Chapter IX: Asiatic Cholera (10)

[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:

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

{St Oswald 924 4027 321 40 350
Suburbs {St John 774 3187 284 52 218
{St Mary 583 2392 240 45 205
{Trinity 330 1605 127 24 97

Old {St Peter 193 920 52 6 39
Parishes{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

‘Inoculation, heavenly maid! descend!’”

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

[1127] _Edin. Med. and Surg. Journ._ I. 507.

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

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

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

[1131] _Lond. Med. Repository._ Sept. 1822.

[1132] J. J. Cribb, _Smallpox and Cowpox_. Cambridge, 1825.

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

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

[1135] John Roberton, _Observations on the Mortality and Physical Management of Children_. London, 1827, p. 59, _note_.

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

[1137] Cribb, u. s.

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

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

[1140] Gregory, _Report on the Smallpox Hospital_, 4 Dec. 1825.

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

[1142] Tables in Murchison’s _Continued Fevers of Great Britain_.

[1143] _Med. Chir. Trans_, XXIV. 15. His other papers are: “Cursory Remarks on Smallpox as it occurs subsequent to Vaccination,” _ibid._ XII. 324; and “Notices of the Occurrences at the Smallpox Hospital during the year 1838,” _ibid._ XXII. 95. He contributed the treatise on Smallpox to Tweedie’s _Library of Medicine_, I. 1840, and indicated his final opinions (which are interesting) in his _Lectures on the Eruptive Fevers_, 1843.

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

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

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

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

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

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

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

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

[1152] McDerment, _ibid._ IV. 201.

[1153] Howison, _ibid._ V. 256-7.

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

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

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

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

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

[1159] 1840.

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.