Chapter 62

[396]Buchanan,Report Med. Officer Privy Council for 1864, andTrans. Epid. Soc.1865,II.17; Hamilton,Lancet,II.1867, p. 608 (Liverpool); Martyn,Brit. Med. Journ.July, 1863; Davies,Med. Times and Gaz.II.1867, p. 427 (Bristol); Thompson,St George’s Hosp. Reports,I.(1866), p. 47 (London); Allbutt,ibid.p. 61 (Leeds).

[397]Buchanan,Report Med. Off. Privy Council for 1865, p. 210.

[398]James Stark, M.D., “Remarks on the Epidemic Fever of Scotland during 1863-64-65” etc.,Trans. Epidem. Soc.N. S.II.312. See also Russell,Glasg. Med. Journ.July, 1864, and R. Beveridge (for Aberdeen),Lancet,I.1868, p. 630.

[399]Weber,Lancet,I.1869, pp. 221, 255; Murchison,ibid.II.1869, pp. 503, 647; Gee (Liverpool),Brit. Med. Journ.II.1870, p. 246; Robinson (Leeds),Lancet,I.1871, p. 644; Muirhead (Edinburgh),Edin. Med. Journ.July, 1870, p. 1; Rabagliati (Bradford),ibid.Dec. 1873; Tennant (Glasgow),Glasgow Med. Journ.May, 1871, p. 354; Armstrong (Newcastle),Lancet,I.1873, p. 48.

[400]Muirhead (l. c.) says: “In no single instance which came under my observation could starvation be said to be the immediate cause of the disease. Not one of those individuals could be said to be emaciated.... On strict and repeated inquiry, not one of them would confess to having been in destitute circumstances.” During the winter of 1870-71 I attended from the Edinburgh New Dispensary several relapsing-fever patients at their homes, and can clearly remember having been surprised at the condition of decency and comfort in which I found them. The appearance of comfort was certainly due in part to the district visitors, who were numerous and active during the epidemic.

[401]Spear, “Typhus Fever in various parts of England, 1886-87.”Rep. Med. Off. Loc. Gov. Bd.N. S.XVI.p. 169.

[402]2303 of these fever deaths in 1864 occurred in the eight principal towns of Scotland, classified as follows: typhus, 1450, relapsing fever, 371, gastric, enteric, or typhoid, 382.

[403]G. B. Longstaff, M.D.,Trans. Epid. Soc.1884-5, p. 72, reprinted in hisStudies in Statistics, Lond. 1891, p. 402. The seasonal curve for the typhoid admissions to the London Fever Hospital over a longer period is nearly the same, as well as that of the registered deaths by typhoid in all London, 1869-84.

[404]The following large registration districts besides those in the Table, had enteric-fever death rates of ·5 and upwards per 1000 persons living, in the ten years 1871-80; in nearly all of them there has been a marked decline in the ten years 1881-90:—Durham, Hartlepool, Easington, Houghton-le-Spring, Darlington, Gateshead (county Durham); Morpeth (Northumberland); Aysgarth, Todmorden, Dewsbury, Pontefract, Barnsley, Rotherham (Yorkshire); Dudley, Leigh, Ormskirk (Lancashire); Crickhowell (Wales); Worksop, Radford (Nottingham); Shrewsbury; Peterborough; Portsea Island (Hants). Of the London districts, Hackney had the highest enteric fever, 0·46 per 1000 in a general death-rate of 20·78. The high rate of a decennium is not unfrequently brought up by one great explosion. In many of the Lancashire, Yorkshire and Midland towns, with rates about ·4 per 1000 persons, the rate has been somewhat steady from year to year. In the decennium 1871-80, many special outbreaks, some of them in villages, were reported on by the inspectors of the Medical Department, and traced for the most part to water-supplies tainted by the percolation of excrement.

[405]The Registration District of Middlesborough was carved out of Stockton and Guisborough in 1875.

[406]Registration District containing a population of 72,707 on a mean between the census of 1871 and that of 1881. In 1891 the population was 146,812.

