Chapter IX: Asiatic Cholera (11)

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

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

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

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

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

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

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

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

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

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

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

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

[1277] _Supra_, p. 125.

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

[1279] Nash, _History of Worcestershire_, II. 39.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[1303] Heysham, in Hutchinson’s _Hist. of Cumberland_, u. s.

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

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

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

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

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

[1309] _Lond. Med. Journ._ XI. 374.

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

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

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

[1313] Sinclair’s _Statist. Account of Scotland_, IX. 190.

[1314] _Ibid._ II. 412.

[1315] _Ibid._ IX. 461.

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

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

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

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

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

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

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

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

[1324] Polwhele’s _Cornwall_. Part VII. _Diseases_, p. 59.

[1325] F. Skirmshire, _Med. Phys. Journ._ VI. 424.

[1326] R. Freeman, _ibid._ IX. 157.

[1327] H. Gilbert, _ibid._ IX. 249.

[1328] Goodwin, _ibid._ IX. 509.

[1329] Braithwaite, _ibid._ XI.

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

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

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

[1333] Ferriar, _Med. Hist. and Reflect_. III. 128.

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

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

[1336] Clarke, _Ed. Med. and Surg. Journ._ XXX.

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

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

[1339] N. Bruce, _Med. Chir. Trans._ IX. 273.

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

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

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

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

[1344] Blackmore, _Lond. Med. Gaz._ VI. 114.

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

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

[1347] Rumsey, _Trans. Prov. Med. Assoc._ III. 194.

[1348] Hamilton, _Edin. Med. Surg. Journ._ XXXIX. 140.

[1349] Cowan, _Journ. Statist. Soc._ III.

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

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

In 1870, Camborne, Wing.
1873, Fleetwood-on-Wyre.
1874, Hetton (Durham).
1877, Massingham, Portsmouth.
1879, Pontypool, Easington (Durham), Fallowfield (near Manchester),
Yeadon.
1880, Bedlington (near Morpeth), Stourbridge, Swindon, Castleford,
Llanelly, Huntingdon, Barkingside (Orphans’ Home near Romford).
1881, Durham, Halifax, Thame.
1882, Bedwelty (Tredegar and Aberystruth), Potton.
1883, Sutton in Ashfield, Thorne, Donington and Moulton (Spalding).
1885, Sandal (near Wakefield).
1886, Atherton, Hayfield, Hindley, Wombwell.
1889, Spennymoor (Durham), Macclesfield, Faringdon, Brixham.

[1352] William Ogle, M.D., in the _49th Report of the Registrar-General_ (_for 1886_), p. xiv.

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

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

[1355] Longstaff, _Trans. Epid. Soc._ N. S. IV. (1880), 421, and _Studies in Statistics_. London, 1891, p. 310. D. A. Gresswell, _Contribution to the Natural History of Scarlatina_. Oxford, 1890, p. 193.

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

[1357] _Cutaneous Diseases._ Vol. I. 1808, p. 254.

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

[1359] The first instance showing this came from a dairy at Hendon. See James Cameron, M.D. _Trans. Epid. Soc._ V. (1885-6), p. 104; and _ibid._ VIII. 40. One of the latest and most fully investigated came from a dairy near Glasgow, J. B. Russell, M.D., LL.D., and A. K. Chalmers, M.D. _Glas. Med. Journ._ Jan. 1893, p. 1. An outbreak at Wimbledon and Merton is described, _Rep. Med. Off. Loc. Gov. Bd._ for 1886, p. 327. See also _ibid._ for 1882, p. 63. The scarlatina caused by cream (with strawberries) is traced, _ibid._ for 1875, p. 72. A very clear case of scarlatinal epidemic due to contaminated milk occurred at Blackheath, both among children and adults, in April, 1894.

[1360] E. M. Crookshank, _Path. Trans._ XXXIX. 382, in an extensive prevalence of cowpox on a dairy farm near Cricklade. No scarlatina could be traced in the neighbourhood.

[1361] Alfred Carpenter, M.D. _Lancet_, 28 Jan. and 4 Feb. 1871.

[1362] Wall, _Gent. Magaz._ 1751, p. 71, 501. He quotes Severinus to the effect that the great epidemic of _garrotillo_ in the province of Naples in 1618 was preceded by a murrain.

[1363] Prince A. Morrow, “Drug Eruptions,” edited for the New Sydenham Society by T. Colcott Fox, in _Selected Monographs on Dermatology_. London, 1893.

[1364] Hirsch, III. 87.

[1365] Cullen, _First Lines of the Practice of Physic_, Part I., Book II. chap. 5, § 2, and Book III. chap. 4.

