[247] The rumour of London fevers seems to have reached Barker, who kept an epidemiological record at Coleshill. Referring to the winter of 1788-89, he says: “At this time there were dreadful fevers in London, fatal to many, and a very infectious one in Coventry, of which many among the poor died, most of them being delirious, and many phrenetical.”

[248] Robert Willan, M.D., _Reports on the Diseases of London, particularly during the years 1796-97-98-99 and 1800_. London, 1801.

[249] He names specially some streets of St Giles’s parish, the courts and alleys adjoining Liquorpond Street, Hog-Island, Turnmill Street, Saffron Hill, Old Street, Whitecross Street, Golden Lane, the two Bricklanes, Rosemary Lane, Petticoat Lane, Lower East Smithfield, some parts of Upper Westminster, and several streets of Southwark, Rotherhithe, etc. “I recollect a house in Wood’s Close, Clerkenwell, wherein the fomites of fever were thus preserved for a series of years; at length an accidental fire cleared away the nuisance. A house, notorious for dirt and infection, near Clare-market, afforded a farther proof of negligence: it was obstinately tenanted till the wall and floors, giving way in the night, crushed to death the miserable inhabitants.”

[250] _Medical Reports on the Effects of Water, Cold and Warm, as a Remedy in Fever and other Diseases._ 2nd ed., 1798. It need hardly be explained that Dr Currie was competent on fevers, his use of the clinical thermometer marking him as a man of precision. He is best known to the laity as the biographer of Robert Burns and the generous helper of the poet’s widow and family.

[251] “If it be supposed,” says Currie, “that some cases may be denominated typhus by mistake, let it be considered how many cases of this disease do not appear in the books of the Dispensary, though occurring among the poor, being attended by the surgeons and apothecaries of the Benefit Clubs to which they belong.”

[252] Moss (_A Familiar Medical Survey of Liverpool_, 1784), who had not the same means of knowing the prevalence of typhus in Liverpool as Currie, declares that “there has been but one instance of a _truly_ malignant fever happening in the town for many years; it was in the autumn of 1781, and appeared in Chorley Street, which is one of the narrowest and most populous streets in the town, and nine died of it in one week; it was only of short duration, and did not spread in any other part of the town.” He admits that the habitations of the poorer class were confined, being chiefly in cellars; yet the diet of the _sober_ and _industrious_ is wholesome and sufficient, the comfortable artizans being ship-carpenters, coopers, ropers and the like.

[253] John Clark, M.D., _Observations on the Diseases which prevail in Long Voyages_, &c. 2nd ed., Lond. 1792; _Account of the Newcastle Dispensary from its Commencement in 1777 to March 1789_, Newcastle, 1789; and subsequent Annual Reports.

[254] Haygarth, _Phil. Trans._ LXIV. 67; Hemingway, _History of Chester_, I. 344 _seq._

[255] Arnold Toynbee, _Lectures on the Industrial Revolution of the 18th Century, etc._ London, 1884.

[256] Toynbee (u. s.) says of the time before the mills were built: “The manufacturing population still lived to a very great extent in the country. The artisan often had his small piece of land, which supplied him with wholesome food and healthy recreation. His wages and employments too were more regular. He was not subject to the uncertainties and knew nothing of the fearful sufferings which his descendants were to endure from commercial fluctuations, especially before the introduction of free trade.”

[257] Percival, “Population of Manchester.” _Phil. Trans._ LXIV. 54.

[258] James Lucas, “Remarks on Febrile Contagion.” _London Medical Journal_, X. 260.

[259] In Appendix to Hutchinson’s _Cumberland_, 1794. Reprinted in Appendix to Joshua Milne’s _Valuation of Annuities_, Lond. 1815.

[260] John Heysham, M.D., _Account of the Jail Fever, or Typhus Carcerum, as it appeared at Carlisle in 1781_. London, 1782.

[261] Aikin, _Phil. Trans._ LXIV. 473.

[262] John Aikin, M.D., _The Country from 30 to 40 miles round Manchester_. Lond. 1795, p. 584.