[407]F. W. Barry, M.D., inRep. Med. Off. Loc. Gov. Board for 1882, p. 72. The contention of the inspector was that the water-supply had been tainted by enteric-fever evacuations from a case which began on 22 May in a cottage some half-mile distant from the reservoir but in communication with it through ditches and brooks. The area of the water-supply did not correspond with the area of the fever.

[408]The report for the Medical Department by F. W. Barry, M.D. (Enteric Fever in the Tees Valley, 1890-91, Parl. papers, Nov. 1893), is an elaborate argument to prove that the flooded state of the Tees was indeed the relevant antecedent, not as indexing the rise of the ground-water in the respective towns, but as dislodging and sweeping down the slops, sewage and dry refuse of the market town of Barnard Castle, in upper Teesdale, whereby the water taken in from the Tees two miles above Darlington to the tanks, filters and reservoirs of the Darlington Corporation, and of the Stockton and Middlesborough Water Board, was tainted in some unusual degree—a hypothesis the more remarkable that the refuse, such as it was, had been suspended or dissolved in an unusual volume of water, that little refuse could have collected between the first floods and the second, and that no cases of enteric fever were known in the upper valley of the Tees. This judicial deliverance has not been accepted by the authorities of Darlington, Stockton and Middlesborough, nor by the Royal Commission on Water Supply, before whom it was laid.

[409]Besides the epidemic at Worthing in 1893, which is stillsub judice, the best known instance of typhoid following a certain water-supply is the explosion at Redhill and Caterham in Jan.-Feb. 1879,Rep. Med. Off. Loc. Gov. Board, for 1879, Parl. papers, 1880, p. 78. The first instance alleged of the distribution by milk was the Islington explosion in July-August 1870 (Ballard,Med. Times and Gaz.1870,II.611). It was soon followed by the Marylebone explosion in the summer of 1873 (Rep. Med. Off. L. G. B.,N. S. II.193); but such instances have become less common, while instances of scarlatina and diphtheria following a milk-supply have become more common.

[410]Second Letter to Sir Hercules Langrishe, May, 1795.

[411]Berkeley’sQuerist, Q. 362.

[412]Radulphus de Diceto,Imag. Histor.Eng. Hist. Soc. ed.I.350.

[413]“Topogr. Hiberniae” inOpera, Rolls ed.V.67. This and the preceding reference had escaped the notice of Dr John O’Brien, in the historical introduction to hisObservations on the Acute and Chronic Dysentery of Ireland. Dublin, 1822.

[414]Polychronicon, Rolls ed.I.332-3.

[415]“Many of the English-Irish have by little and little been infected with the Irish filthinesse, and that in the very cities, excepting Dublin and some of the better sort in Waterford, where the English continually lodging in their houses, they more retain the English diet.” And again: “In like sort the degenerated citizens are somewhat infected with the Irish filthinesse, as well in lowsie beds, foule sheetes, and all linnen, as in many other particulars.... Touching the meere or wild Irish, it may truely be said of them, which was of old spoken of the Germans, namely, that they wander slovenly and naked, and lodge in the same house (if it may be called a house) with their beasts.” Fynes Moryson,Itinerary, Pt.IV.p. 180.

[416]Ireland’s Natural History, &c.Written by Gerard Boate, late Doctor of Physick to the State in Ireland. And now published by Samuel Hartlib, Esquire. Lond. 1652. The author died at Dublin, shortly after his arrival there, on 9/19 January 1650/49. His information would seem to have come in part from his brother Arnold Boate, resident in Ireland.

[417]Hardiman,History of Galway, p. 126seq.The plague from July 1649 to Lady Day 1650 is said to have swept away 3700 of the inhabitants, including 210 of the most respectable burgesses and freemen, with their families. The capitulation on 5 April, 1652, was followed by famine throughout the country, and by a revival of plague for two years, “during which upwards of one-third of the population of the province was swept away.”

[418]Cromwell’s Letters and Speeches,II.55, 77.