[1366] _On Cutaneous Diseases_, vol. I., London, 1808, pp. 319, 326, 333. He included also the _garrotillo_ of Spain and the throat-plague of Naples (1618) among the “varieties of scarlatina,” inasmuch as they had not unfrequently a rash which was of the erysipelatous kind. Hirsch (u. s.) and Max Jaffe (“Die Diphtherie in epidemiologischer und nosologischer Beziehung vornehmlich nach Französischen und Englischen Autoren zusammengestellt,” Originalabhandlung in _Schmidt’s Jahrbücher_, CXIII., 1862, pp. 97-120) do not seem to doubt the diphtheritic nature of the _garrotillos_ of Spain and Italy in the 16th and 17th centuries, but they agree with Willan in classing most of the 18th century throat-distempers of English and American writers as scarlatinal, reserving as diphtheritic, or as more nearly allied to diphtheria, Starr’s “morbus strangulatorius” of Cornwall, some cases of infants recorded by Denman (_supra_, p. 714), Rumsey’s cases of “croup” (_supra_, p. 716), and the epidemic described by Bard, of New York (_supra_, p. 690). These matters of identification appear to be like matters of taste, for which the best rule is _non disputandum_. I have already pointed out that Bard himself did not hesitate to identify the epidemic throat-disease of his time with that which Douglass had described in New England thirty years before.

[1367] P. Bretonneau, _Des inflammations spéciales du tissu muqueux et en particulier de la Diphthérite_, Paris, 1826, with supplement in 1827.

[1368] Id. _Arch. gén. de méd._, Jan., 1855.

[1369] Mackenzie, _Ed. Med. and Surg. Journ._, April, 1825, p. 294, and _Med. Chir. Rev._, 1827, p. 289, for Glasgow in 1819. The disease which Mackenzie called croup, was generally known in Glasgow at that time as “croupy sore throat.” It was very fatal, attacking several children in the same family, was reckoned contagious, was not a modification of scarlatina, was very different from idiopathic croup as it began on the tonsils and descended to the larynx and trachea, and, lastly, was sometimes marked by gangrenous foetor.

Robertson, _Edin. Med. and Surg. Journ._ (1826) XXV. 279, for Kelso in 1825.

Bewley, _Dub. Journ. of Med. Sci._ VIII. 401, for Dublin in 1835-36. An outbreak observed by Brown, at Haverfordwest, in 1849-50, involving some 200 cases and 40 deaths, was identified in 1858 with diphtheria (_Med. Times and Gaz._, May, 1858, p. 566, see also _Med. Chir. Trans._ XL. 49). Outbreaks more vaguely recalled in 1858 as diphtheria occurred at Ashford in 1817, and at Leatherhead (30 deaths in the workhouse) at an uncertain date (_2nd Rep._ (1859) _Med. Offices Privy Council_, pp. 244, 320). F. Ryland, _Diseases and Injuries of the Larynx and Trachea_, London, 1837, pp. 161-175, described a similar disease as a complication of measles at Birmingham in 1835.

[1370] _Med. Times and Gazette_, _Lancet_, _British Med. Journal_, _&c._ for 1858 and 1859. See references in Hirsch, III. 89.

[1371] _Second Report_ (for 1859) _by the Medical Officer of the Privy Council_, London, 1860, p. 161 _seq._ Dr Greenhow published an essay on Diphtheria in 1860. Lectures important for the nosological definition were published by Sir William Jenner in 1861 (reprinted in 1893). Other essays called forth by the epidemic were by W. F. Wade (1858), Ernest Hart (1859), Edward Copeman (Norwich, 1859). Christison, J. W. Begbie and others wrote upon it in Scotland.

[1372] Mr Jones, of Fletching, Sussex, wrote that scores of cases (probably at least 50 or 60) have had more or less eruption. In one case it was general and bright.... It was like scarlatina ... but the whole surface was covered with minute miliary vesicles of clear fluid, ‘one mass of small vesications.’ There was a great deal of itching and no subsequent dropsy. In other cases the eruption was partial. _Rep. Med. Off. Privy Council_, II. (1859), p. 284.

[1373] Starr’s description for 1748 is referred to _supra_, p. 695. Sanderson, _Report_, u. s. p. 263, says of the disease in 1858: “At Launceston the diphtheritic pellicle was tough, leathery, and highly elastic; and on the mucous surface of the fauces and pharynx it attained so great thickness (from one-tenth to one-eighth of an inch) that it was compared by several practitioners to the coriaceous lichens which grow on rotten bark. In the other districts this was never observed.”

[1374] G. B. Longstaff, M.D., “The Geographical Distribution of Diphtheria in England and Wales,” in _Supplement to the 17th Annual Report of Loc. Gov. Board_, 1887-8, p. 135. See also Downes, _Trans. Epid. Soc._ N. S. VII. 193. Farr, _Rep. Reg. Genl._ for 1874, p. 219, gave the following illustration: “It is remarkable that of diphtheria, out of the same number born, more die in the healthy districts of England than in Liverpool; the proportions are 1029 in the healthy districts and 442 in Liverpool of 100,000 born. The deaths from scarlet fever are 2140 in the healthy districts to 3830 in Liverpool.”