[263] John Ferriar, M.D., _Medical Histories and Reflections_. 4 vols., 1810-13, I. 172.

[264] Ferriar, I. 261.

[265] _Ibid._ I. 234.

[266] _Ibid._ II. 213-20.

[267] _Ibid._ I. 153-6; and II. 57.

[268] Ferriar, I. 166-8.

[269] This is perhaps the first numerical evidence of the slight fatality of typhus in children. A more elaborate proof of the same was given long after by Geary for Limerick. An early age-table for Whitehaven is given under Smallpox, _infra_.

[270] David Campbell, M.D., _Observations on the Typhus or Low Contagious Fever_. Lancaster, 1785.

[271] Joshua Dixon, M.D., _Annual Reports of the Whitehaven Dispensary, 1795 to 1805_. Details for 1773-4 in his note in _Memoirs of Lettsom_, III. 353.

[272] Dixon, _Literary Life of Dr Brownrigg_, pp. 238-9.

[273] Aikin, _Country round Manchester_. Lond. 1795, p. 616.

[274] _Nature and Origin of the Contagion of Fevers._ Hull, 1788.

[275] _Account of a Contagious Fever at Aylesbury._ Aylesbury, 1785.

[276] Thomas Day, _Some Considerations ... on the Contagion in Maidstone Jail_, 1785.

[277] See Barnes, in _Mem. Lit. Phil. Soc. Manchester_, II. 85. Dr Samuel Parr wrote his epitaph in the Cathedral. Also Johnstone sen. to Lettsom, _Memoirs_, III. 241.

[278] Martin Wall, M.D., _Clin. Obs. on the Use of Opium in Low Fevers and in the Synochus_. Oxford, 1786.

[279] J. C. Jenner, in _Lond. Med. Journal_, VII. 163.

[280] _Gent. Magaz._ 1785, I. 231, March 1.

[281] This is the period and the district to which Robert Burns refers, under date of 21 June, 1783, in a letter to his cousin, James Burness, of Montrose: “I shall only trouble you with a few particulars relative to the wretched state of this country. Our markets are exceedingly high, oatmeal 17_d._ and 18_d._ per boll, and not to be got even at that price. We have, indeed, been pretty well supplied with quantities of white peas from England and elsewhere; but that resource is likely to fail us, and what will become of us then, particularly the very poorest sort, heaven only knows.” The lately flourishing silk and carpet weaving had declined during the American War, and the seasons had been adverse to farmers. The lines in Burns’ poem, “Death and Dr Hornbook”:

‘This while ye hae been mony a gate
At mony a house.’
‘Ay, Ay,’ quoth he, and shook his head.--

are explained by a note, “An epidemical fever was then raging in the country.”

[282] Account by Rev. Geo. Skene Keith, _Statist. Act._ II. 544.

[283] Also Banff, _ibid._ XX. 347.

[284]

“Not twenty years ago, but you I think
Can scarcely bear it now in mind, there came
Two blighting seasons, when the fields were left
With half a harvest. It pleased heaven to add
A worse affliction in the plague of war, &c.”

Trotter, _Medicina Nautica_, I. 182, 1797, gives these real cases:--“During the short time that I attended the dispensary at Newcastle, just at the beginning of the [French] war, I was sent for to a poor man in a miserable and low part of the town called Sandgate. He was ill with what is called a spotted fever.” Six children were standing round his bed, the oldest not more than nine. They had been ill first, then his wife, who was recovered and had gone out to pawn the last article they had to buy meal for the children. The man worked on the quay at 1_s._ 2_d._ per diem. Again, “When I practised as a surgeon and apothecary at the end of the late [American] war in a small town in Northumberland, with an extensive country business, some similar scenes came under my view. Two servants of two opulent farmers applied to me for relief. The first had seven children, who took the fever one by one till the whole became sick. His wages were 1_s._ per diem. His master, a rich man, thought himself charitable by allowing them to pull turnips from his field for food. The other servant was a shepherd; but his herding, as the saying is, was a poor one. The first and second of six children were able to work a little, till they got a fever in a severe winter, and down they fell, one after another, the father and mother at last.” They wanted to sell the cow; but some charitable ladies raised a small subscription, by which means the comforts of wine and diet came within their reach; their master, for his part, sent them the carcase of a sheep, which had been found dead in a furrow, with a request that the skin should be returned.