[419]Edmund Borlase,History of the Reduction of Ireland to the Crown of England. 1675, p. 172.

[420]Boyle’sWorks, fol. Lond. 1744,V.92.

[421]The war-pestilence at Londonderry in 1689 is the third recorded epidemic of the kind there, not including what may have happened in the capture of the town by the Catholics in O’Neill’s rebellion, when Derry was destroyed, to be rebuilt in 1613 by the London Companies with a new charter under the name of Londonderry. The first historical occasion of sickness was in 1566. The troops of Elizabeth were landed on Loch Foyle in October and built their huts on the site of the old monastery. In the course of the winter the greater part of a force of 1100 men perished by dysentery and the infection which it breeds (see former volume, p. 372). On 12 Dec. 1642, a year after the outbreak of the Rebellion of Confederate Catholics, a petition of the agents of the distressed city of Londonderry to the Commons represented that there were 6059 persons in the city, whereof 5123 were women and children, or sick, aged or impotent; only 2000 were inhabitants of the city, the rest having fled there for safety. Spotted fever had broken out. (Hist. MSS. Comis.V.“MSS. of the House of Lords.”)

[422]With the exception of the last quoted piece of information, the most minute particulars of the siege of Londonderry are in an essay by an army chaplain, John Mackenzie,A Narrative of the Siege of Londonderry, London, 1690, which was written to correct and augmentA True Account of the Siege of Londonderryby the Rev. Mr George Walker, rector of Donoghmoore in the county of Tyrone, and late Governor of Derry. London, 1689.

[423]See former volume, pp. 634-43.

[424]Minute particulars of it are given inAn Impartial History of the Wars in Ireland[1689-1692]. By George Story, Chaplain to Sir Thomas Gower’s Regiment. London, 1693. Part I.

[425]Gangrene of the extremities was one of the symptoms of the “plague of Athens” as described by Thucydides. There is no need to invoke ergotism for an explanation of it, as some have done.

[426]At that time there was little systematic knowledge of military hygiene. Nearly two generations after, the experiences of Pringle, Donald Monro and Brocklesby in the campaigns of 1743-48 and 1758-63 in Germany and the Netherlands, yielded many valuable hints, some of which Virchow made use of in compiling his “Rules of Health for the Army in the Field,” in the Franco-Prussian War of 1870-71. See hisGesammelte Abhandlungen aus dem Gebiete der öffentlichen Medicin und Seuchenlehre.

[427]Bde. Berlin, 1879,II.193.

[428]Joseph Rogers, M.D.Essay on Epidemic Diseases.Dublin, 1734.

[429]In further illustration of the power of morbid effluvia, he says: “We see how small a portion of a putrid animal juice, taken into the blood by inoculation, like a most activeleavensets all in a ferment; and in a very short time brings the whole juices of a sound body into an equal state of corruption with itself,”—instancing war-typhus, plague from cadaveric corruption (according to Paré), the Oxford gaol fever, and “a later instance at Taunton not more than five or six years ago.”

[430]Dr Rogan of Strabane, in hisCondition of the Middle and Lower Classes in the North of Ireland, 1819, was of a different opinion (p. 90): “No police regulations exist in Strabane to prevent the slaughtering of cattle in any part of the town. The butchers, therefore, most of whom live in the narrow streets near the shambles, have their slaughter-houses immediately behind their dwellings. The garbage is thrown into a large pit, which is generally cleaned but once in the year, at the season when the manure is required for planting potatoes, and at this time an offensive smell pervades the whole town, and is perceptible for a considerable distance around. The families exposed constantly to the effluvia arising from these heaps of putrid offal might have been expected to suffer severely from fever; but on the contrary, they were found to be much less liable to it than others in the same rank of life. This was no doubt owing to their living chiefly on animal food, and thus escaping the debility induced by deficient nourishment, which certainly had the chief share in creating a predisposition to the disease.”

[431]Bp. Nicholson to Archbp. of Canterbury, cited by Lecky (II. 216) fromBrit. Mus. Add. MS. 6116.