[1375] _8th Detailed Report of the Reg. Gen. Scot._, p. xxxix.

[1376] R. T. Thorne, M.B., _Diphtheria: its Natural History and Prevention_. Milroy Lectures for 1891. London, 1891.

[1377] Farr, _Rep. Reg.-Genl._ XXIV. (1861), p. 217.

[1378] Longstaff, u. s.

[1379] G. Budd, M.D., “Obs. on Typhoid or Intestinal Fever.” _Brit. Med Journ._, 9 Nov. 1861, p. 485.

[1380] _Supra_, pp. 210, 213.

[1381] Matthew A. Adams, cited by Thorne, u. s. with diagram.

[1382] M. W. Taylor, M.D., “Diphtheria in connection with Damp and Mould Fungi.” _Trans. Epic. Soc._ N. S. VI. (1886-7), p. 104. Thorne, u. s. gives instances in which diphtheria seemed to choose out wet and impervious soils.

[1383] L. Traube, _Gesammelte Beiträge, &c._, Berlin, 1871, II. 11.

[1384] Thorne, u. s. has collected and analysed very fully the instances of diphtherial epidemics traced to cows’ milk. It is commonly assumed that the epidemics are either wholly diphtherial or wholly scarlatinal, but not a mixture of the two diseases.

[1385] W. N. Thursfield, _Lancet_, 3 Aug. 1878, p. 180, has contended for some such correlation between diphtheria and enteric fever in their respective preferences, at that time, for rural and urban districts.

[1386] William Heberden, M.D. junior. _Observations on the Increase and Decrease of Diseases, particularly the Plague._ Lond. 1801.

[1387] Among the numerous medical writers who have used it are Macmichael, Watson and Chevers. Among historians Lecky (I. 573) has thought it worthy of mention among the progressive improvements of the 18th century.

[1388] Heberden (l. c. p. 42) accounted for the enormous increase of the article “convulsions” in the Bills by the inclusion under that term of most of the deaths originally entered under “chrisomes and infants,” which were infants under one month. But the latter had been mostly transferred at an early period while convulsions was still a small total; and even at the worst period of the public health in London, about 1730-40, they would not have accounted for a sixth part of the deaths under convulsions. The probability of the deaths from “griping in the guts” having been transferred to “convulsions” was pointed out in a review of Heberden’s essay in the _British Critic_ on its appearance, without reasons given such as I adduce in the sequel.

[1389] _Observ. Med._ IV. cap. 7, § 2.

[1390] _Ibid._ III. cap. 2, § 54.

[1391] _Pathol. Cerebri._ Pordage’s Transl. p. 25.

[1392] Walter Harris, M.D., _Tractatus de Morbis Acutis Infantum_. Lond. 1689. Engl. Transl. by Cockburn, 1693, p. 39.

[1393] _Obs. Med._ IV. cap. 2, § 7: “haud aliter ac si in aëre peculiaris mensis hujus [Augusti] lateat reconditum ac peculiare quiddam, quod specificam hujus modi alterationem, soli huic morbo adaptatam, vel cruori vel ventriculi fermento valeat imprimere.”

[1394] See the reference to Simpson’s essay, _supra_, p. 333.

[1395] W. Fordyce, M.D. _A new inquiry into the Causes, Symptoms and Cure of Putrid and Inflammatory Fevers: with an Appendix on the Hectic Fever and on the Ulcerated and Malignant Sore Throat._ London, 1773, p. 207.

[1396] See the Representation of the College of Physicians on Drink in 1726, cited at p. 84.

[1397] Joseph Clarke, M.D. “Nine-day Fits in the Lying-in Hospital of Dublin.” _Trans. Royal Irish Academy_ (in _Med. Facts and Obs._ III. 1792).

[1398] Moss, u. s. He makes out that the infants of the poorer class were much neglected by their drunken parents.

[1399] John Ferriar, M.D., _Medical Histories and Reflections_. 2 vols. Lond. 1810. II. 213 seq. “On the Prevention of Fevers in Great Towns.”

[1400] Watt, u. s., says that “bowel-hive” at Glasgow included, along with teething, “a promiscuous mass which may be considered nearly in the same light as the great number of deaths in the London bills of mortality ranked under the terms convulsions, gripes of the guts, &c.... If the patient dies in a state of convulsions, this, we are told, is owing to the hives having gone in about the heart, or their having seized the bowels.”

[1401] Hirsch, _Geographical and Historical Pathology_, Engl. Transl. III. 376.

[1402] Supplement to the 45th Annual Report of the Registrar-General. London, 1885, p. xiii. Ballard, following the method of Pfeiffer (1871) for Asiatic cholera, has shown that the correspondence is closest with the temperature of the ground four feet deep.