[285] Jenner to Shrapnell, Baron’s _Life of Jenner_, I. 106-7.

[286] John Barker, _Epidemicks_, pp. 201-6.

[287] The dearth of 1794-95 called forth one notable piece, the ‘Thoughts and Details on Scarcity,’ drawn up by Mr Burke, from his experience in Buckinghamshire, originally for the use of Mr Pitt, in November, 1795. Burke takes an optimist line, and preaches the economic doctrine of _laissez faire_: “After all,” he asks, “have we not reason to be thankful to the Giver of all good? In our history, and when ‘the labourer of England is said to have been once happy,’ we find constantly, after certain intervals, a period of real famine; by which a melancholy havock was made among the human race. The price of provisions fluctuated dreadfully, demonstrating a deficiency very different from the worst failures of the present moment. Never, since I have known England, have I known more than a comparative scarcity. The price of wheat, taking a number of years together, has had no very considerable fluctuation, nor has it risen exceedingly within this twelvemonth. Even now, I do not know of one man, woman, or child, that has perished from famine; fewer, if any, I believe, than in years of plenty, when such a thing may happen by accident. This is owing to a care and superintendence of the poor, far greater than any I remember.... Not only very few (I have observed that I know of none though I live in a place [Beaconsfield] as poor as most) have actually died of want, but we have seen no traces of those dreadful exterminating epidemicks, which, in consequence of scanty and unwholesome food, in former times not unfrequently wasted whole nations. Let us be saved from too much wisdom of our own, and we shall do tolerably well.” The last sentence is his favourite principle of “a wise and salutary neglect” on the part of Government.

[288] A labourer at Bury St Edmunds, receiving a weekly wage of five shillings, was able to buy therewith at the old prices:

Cost of same in 1801
£ _s._ _d._
{A bushel of wheat 0 16 0
{A bushel of malt 0 9 0
5_s._{A pound of butter 0 1 0
{A pound of cheese 0 0 4
{Tobacco, one penny 0 0 1
-----------
£1 6 5
{Weekly wage in 1801, 9_s._
{Parish bonus 6_s._ 15 0
----------
0 11 5 deficiency

[289] _Loidis and Elmete_, 1816, p. 85.

[290] Thorp, Tract of 1802, cited by Hunter, _Ed. Med. Surg. Journ._ April, 1819, p. 239.

[291] Currie, _Med. Phys. Journ._ X. 213.

[292] Beddoes.

[293] Goodwin, _Med. Phys. Journ._ IX. 509. Cf. Gervis, _Med. Chir. Trans._ II. 236.

[294] Elizabeth Hamilton, _The Cottagers of Glenburnie_, Edin. 1808: “The only precaution which the good people, who came to see him [the farmer] appeared now to think necessary, was carefully to shut the door, which usually stood open.... The prejudice against fresh air appeared to be universal.... The doctor did not think it probable that he would live above three days; but said, the only chance he had was in removing him from that close box in which he was shut up, and admitting as much air as possible into the apartment.... While the farmer yet hovered on the brink of death, his wife and Robert, his second son, were both taken ill.... Peter MacGlashan had taken to his bed on going home and was now dangerously ill of the fever.... All the village indeed offered their services; and Mrs Mason, though she blamed the thoughtless custom of crowding into a sick room, could not but admire the kindness and good nature with which all the neighbours seemed to participate in the distress of this afflicted family.”