[432]Cited by O’Rourke,History of the Great Irish Famine of 1847. Dublin, 1875, from pamphlet in the Halliday Collection of the Royal Irish Academy.

[433]See Boulter’sLetters to the English Ministers.

[434]Wakefield’sIreland,II.6, cited by Barker and Cheyne.

[435]John Rutty, M.D.Chronological History of the Weather and Seasons and prevailing Diseases in Dublin during Forty Years.London, 1770.

[436]Maurice O’Connell, M.D.Morborum acutorum et chronicorum Observationes.Dublin, 1746.

[437]Boulter’sLetters. Oxford, 1769,I.226.

[438]Lecky,II.217.

[439]Berkeley’sWorks. Ed. Fraser, Oxford, 1871,III.369.

[440]Lord John Russell used these historical parallels from England and Scotland in his great speech in the House of Commons, during the debate on Ireland, 25th January, 1847.

[441]Fraser, “Life and Letters of Berkeley,” inWorks,IV.262.

[442]Berkeley to Prior, Feb. 8 and 15, 1740/1.

[443]He published the receipt in a Dublin journal.

[444]Berkeley to Thomas Prior, in “Life and Letters,” u. s., p. 265. Some attempts at relief-works had been made the year before, two of which are still to be seen in the obelisks on Killiney Hill near Dublin and on a hill near Maynooth (“Lady Conolly’s Folly.” O’Rourke, u. s.).

[445]Rutty, p. 93.

[446](Dublin, 1741).

[447]Cited by O’Rourke. Short, a contemporary, also says that the fever in Galway was like a plague.

[448]Dutton,Statistical Survey of the County of Galway. Dublin, 1824, p. 313: “1741. A fever raged this year that occasioned the judges to hold the assizes in Tuam. Numbers of the merchants of Galway died this year, and multitudes of poor people, caused partly by fever and by the scarcity, as wheat was 28s.per cwt.”

[449]The author ofThe Groans of Ireland(Dublin, 1741) says: “On my return to this country I found it the most miserable scene of distress that I ever read of in history: want and misery in every face; the rich unable to relieve the poor; the road spread with dead and dying bodies; mankind of the colour of the docks and nettles which they fed on; two or three, sometimes more, on a car going to the grave for want of bearers to carry them, and many buried only in the fields and ditches where they perished.” Skelton, a Protestant clergyman, says: “Whole parishes in some places were almost desolate; the dead have been eaten in the fields by dogs, for want of people to bury them.” Skelton’sWorks, Vol.V.Cited by Lecky.

[450]Report by Dr Phipps to Baron Wainwright, 10 March, 1741. Cited by F. C. Webb,Trans. Epidem. Soc.1857, p. 67.

[451]Smith’sKerry, p. 77. He adds that many were excused the hearth-tax on account of their poverty, by certificate of the magistrates; so that the decrease in 1744 may mean a greater proportion excused the tax, as well as a depopulation.

[452]How near the verge of want the people were is brought out by an experience in Galway county in 1745: a great fall of snow smothered vast numbers of cattle and sheep, which caused a great many farmers to surrender their lands. Wheat rose from six to eighteen shillings the hundredweight, while, after the distress, the best land in Connaught could be rented for five shillings an acre. Dutton’sGalway, p. 313.

[453]For Kinsale, Cork and Bandon, see Marjoribanks,Med. Press and Circ.1867,II., 8.

[454]James Sims, M.D.Observations on Epidemic Disorders, with Remarks on Nervous and Malignant Fevers.London, 1773, p. 10. The preface is dated from London, whither Sims had removed from Tyrone. He rose to eminence in the London profession.

[455]A Letter to a Member of the Irish Parliament relative to the present State of Ireland.By Philo-Irene. London, 20 May, 1755. The turning of hundreds of acres into one dairy-farm had caused the depopulation which Goldsmith described in theDeserted Village: “By this unhappy policy several villages have been deserted at different times by the inhabitants, and numbers of them set a-begging,” p. 6.