[1403] Ballard, _Report to the Local Government Board upon the Causation of Summer Diarrhoea_, 1889, p. 32.

[1404] Willis mentions an instance (_Pathol. Cerebri_, Pordage’s transl. p. 25) which can hardly mean anything but congenital feebleness as a cause of infantile convulsions. A neighbour of his (in St Martin’s Lane) had lost all his children by convulsions within the space of three months. Another child was born, and Willis was sent for to advise what regimen should be followed so as to save it from the same fate.

[1405] This is clearly seen in comparing ages at death in Liverpool, and in Preston or Salford. Again in the ten years 1871-80, there were 4530 deaths from diarrhoea in the group of shipping towns, Yarmouth, Hull (with Sculcoates), Goole and Hartlepool, of which 70 per cent. were under one year, 19 per cent. from one to five, and 11 per cent. above five, chiefly in old age. In the group of Leicester, Worcester, Northampton and Coventry in the same period, there were 5001 deaths, of which 74 per cent. were under one year, 17 per cent. from one to five, and 9 per cent. above five, chiefly in old age.

[1406] Ballard, _Report, &c._ u. s. says that “occupation of females from home,” which had been often assigned by medical officers of health and others as a fruitful cause of infantile fatal diarrhoea, “resolves itself mainly into the question of maternal neglect, with the substitution more or less of artificial feeding for feeding at the breast.” Tatham, _Brit. Med. Journ._ 1892, II. 277, is of opinion that the rate of infant mortality was considerably increased by the practice, which obtained in most manufacturing towns, of allowing women to return to work within a week or ten days after their confinement, so that the duties of the mother were necessarily delegated. The paper by Dr G. Reid, _ibid._ p. 275, which called forth that and similar opinions as to the kind of maternal neglect that favoured the mortality by infantile diarrhoea, bore the title, “Legal restraint upon the employment of women in factories before and after childbirth”; but the emphasis falls almost wholly upon restraint of the mother’s industrial occupation after the child is born.

[1407] L. c. pp. 43-45.

[1408] Ballard, u. s. Table VI.

[1409] See former volume, p. 412.

[1410] _The Triall of Tabacco, &c._ by E. G. [Edmund Gardiner], Gent. and Practicioner in Physicke. London, 1610, fol. II.

[1411] _Obs. Med._ IV. cap. 2.

[1412] _Ibid._ IV. cap. 7.

[1413] Dr Andrew Wilson, a pupil of the Edinburgh School in the great period of the first Monro, Whytt and Rutherford, used his Newcastle experiences in 1758 and following years as the basis of two excellent essays, one on Dysentery (1761) and the other upon Autumnal Disorders of the Bowels (1765). In the latter he includes both cholera nostras and bilious colic, (as well as dry colic) as Sydenham had done, and makes the following distinction between the two forms, which “are very nearly allied in their nature”:--“The vomiting of bile in the cholera is not so early as it is in the other; neither is it so constant, nor in so large quantities. Though a purging generally attends the bilious colic, yet it does not correspond so regularly as it does in the cholera, in which there generally is a call to stool soon after every paroxysm of vomiting.... The bilious colic is not generally so quickly hazardous as the cholera is. The intervals between the sick fits are often longer, and when it is attended with danger, it does not become so so suddenly as the cholera does.” Bilious colic was not so strictly an autumnal complaint as cholera. It was not so soon relieved by medicines. It resembled cholera in the remarkable character of exciting cramps in other muscles than the abdominal.

[1414] _Pharmaceutice rationalis._

[1415] Appendix to _Essay on Smallpox_, 1740.

[1416] _Gent. Magaz._, Sept. 1751, p. 398.

[1417] _Two Papers on Fever and Infection_, 1763, p. 35.

[1418] _Med. Hist. and Reflect._ II. 220.

[1419] _Ed. Med. Surg. Journ._, 1807.

[1420] Charles Turner Thackrah, _Cholera, its character and treatment, with remarks on the identity of the Indian and English_. Leeds, 1832, p. 24.

[1421] W. Horsley, _Med. Phys. Journ._ 24 March, 1832, p. 270.

[1422] _Geogr. and Histor. Path._ Engl. transl. III. 315.

[1423] It is probable that the association of surfeit with bowel-complaint in general and at length with dysentery in particular came from the popular belief that these maladies of the autumnal season were due to repletion with fruit. That was the popular belief from an early period, which nearly all the medical writers on autumnal diarrhoea and dysentery took occasion to combat as either inadequate or erroneous.

[1424] See Vol. 1. of this History, p. 626. The following is in a letter from Charles Bertie to Viscountess Campden, London, 22 Nov. 1681: “I have safely received your choice present of four bottles, three of Plague and the other of Surfeit water, which I shall preserve against the occasion, being confident that better are not made with hands.” _Cal. Belvoir MSS._ (Hist. MSS. Com.) II. 60.