[295] Charlotte Brontë’s story of _Shirley_ falls in this period and turns upon the industrial crisis in Yorkshire; but it is on the whole a happy idyllic picture. Harriet Martineau wrote in _Household Words_, vol. I. 1850, Nos. 9-12, a story entitled “The Sickness and Health of the People of Bleaburn,” a Yorkshire village supposed to have been Osmotherly. It is, in substance, an account of a terrible epidemic of fever in the year 1811, the story opening with the news of the victory of Albuera and the rejoicings thereon. It appears to have been constructed very closely from the real events of the plague of 1665-66 in the village of Eyam, in the North Peak of Derbyshire, and had probably a very slender foundation in any facts of fever in Yorkshire or elsewhere in the year 1811. “Ten or eleven corpses,” says the novelist, “were actually lying unburied, infecting half-a-dozen cottages from this cause.” Cf. infra, Leyburn, p. 167.

[296] T. Bateman, M.D., _Reports on the Diseases of London ... from 1804 to 1816_. Lond. 1819.

[297] Parl. Committee’s Report on Contag. Fev. 1818, p. 33. Table by P. M. Roget.

[298] Adam Hunter, _Ed. Med. Surg. Journ._, April, 1819.

[299] Cleland, _Glasgow and Clydesdale Statist. Soc. Transactions_, Pt. I. Nov. 2, 1836.

[300] Sutton, _Account of a Remittent Fever among the Troops in this Climate_. Canterbury, 1806.

[301] In the first three months of 1811 a singular fever occurred among working people in part of a suburb of Paisley, one practitioner having 32 cases in 13 families. It was marked by rigors at the onset, pain in the back, headache, dry skin, loaded very red tongue, quick fluttering pulse, watchfulness, delirium-like fatuity, abdominal pain in many, foetid stools, great prostration, gradual recovery after fifteen or sixteen days without manifest crisis, and relapses in some. In this fever Murchison discovers enteric or typhoid. Its limitation to a part of one of the suburbs of Paisley is, of course, in the manner of enteric fever; on the other hand, only one of those 32 cases died, which is a rate of fatality perhaps not unparalleled in typhoid but much more often matched in typhus or relapsing fever of young and old together; while the length of the fever, fifteen or sixteen days or sometimes more, is too great for the abortive kind of enteric and too little for enteric fever completing both its first and second stages. James Muir, _Edin. Med. and Surg. Journ._ VIII. 134. Murchison, _Continued Fevers_, p. 428.

[302] James Clarke, M.D., “Medical Report for Nottingham from March 1807 to March 1808,” _Edin. Med. and Surg. Journ._ IV. 422. His account of the unwholesome state of the weavers’ houses is as bad as any of those already given.

[303] McGrigor, “Med. Hist. of British Armies in Peninsula,” _Med. Chir. Trans._ VI. 381.

[304] Richard Hooper, “Account of the Sick landed from Corunna,” _Edin. Med. and Surg. Journ._ V. (1809), p. 398. See also Sir James McGrigor, _ibid._ VI. 19.

[305] James Johnson, _Influence of Tropical Climates_, p. 20.

[306] J. Terry, in _Ed. Med. and Surg. Journ._, Jan. 1820, p. 247.

[307] Bateman, _Account of the Contagious Fever of this Country_. Lond. 1818.

[308] The following from the “Observations on Prevailing Diseases,” Oct.-Nov., 1818 (perhaps by Dr Copland), in the _London Medical Repository_, X. 525, shows that the relapses in the earlier part of this epidemic had been commonly remarked in London: “Fevers are still prevalent.... Relapses have been noticed as of frequent occurrence in the instances of the late epidemic. To what are these to be attributed? Are we to ascribe them to the influence of the atmosphere, to anything in the nature of the disorders themselves, or to the vigorous plans of treatment which are adopted for their removal? These relapses are more common in hospital than in private practice.... It has recently become the fashion to consider the state of recovery from fever as one which will do better without than with the interposition of the cinchona bark. Has the prevalence of this negative practice anything to do with the admitted fact of frequent relapse?”

[309] _Report of the Select Committee of the House of Commons on Contagious Fever_, Parl. Papers, 1818.

[310] _On the Epidemic Fever at present prevailing._ Lond. 1819, p. 40.