[456]Sims, u. s. pp. 164-5.

[457]F. Barker and J. Cheyne,Account of the Fever lately epidemical in Ireland, 2 vols. London, 1821. This work relates mainly to the epidemic of 1817-19, but there is a short retrospect, the valuable part of which is for the years 1797-1802.

[458]The history of the Limerick and Belfast fever-hospitals is carried back to a few years before the founding of the Waterford hospital; but the latter was the first that was formally organised as a fever-hospital.

[459]“The fever in 1800 and 1801 very generally terminated on the fifth or seventh day by perspiration; the disease was then very liable to recur. The poor were the chief sufferers by it; and it was much more fatal amongst the middling and upper classes in proportion to the number attacked.” Barker and Cheyne,op. cit.p. 20.

[460]Smith’sKerry. Dublin, 1756, p. 77.

[461]Smith’sKerry, p. 88.

[462]A Tour in Ireland ... in 1776-78.London, 1780.

[463]The forty-shillings freeholder of Ireland was a life-renter whose farm was worth forty shillings annual rent more than the rent reserved in his lease.

[464]Malthus,Essay on the Principle of Population. Bk.II.chap. 10, Bk.III.chap. 8, and Bk.IV.chap. 11.

[465]Francis Rogan, M.D.,Observations on the Condition of the Middle and Lower Classes in the North of Ireland, as it tends to promote the diffusion of Contagious Fever; with the History and Treatment of the late Epidemic Disorders. London, 1819.

[466]William Carleton, thevates sacerof the Irish peasantry, was born, in 1798, in one of those Tyrone thatched cottages, in the parish of Clogher. His father had changed his holding three times before William, the youngest child, was fourteen years old; the last of the four was a farm of sixteen or eighteen acres in the north of Clogher parish, and “nearer the mountains.” Carleton says that he “lived among the people as one of themselves” until he was twenty-two, which would have been until the year 1820; so that he probably saw the famine and fever of 1817-18 among that very Tyrone peasantry whom Dr Rogan brings before us from the medical side. The scenes of famine and fever in the ‘Black Prophet’ are those “which he himself witnessed in 1817, 1822, and other subsequent years,” having been recalled by him in the form of a tale which was published in 1846, at the beginning of the Great Famine of that and the following year. His early recollections of famine and fever come into other tales, such as the ‘Clarionet,’ the ‘Poor Scholar’ and ‘Tubber Derg,’ in which last is related the almost inevitable reduction to poverty and at length to beggary of a most upright and industrious farmer owing to the fall of prices, without fall of rents, after the Peace of 1815. Carleton’s work has always the quality of fidelity, and he may be credited when he says that the scenes of famine and fever are not exaggerated.

[467]Rogan, u. s. p. 95: “A farmer within my knowledge, who holds fifteen acres of arable land, with nearly an equal quantity of cut-out bog, for which he pays £28 per annum, has erected six cabins for labourers. They are built with mud, instead of lime, and are thatched, so that they cannot each have cost more than three or four pounds. For some time he received from three of his tenants six guineas per annum, and from the others two guineas each, the latter only holding a cottage and a small garden [the former three having also grazing for a milch cow, half a rood of land for flax, and half an acre for oats, with privileges of cutting turf and planting as many potatoes as they could each provide manure for]; but they have been all so reduced in circumstances by the late scarcity as to be now unable to keep a cow, and for the two last years have rented their cabins and potato gardens alone. All the straw raised on the farm would scarcely suffice to keep the houses water-fast if applied solely to this purpose.” One of the first things that the Marquis of Abercorn did in the epidemic of 1817 was to call upon the subletting farmers on his manors to repair the roofs of their cottiers’ cabins.

[468]Carleton, in one of his tales, has given a vivid picture of the lurid or gloomy appearance of the country in the late autumn of 1816, as if it foreboded the distress of the following spring.