[1425] _Obs. Med._ IV. cap. 3.

[1426] _Pharmaceutice Rationalis_, lib. III. cap. 3.

[1427] _Supra_, p. 103.

[1428] Andrew Fletcher, _Two Discourses, &c._ No. 2. p. 2, 1698.

[1429] John Jones, M.D., _De Morbis Hibernorum specialim vero de Dysenteria Hibernica. Accesserunt nonnulla de Dysenteria Epidemica_. Inaug. Diss. Trin. Col. Dub. Londini, 1698, p. 12.

[1430] _Edin. Med. Essays and Obs._ I. (1733) 37, II. 30, IV. V.

[1431] James Stephen, surgeon to Gen. Whetham’s regiment, in Pringle’s collection of accounts of the “Success of the vitrum Antimonii ceratum.” _Ibid._ V. pt. 2, p. 179, 4th ed.

[1432] Professor T. Simpson, of St Andrews, Andrew Brown, of Dalkeith, John Paisley and John Gordon, of Glasgow. _Ibid._

[1433] _Gent. Magaz._, 1741, p. 705.

[1434] The “epidemic constitution” of 1743 was so markedly dysenteric after the influenza in the spring that Huxham regarded the dysentery as a sequela of the influenza.

[1435] Mark Akenside, M.D., _De Dysenteria Commentarius_, London, 1764.

[1436] George Baker, M.D., _De Catarrho et de Dysenteria Londinensi Epidemicis utrisque An._ MDCCLXII. _Libellus_, Lond., 1764.

[1437] William Watson, M.D., in _Phil. Trans._ LII. pt. 2 (1762), p. 647.

[1438] Pringle also, who was well acquainted with the dysentery of campaigns, speaks of the London epidemic as an exceptional occurrence, and as having caused few deaths.

[1439] _Med. Obs. and Inquiries_, IV. (1771), p. 153.

[1440] MS. Infirmary Book of the Foundling Hospital.

[1441] _An Essay on the Autumnal Dysentery._ By a physician (Andrew Wilson, M.D.), Lond., 1761 (Preface dated Newcastle, 25 March, 1760), pp. 1, 23.

[1442] _Trans. K. and Q. Col. Phys._ V. (1828), p. 221.

[1443] _Obs. on the History and Treatment of Dysentery and its Combinations, etc._, 2nd ed., Dublin, 1847.

[1444] _Alexandri Tralliani Medici libri duodecim._ Basil, 1556, Lib. VIII. pp. 423, 432.

[1445] Akenside, _l. c._ “Ut dysenteriam jam pro rheumatismo intestinorum habeam, et similem utriusque morbi causam et materiem esse contendimus.”

[1446] Hirsch, III. 333 (Eng. transl.): “As to the influence of an extreme diurnal range of the thermometer (cold nights after very hot days) there is almost complete agreement among the observers in those parts [tropical and subtropical] of the world.”

[1447] I have enunciated this view of the pathology of acute rheumatism more fully in the Article “Pathology” in the _Encyclopaedia Britannica_.

[1448] _Lond. Med. Journal._ Editorial note, II. 211. The parish register of Finchley shows double the average mortality in 1780, and indicates dysentery as a fatal malady. Lysons, _Environs of London_.

[1449] Moss, u. s.

[1450] Francis Geach, F.R.S., _Some Observations on the present Epidemic Dysentery_, 1781.

[1451] Dennis Ryan, M.D., “Remittent Fever of the West Indies.” _Lond. Med. Journ._ II. 253, iii. 63.

[1452] Dr Livingston to Dr Lettsom, Aberdeen, 29 June, 1789, in _Memoirs of Lettsom_, III.

[1453] Willan, _Report on the Diseases etc._, p. 42. The nearest approach to a fatality in dysentery, he says, happened in the case of a lady residing in Spa Fields, at whose window a brown owl, attracted by the solitary light, came flapping and hooting at midnight, to the great aggravation of the patient’s symptoms.

[1454] Bateman, u. s.

[1455] _Glasg. Med. Journ._ IV. (1831), pp. 5, 229.

[1456] Cheyne, _Dubl. Hosp. Reports_, III. (1822), p. 3. At Limerick, from June to September, 1821, there were 47 cases among the men of the 79th regiment.

[1457] Clarke, _Edin. Med. and Surg. Journ._ IV. 423.

[1458] A. C. Hutchinson, _Statement of the extraordinary sickness at the Penitentiary at Milbank_, Lond. 1823; P. M. Latham, M.D., _Account of the Disease lately prevalent at the General Penitentiary_. Lond. 1825.

[1459] James Wilson, _Glasgow Med. Journ._ I. (1828), p. 40.

[1460] James Wilson, _Glasgow Med. Journ._ I. 39; James Brown, _ibid._; Macfarlane, I. 99; Paterson, I. 438; Editors, IV. 1; Hume (Hamilton), IV. 14, and 229; McDerment (Ayr), IV. 19; Macnab (Callander), IV. 241.