[311] J. B. Sheppard, “Remarks on the prevailing Epidemic.” _Edin. Med. Surg. Journ._, July 1819, p. 346. Also for Taplow, Roberts, _Lond. Med. Repos._ XIV. 186.

[312] W. Hamilton, M.D., _Med. and Phys. Journ._, June 1817, p. 451.

[313] _Laws and Phenomena of Pestilence_, Lond. 1821, p. 39. Christison says: “All great towns, with the exception it is said of Birmingham.”

[314] Adam Hunter, _Edin. Med. Surg. Journ._, Apr. 1819, p. 234, and Apr. 1820.

[315] Wood, “Cases of Typhus.” _Edin. Med. Surg. Journ._, April, 1819.

[316] Adam Hunter, u. s.

[317] T. Barnes, _Edin. Med. Surg. Journ._, April, 1819.

[318] H. Edmonston, _ibid._ XIV. (1818), p. 71.

[319] T. McWhirter, _ibid._ April, 1819, p. 317.

[320] J. C. Prichard, M.D., _History of the Epidemic Fever which prevailed in Bristol, 1817-19_. Lond. 1820.

[321] _Obs. on the Cure and Prevention of the Contagious Fever now in Edinburgh._ Edin. 1818.

[322] _Edin. Med. Surg. Journ._ XVI. 146.

[323] Benj. Welsh, _Efficacy of Bloodletting in the Epidemic Fever of Edinburgh_. Edin. 1819.

[324] _Life of Sir Robert Christison_, Edin. 1885, I. 142:--“I had been scarcely three weeks at my post in the fever hospital when I was attacked suddenly--so suddenly, that in half-an-hour I was utterly helpless from prostration. I had nearly six days of the primary attack, then a week of comfort, repose and feebleness, and next the secondary attack, or relapse, for three days more. My pulse rose to 160, and continued hard and incompressible even at that rate. My temperature under the tongue was 107° &c.” He was bled to 30 oz. and next day to 20 oz. more. Before the end of the epidemic, in August, 1819, he had another attack of relapsing fever, for which he was bled to 24 oz. and a third, after exposure to chill, the same autumn, which last was a simple five-days’ fever without relapse, also treated by the abstraction of 24 oz. of blood. In 1832 he had two attacks of the same _synocha_ without relapses, and throughout the rest of his life many more: e.g. 16 June, 1861, “I have had something like the relapsing fever of my youth”--a five-days’ fever with a relapse on the 18th day; and again, on 19 March, 1868, “Incomprehensible return of mine ancient enemy.” These experiences coloured Christison’s view of relapsing fever, the so-called relapses being, in his opinion, comparable to the returning paroxysms of ague.

[325] Cleland.

[326] Report signed A. Brebner, provost, printed in Harty, _Historic Sketch of the Contagious Fever in Ireland, 1817-19_. Dublin, 1820, Appendix, p. 110.

[327] _Memoir concerning the Typhus Fever in Aberdeen, 1818-19._ By George Kerr, Aberdeen, 1820.

[328] William Gourlay, “History of the Epidemic Fever as it appeared in a Country Parish in the North of Scotland.” _Edin. Med. and Surg. Journ._, July, 1819, p. 329, dated 20 Nov. 1818.

[329] _Trans. K. and Q. Cal. Phys. Ireland_, V. 527.

[330] _Dub. Q. J. Med. Sc._ VIII. 297.

[331] A succession of thirty-one cases of relapsing typhoid at Charing Cross Hospital in 1877-78 were made the subject of an able essay by J. Pearson Irvine, M.D., _Relapse of Typhoid Fever_, London, 1880.

[332] Cited in Aberdeen Report, 17 Dec. 1818, in Harty, App. p. 110.

[333] _Report of Select Committee_, u. s. p. 6, and minutes of evidence.

[334] Prichard, pp. 74, 88.

[335] Christison, _Month. J. Med. Sc._ X.; Bennett, _Princip. and Pract. of Med._ 944-5.

[336] See above, p. 110-11.