[469]Probably their cattle had been impounded for rent and tithe. The author of the pamphletLachrymae Hiberniae(Dublin, 1822), a resident on the western coast, says (p. 8), with reference to the seizures for rent and tithe: “Oh what scenes of misery were exhibited in Ireland in this way during the years 1817, ’18 and ’19; by that time the people were left without cattle; after this their potatoes and corn were seized and sold, and in some cases their household furniture, even to their blankets.” The hardness of landlords in general is alleged by Dr Rogan, with an exception in favour of the Marquis of Abercorn in his own district.

[470]There was dysentery also in the autumn of 1818. Cheyne,Dubl. Hosp. Rep.III.1.

[471]Rogan, p. 31.

[472]The following is an instance, from Boyle, in Roscommon: “In the middle of June, 1817, or a little earlier, a soup-shop was established here by subscription, where soup was daily given out to one thousand persons, who, naturally anxious to procure it in time, crowded together during its distribution, though every pains was taken to keep order amongst them. From the 16th to the 23rd of that month the weather became suddenly and unusually hot, and the disease about that period spread rapidly among those persons, the greater number of whom attributed the origin of their complaint to attendance at the soup-shop; among that crowd, many of whom I have seen faint from absolute want during exposure to the sun, there were persons from houses where the disease existed.” Report by Dr Verdon of Boyle, 26 June, 1818, in Barker and Cheyne,I.325.

[473]Dr King of Tralee (Barker and Cheyne,I.p. 177) wrote as follows: “It is a custom in this country for very poor persons, living in the country parts, and possessing a miserable hovel with a small garden, after they have sowed their potatoes, to shut up their hut and carrying their families with them, to roam about the country, trusting to the known hospitality of the towns and villages for shelter and subsistence till the time for digging the potatoes shall have arrived.”

[474]Barker and Cheyne,I.60.

[475]In Carleton’s tale of ‘The Poor Scholar,’ it is related how the hay-mowers stopped in their work to erect a hut for the fever-stricken youth, and a much larger hut not far from the first for the numerous persons who ministered to his wants under a kind of quarantine arrangement. The stealing of milk from rich men’s cows for the sick youth is the subject of a dialogue between the Roman Catholic bishop and the leader of the kindly party of mowers, in which the latter shows a skill in casuistry creditable to his religious instructors.

[476]William Harty, M.D.,Historic Sketch of the Contagious Fever Epidemic in Ireland during 1817-19. Dublin, 1820. This work contains information collected by a circular of queries addressed to practitioners in the several provinces. It was undertaken by Dr Harty at the instance of Sir John Newport, M.P. for Waterford. The work by Barker and Cheyne on the same epidemic took longer to prepare, having been published in 1821. See also Cheyne,Dubl. Hosp. Rep.II.1-147.

[477]Barker and Cheyne, p. 65. A similar incident comes into Carleton’s tale of ‘The Clarionet’: “At length, out of compassion, the few neighbours who feared not to attend a feverish death-bed, acting on the popular belief that children under a certain age are not liable to catch a fever, placed the boy in her arms.” This popular belief was well founded.

[478]Accounts from various places in Barker and Cheyne, and in Harty. Rogan (u. s. p. 45) says: “The cases of typhus gravior were infinitely more numerous among the rich and well-fed than among the poor; and with them also the head was most frequently the seat of diseased action.”

[479]Report on the Present State of the Distressed District in the South of Ireland: with an Enquiry into the Causes of the Distresses of the Peasantry and Farmers.Dublin, 1822.

[480]Lachrymae Hiberniae, or the Grievances of the Peasantry of Ireland, especially in the Western Counties.By a Resident Native. Dublin, 1822 (September). The author, a resident of the west coast, was concerned in the distribution of relief, and positively asserts the saving of thousands “from his own personal knowledge.”

[481]Robert James Graves, M.D., “Report on the Fever lately prevalent in Galway and the West of Ireland.”Trans. K. and Q. Col. Phys.IV.(1824), p. 408.