[1461] Christison, “Notice on the Dysentery which has lately prevailed in the Edinburgh Infirmary.” _Edin. Med. Surg. Journ._ XXXI. (Jan. 1829), p. 216, and in _Life of Sir Robert Christison_, “Autobiography,” I. 376.

[1462] W. H. Gilby, M.D., “On the Dysentery which occurred in the Wakefield Lunatic Asylum in the years 1826, 1827, 1828 and 1829.” _North of Eng. Med. and Surg. Journ._ I. (1830-31), 91.

[1463] Hume, “Case of the Edinburgh New Town Epidemic.” _Glasgow Med. Journ._ IV. 229.

[1464] _Ibid._ IV. 7. The following is Buchanan’s reference to it: “The only epidemic fever belonging to the family of diseases we are here considering that occurred in Scotland during the _dysenteric_ years was that of the New Town of Edinburgh, in 1828, of which we have already spoken. As our knowledge of this fever is not derived from any source on which we can certainly rely, it is possible that we may have formed an erroneous opinion respecting it; but from all we have heard of its symptoms and mode of distribution, we are disposed to consider it as totally different in nature from the common fever of this country. The latter circumstance alone, the mode of distribution of the disease, is, we think, perfectly sufficient to demonstrate our proposition. Instead of occupying the Cowgate, the Grassmarket, and the High Street, the usual haunts of typhus, this fever had its head-quarters in Heriot Row and Great King Street; and, according to our information, it extended from the last mentioned street in the direction of the Water of Leith, and from Leith, along the shore, to Musselburgh. We do not vouch for the accuracy of these minute details, but we believe the important fact to be beyond doubt that this fever prevailed chiefly, not in the districts where typhus is invariably to be met with, but in the most fashionable parts of the New Town.”

[1465] James Black, M.D., _Edin. Med. Surg. Journ._ XLV. (1836), p. 63. “As the epidemic was ushered in and was accompanied during the half of its course with cholera, fever of a typhous character followed close in its train among the working and lower classes, and continued more or less during the first months of winter, after dysentery had totally disappeared.” The latter had not been seen again down to 1835.

[1466] J. Smith, _ibid._ XLII. (1833), p. 342.

[1467] Cleland, _Trans. Glasg. and Clydesd. Statist. Soc._ I. 1837.

[1468] Arrott, _Edin. Med. Surg. Journ._, Jan. 1839, p. 121.

[1469] Farr, in _First Report of the Registrar-General_, 1837-8, p. 103.

[1470] Baly, _Pathology and Treatment of Dysentery_. London, 1847.

[1471] Moyle, _Lond. Med. Gaz._ N. S. VII. Dec. 29, 1848, p. 1093.

[1472] Christison, “On a local Epidemic of Dysentery.” _Month. Journ. Med. Sc._ XVII. (Dec. 1853), 508.

[1473] T. S. Clouston, _Med. Times and Gaz._ 1865, I. 567.

[1474] W. H. Duncan, M.D., “On the recent Introduction of Fever into Liverpool by the crew of an Egyptian frigate.” _Trans. Epidemiol. Soc._ vol. 1. pt. 2. p. 246. (1 July, 1861).

[1475] James Boyle, surgeon to H. M. S. ‘Minden,’ _Epidemic Cholera of India_, London, 1821; W. B. Carter, _Cholera Indica vel Spasmodica_, Thesis, Glasgow, 1822; Thomas Brown, of Musselburgh, _On Cholera, more especially as it has appeared in British India_, Edin. 1824; Whitelaw Ainslie, M.D., _The Cholera Morbus of India_, Letter to the Court of Governors, H. E. I. C., Edin. 1825; A. T. Christie, M.D. (of Madras), _Obs. on the Nature and Treatment of Cholera_, Edin. 1828; Charles Searle (of Madras), _Cholera, its Nature, Cause and Treatment_, London, 1830 (dated 1st May, instigated, not by the Orenburg epidemic, but by the deaths of Sir Thomas Monro and others from cholera in Madras).

[1476] See extract in _Glas. Med. Journ._, Feb. 1831, p. 105, from _Scottish Mission. and Philan. Reg._