[337] A complementary measure, namely, notification of contagious sickness to the authorities, was put in practice at Leeds in 1804 on the opening of the House of Recovery there. The Leeds House of Recovery, with fifty beds, was opened on 1 November, 1804, the epidemic of fever being then about over. One of its officers was an inspector, whose duty was “to detect the first appearance of infection, to cause the removal of the patient to the House of Recovery, and to superintend the fumigating and whitewashing of the apartment from which he is removed. So great is the solicitude of the physicians to promote early removal that rewards are offered to such as shall first give information of an infectious fever in their neighbourhoods.” It was claimed that this had been a great success, Leeds having been for twelve years previous to the epidemic of 1817 nearly exempted from two of the most infectious and fatal diseases, namely, typhus and scarlet fever. (It happened, however, that the whole of England, Scotland and even Ireland were exempted to the same remarkable, and of course gratifying degree.) Whitaker, _Loidis and Elmete_, 1816, p. 85.

[338] A strange epidemic of the early summer of 1824 in a semi-charitable girls’ school at Cowan Bridge, between Leeds and Kendal, which is the subject of a moving chapter in ‘Jane Eyre,’ was inquired into by Mrs Gaskell, the biographer of Charlotte Brontë. Forty girls were attacked with fever. A woman who was sent to nurse the sick, saw when she entered the school-room from twelve to fifteen girls lying about, some resting their heads on the table, others on the ground; all heavy-eyed and flushed, indifferent and weary, with pains in every limb, the atmosphere of the room having a peculiar odour. The symptoms, so far as known, and the circumstances of the school, point more to relapsing fever than to typhus, which is the name given to it by Charlotte Brontë. None died of the fever (it is otherwise in the tale), but one girl died at home of its after-effects. Dr Batty, of Kirby, who was called in, did not consider the type of fever to be alarming or dangerous. The dietary of the school had undoubtedly been most meagre for growing girls, and its discipline severe. The house was old and unsuited for the purposes of a boarding-school.

[339] Cowan, _Journ. Statist. Soc._ III. (1840) p. 271; _Glas. Med. Journ._ III. 437.

[340] Some of these were treated at the extra fever-hospital in Spring Gardens.

[341] From the table by Christison, _Edin. Med. Journ._, Jan. 1858, p. 581.

[342] _Life of Christison_, “Autobiography.”

[343] John Burne, M.D., _Pract. Treatise on the Typhus or Adynamic Fever_. London, 1828.

[344] To show the effect of emotion in causing a relapse, he gives an instance, almost the only concrete illustration in all his book: An Irishwoman, Ann McCarthy, aged 26, was admitted to Guy’s Hospital on 20 June, 1827, with “adynamic fever of the second degree,” having been already ill for two weeks: the course of her fever was favourable and she was “soon convalescent.” While still in the ward mending her strength, she lent her bonnet to another female patient to go out with; finding that her kindness had been abused by the woman forgetting to return the bonnet, she became exceedingly angry, relapsed into the fever on the 10th of July, was wildly delirious for several days, and died on the 19th of July. At this time it was the practice at Guy’s to examine the bodies after death; but permission was refused in the case in question, so that Burne was unable to say “whether the bowels were affected.” The case, therefore, may have been one of relapsing enteric fever. A similar ambiguity is discussed by Hughes Bennett in his _Principles and Practice of Physic_ (p. 923), and decided in favour of relapsing fever proper, or relapsing synocha.

[345] Sir William Jenner, M.D., _Lectures and Essays on Fevers and Diphtheria_, 1849 to 1879. London, 1893.

[346] Christison, _Life_, u. s. I. 341.

[347] “Cases showing the frequency of the occurrence of Follicular Ulceration in the Mucous Membrane of the Intestine during the progress of Idiopathic Fever, with Dissections, and Observations on its Pathology.” _Lond. Med. and Physical Journ._, Aug. 1826, p. 97.

[348] _Ibid._ p. 351.

[349] Burne, u. s.

[350] Richard Bright, M.D., _Reports of Medical Cases_. Part I., 1827.