[1477] George Hamilton Bell, _Treatise on Cholera Asphyxia or Epidemic Cholera as it appeared in Asia and more recently in Europe_, Edin. 1831; Reginald Orton, _An Essay on the Epidemic Cholera of India_, 2nd. ed. with a supplement, London, 1831 (August); 1st ed. Madras, 1820; H. Young, M.D. (of the Bengal Service), _Remarks on the Cholera Morbus_, 2nd ed. 1831; Alex. Smith, M.D. (Calcutta), _Description of the Spasmodic Cholera_ (substance of an old report to the Army Medical Board); W. Macmichael, M.D., _Is the Cholera Spasmodica of India a Contagious Disease?_ London, 1831 (Sept.); T. J. Pettigrew, _Obs. on Cholera, comprising a description of the Epidemic Cholera of India_, London, 1831 (13 Nov.); John Austin, _Cholera Morbus, Indian and Russian Cholera_, London, 1831 (July); John Goss, late H. E. I. C. S., _Practical Remarks on the Disease called Cholera_, London, 1831 (Nov.); Whitelaw Ainslie, _Letters on the Cholera_, London, 1832 (from Edinburgh, Dec. 1831); Henry Penneck, M.D., _Nature and Treatment of the Indian Pestilence commonly called Cholera_, London, 1831 (Penzance, 24 Nov.); A. P. Wilson Philip, _Nature of Malignant Cholera_, London, 1832; _Official Reports made to Government by Drs Russell and Barry on Cholera Spasmodica observed during the Mission to Russia in 1831_, London, 1832; John V. Thompson, Dep. Insp. Gen. of Hosps. _The Pestilential Cholera unmasked_, Cork, 1832 (January).

[1478] _Op. cit._ p. 469.

[1479] _Lond. Med. Gaz._ 1831.

[1480] James Hall, “Narrative of an Epidemic English Cholera that appeared on board ships of war lying in ordinary in the River Medway during the Summer and Autumn of 1831.” _Edin. Med. Surg. Journ._, Feb. 1832, p. 295.

[1481] John Marshall, M.D., _Obs. on Cholera as it appeared at Port Glasgow in July and August, 1831. Illustrated by numerous cases._ 1831.

[1482] William Dixon, _Lond. Med. Gaz._ 4 Feb. 1832, IX. 668.

[1483] Dixon, u. s.

[1484] Kell, p. 22.

[1485] Kell, Dixon, and others; the statements about Henry’s case are contradictory.

[1486] Clanny, p. 19.

[1487] A table of the daily course of the cholera at Sunderland, which I must omit for want of space, is given in the essay by Haslewood and Morbey, _History and Medical Treatment of Cholera as it appeared in Sunderland in 1831_, London, 1832, p. 151.

[1488] Kell, however, suspected that there were many malignant cases in Monk Wearmouth after the 31st of October, which were not reported. l. c. p. 73.

[1489] Clanny says (p. 42), “At first our epidemic appeared only in certain streets or lanes, namely, the Fish Landing, Long Bank, Silver Street, High Street, Burleigh Street, Mill Hill, Sailors’ Alley, Love Lane, Wood Street, Warren Street; as also in several lanes in Bishopwearmouth, the New Town, Ayre’s Quay, and on the north side of the river in Monkwearmouth, in several of the byelanes near the river.... Generally speaking the disease fixed its residence in such places as medical men could have pointed out _à priori_.”

[1490] Besides the essay of Haslewood and Morbey, and the paper by Dixon, _supra_, the following were written on the Sunderland cholera: W. Ainsworth, _Obs. on the Pestilential Cholera at Sunderland_, London, 1832; John Butler Kell, surgeon to the 82nd Regt., _Cholera at Sunderland in 1831_, Edin. 1834; W. Reid Clanny, M.D., (chairman of the Local Board of Health), _Hyperanthraxis, or the Cholera of Sunderland_, Lond. 1832; Emile Dubuc, _Rapport sur le Cholera Morbus à Sunderland, Newcastle, etc._ Rouen, 1832.

[1491] Ainsworth, p. 164, u. s., says: “Dennis Mc Gwin, who took the disease to North Shields, came from Sunderland. The first case in South Shields was a boy from Gateshead. A pedler woman took it to Houghton, a traveller to Morpeth, and I have no doubt its arrival could similarly be traced to Durham, Haddington and Tranent, all towns on the same high road. A wanderer also perished of the disease at Doncaster; but luckily there were no other cases.”

[1492] T. M. Greenhow, M.D., _Cholera as it has recently appeared in the Towns of Newcastle and Gateshead, including Cases_, London, 1832; Thomas Mollison, M.D., _Remarks on the epidemic Disease called Cholera, as it occurred in Newcastle_, Edin. 1832. (He arrived at Newcastle from Edinburgh on the 21st Dec. and remained eleven days.)

[1493] In Greenhow, u. s.

[1494] Craigie, _Edin. Med. Surg. Journ._ XXXVII. 337.

[1495] John Douglas, M.D., “History of the Epidemic Cholera of Hawick,” in _Cholera Gazette_, no. 6, April 7, p. 234.

[1496] Chiefly from the paper by Professor George Watt, _Glas. Med. Journ._ v. 298, 384; see also Bryce, _ibid._ 262.

[1497] W. Auchincloss, M.D., “Report of the Epidemic Cholera as it appeared in the Town’s Hospital of Glasgow in February and March, 1832,” _Glas. Med. Journ._ v. 113.