[351] _Life of Sir Robert Christison_, I. 144. Also in _Trans. Soc. Sc. Assn._ 1863, p. 104.

[352] _Edin. Med. Journ._, Jan. 1858, p. 588. Cf. _infra_, under Dysentery, 1828.

[353] Reid, _Trans. K. and Q. Coll. of Phys. in Ireland_, V.; O’Brien, _ibid._

[354] Writing in 1839, Dr Stokes, of Dublin, made the following remarkable assertion (_Dub. Journ. Med. and Chem. Sc._ XV. p. 3, note): “In the epidemic of 1826 and 1827 we observed the follicular ulceration (dothienenteritis of the French) in the greater number of cases.” As the epidemic of 1826-27 was almost wholly one of relapsing fever, the statement is at least puzzling. It was made twelve years after the epidemic, at a time when the discrepancies between British and French observers, as to the occurrence of ulceration of the ileum in continued fever, were much discussed. Dr Lombard, of Geneva, having visited Glasgow, Dublin and other places, and confirmed the fact that the characteristic lesion of enteric fever was at that time only occasional, went on to say that Irish typhus was a species of disease by itself, a _morbus miseriae_. Whereupon the editor of the ‘Dublin Journal of Medical Science’ (XII. 503, in a review of Cowan’s Glasgow Statistics) gave the following truly Irish reply: “Had Dr Lombard made more inquiries, he would have found that Ireland is not so sunk in misery and debasement but that she can produce occasionally a fever which, in abdominal ulcerations, can compete with the sporadic diseases of her wealthier and more enlightened neighbours.” It may have been in the same patriotic spirit that Stokes declared “the greater number of cases” in the epidemic of 1826 and 1827 to have had follicular ulceration.

[355] G. L. Roupell, M.D., _Some Account of a Fever prevalent in 1831_. Lond. 1837.

[356] In addition to what has been said on this point already, for particular epidemics, I shall give a statement for ordinary years by Dr Carrick, of Bristol, in his ‘Medical Topography’ of that city: _Trans. Prov. Med. Assocn._ II. (1834), p. 176. “Continued fever is common enough, but nine-tenths of the cases are of a simple character, terminating for the most part within seven days, and unaccompanied with anything more serious than slight catarrhal or rheumatic disorder. Typhus gravior is rare--much more so than might be expected.”

[357] Charles West, M.D., “Historical Notices designed to illustrate the question whether Typhus ought to be classed among the Exanthematous Fevers.” _Edin. Med. and Surg. Journ._ 1840, April, p. 279.

[358] Alexander Kilgour, M.D., _ibid._ Oct. 1841, p. 381.

[359] Cowan, “Vital Statistics of Glasgow,” _Journ. Statist. Soc._ III.

[360] Cases at Mile-End Fever Hospital.

[361] Including 906 male fever-patients at Albion Street temporary hospital.

[362] _Blackwood’s Magazine_, March, 1838, p. 289.

[363] In 1819 the Irish in Glasgow had been estimated at 1 in 9·67: in 1831 the Irish part of the population had risen to 1 in 5·69. Dr Cowan, however, said of them: “From ample opportunities of observation, they appear to me to exhibit much less of that squalid misery and habitual addiction to the use of ardent spirits than the Scotch of the same grade.”

[364] Robert Cowan, M.D., “Statistics of Fever in Glasgow for 1837.” _Lancet_, April 10, 1839.

[365] James Arrott, M.D., _Edin. Med. and Surg. Journ._, Jan. 1839, p. 121.

[366] Craigie _ibid._ April, 1837.

[367] Christison, _Monthly Journ. Med. Sc._ X. 1850, p. 262.

[368] Kilgour, u. s.

[369] Cowan, _Journ. Statist. Soc._ III. 1841.

[370] Arrott, u. s.

[371] Craigie, u. s.

[372] _Edin. Med. and Surg. Journ._ July, 1838.

[373] _Principles and Practice of Physic_, 3rd ed. 1848, II. 742, 732.

[374] _First Report of the Registrar-General_, London, 1839.