[1498] James Cleland, LL.D., and James Corkindale, M.D., _Edin. Med. Surg. Journ._ XXXIX. 503.

[1499] J. Adair Lawrie, M.D., “Report of the Albion Street Cholera Hospital.” _Glas. Med. Journ._ V. 309, 416.

[1500] _Month. Journ. Med. Sc._ March, 1850, p. 302.

[1501] Wood, _Glas. Med. Journ._ VI. 1833.

[1502] Grieve, _Month. Journ. Med. Sc._ IX. 1849, p. 777.

[1503] Scott, _Edin. Med. and Surg. Journ._ XXXIX. 276. For a whole month it was confined to one suburb. All the earlier cases were without exception fatal. There were 130 cases and 65 deaths.

[1504] It is probably to Portmahomak or Inver that Howison refers in the following (_Lancet_, 10 Nov. 1832, p. 203): Cholera broke out in a small village several miles from Tain, and in a few days it carried off 41 out of a population of 120 to 140. Coffins could not be made fast enough. Many were buried in sailcloth. The people fled from their houses to the fields.

[1505] Hugh Miller, _My Schools and Schoolmasters_, Chap. XXII.

[1506] The good account by Paterson, “Observations on Cholera as it appeared at Collieston and Footdee,” _Edin. Med. and Surg. Journ._ XLIX. (1838), p. 408, shows how much panic a mortality of nine stood for.

[1507] Sir J. Y. Simpson gave to Dr Graves of Dublin a list of some places in Scotland where cholera had appeared, which contains the additional names of Helmsdale (23 July), Fort William (24 Sept.), Fort George (7 May), Islay (23 Oct.), Portpatrick (7 Aug.), Crieff (2 Oct.), and Kelso (29 Oct.).

[1508] _Dubl. Journ. Med. Sc._ III. 74.

[1509] _Times_, 1 July, 1832.

[1510] Simon McCoy, “Notes on Malignant Cholera as it appeared in Dublin,” _Dub. Journ. Med. Sc._ II. 357, and III. 1.

[1511] Compare Grimshaw’s observations on the admissions for fever to the Cork Street Hospital in the summer of 1864, _supra_, p. 298.

[1512] Wilde, _Census of Ireland 1841_. Table of Deaths, p. xxi.

[1513] _Gent. Magaz._ 1832, June, p. 555; _Annual Register_, 1832, Chronicle (June), p. 71.

[1514] Graves, _Dubl. Quart. Journ. Med. Sc._ Feb. 1849, p. 31, from information by Dr Little of Sligo.

[1515] W. Howison, M.D., of Edinburgh, _Lancet_, 10 Nov. 1832, p. 203. He was at Londonderry in August, and had probably heard the reports of the Sligo cholera there.

[1516] John Colvan, M.D., _Dubl. Journ. Med. Sc._ IV. 186. These five deaths in Armagh County in 1833 do not appear in the table.

[1517] Graves, u. s. 1849, VII. 246.

[1518] Roupell, _Croomian Lectures on Cholera_, Lond. 1833, p. 33, gives the suspicious case of a man named Webster, who sailed from Sunderland on 20 Jan. and arrived in the Thames about the 30th. “The vessel immediately obtained _pratique_; but a few days after, this man was seized with extreme pain in the epigastrium” &c. and died suddenly after symptoms in part those of cholera. Postmortem, 20 oz. of blood were found in the peritoneum, and some blood in the lower part of the bowel.

[1519] The populous parishes of the Black Country around Wolverhampton came under notice in another way in 1832 as a crucial instance in the redistribution of seats by the Reform Act.

[1520] T. Ogier Ward, “Cholera in Wolverhampton in Aug.-Oct. 1832,” _Trans. Prov. Med. and Surg. Assoc._ II. 368.

[1521] Rev. W. Leigh, _An authentic narrative of the awful visitation of Bilston by Cholera in Aug.-Sept. 1832_. Wolverhampton, 1833.

[1522] Rev. C. Girdlestone, _Seven Sermons preached during the prevalence of the Cholera in the parish of Sedgley, with a narrative of that visitation_. London, 1833.

[1523] T. Ogier Ward, u. s., p. 376.

[1524] James Collins, M.D., _Lond. Med. Gaz._ 30 June, 1832, p. 412; and report by Thompson, surgeon of the ‘Brutus,’ in the _Cholera Gazette_, s. d.

[1525] Henry Gaulter, M.D., _The Origin and Progress of the Malignant Cholera in Manchester_. London, 1833, p. 113.

[1526] The first case was of a coach-painter, who had had frequent attacks of painter’s colic. Opposite his house was a large stable dunghill in a very foetid state. On the evening of the 16th May he had eaten a heavy supper of lambs’ fry, and had been ill thereafter, the symptoms becoming those of Asiatic cholera on the night of the 18th, death ensuing at 2 p.m. 20th.