[482]John O’Brien, M.D., “On the Epidemic Dysentery which prevailed in Dublin in the year 1825.”Trans. K. and Q. Col. Phys.V.(1828) p. 221; Burke,Ed. Med. Surg. Journ.July, 1826, p. 56; Speer,Med. Phys. Journ.N. S. VI.199.

[483]John O’Brien, “Med. Rep. of the H. of Recovery, Cork Street, Dublin, for the year ending 4 Jan. 1827.”Trans. K. and Q. Col. Phys.V.512.

[484]Graves,Clinical Medicine, 1843. Lect.XVIII.

[485]O’Brien, u. s.

[486]“Remarks on the Epidemic Dysentery of the Autumn of 1826 in the South of Ireland.” By Alexander McCarthy, M.D.Edin. Med. and Surg. Journ.April, 1827, p. 289.

[487]“It is a melancholy picture of society to witness the increase of wealth and luxury on one side, and the greatest want and wretchedness on the other; to meet famine and exhaustion in the great body of the people, in a country that produces as much food as would afford a full supply for once and a half its present population; to see the granaries full of corn and flour, and the great body of the people scarcely existing on a half supply of bad potatoes. Such is the miserable situation of the Irish, a race of people distinguished for their intellect, and above all for their resignation and patience under afflictions the most trying.”

[488]Dub. Quart. Journ. Med. Sc.XI.385.

[489]W. J. Geary, M.D., “Report of the St John’s Fever and Lock Hospitals.”Dub. Quart. Journ. Med. Sc.XI.378:XII.94.

[490]Various descriptions of these exist, of which that by Carleton in the tale ‘Barney Branagan,’ is probably not overdone.

[491]The Report of the Roscrea Fever Hospital for 1827 says: “In March, when the dung is being removed from the back yards for the purpose of planting the potatoes, the number of patients becomes double in the Fever Hospital.”Dublin Medical Press, Jan. 1846, p. 235.

[492]Babington, “Epidemic Typhous Fever in Donoughmore.”Dub. Quart. Journ.X.404.

[493]G. A. Kennedy, “Report of Cork St. Fever Hosp. 1837-38.”Ibid.XIII.311. Graves,Ibid.XIV.363.

[494]Lynch,Ibid.N. S. VII.388, gives some particulars of it also at Loughrea, Galway, in 1840.

[495]System of Clinical Medicine.Dublin, 1843, p. 57. The “change of type,” with special reference to treatment, is discussed more fully in LectureXXXIV. pp. 492-500. See alsoDub. Quart. Journ. Med. Sc.XIV.502, where a letter on the changed character of fever at Sligo is cited.

[496]The Census of Ireland, 1841, Parl. Papers, 1843. “Report on the Table of Deaths,” by W. R. Wilde. The deaths in the family, with their causes, &c., in each of the previous ten years were entered on the census paper by the head of the family, or by the parish priest for him. These returns were, of course, far from exhaustive or correct.

[497]Graves,Clinical Medicine, 1843, p. 46. Remarking on the much greater frequency of fever in Ireland than in England, he says (p. 47): “Nothing can be more remarkable than the facility with which a simple cold (which in England would be perfectly devoid of danger), runs into maculated fever in Ireland, and that, too, under circumstances quite free from even the suspicion of contagion—in truth, except when fever is epidemic, catching cold is its most usual cause.”

[498]The principal work on the general circumstances of the Irish famine of 1846-47 isThe History of the Great Irish Famine of 1847, with notices of Earlier Irish Famines. By Rev. John O’Rourke, P.P., M.R.I.A. Dublin, 1875.

[499]Joseph Lalor, M.D.,Dub. Quart. Journ. Med. Sc.N. S. III.38.

[500]Cited by O’Rourke, p. 152.

[501]The Census of Ireland, 1851. Part V. Table of deaths, vol.I.Dublin, 1856, p. 235.

The following are a few instances of depopulation between 1841 and 1851.

[502]Essay on the Principle of Population.Bk. IV. chap.XI.Thorold Rogers has in many passages emphasized the advantages of the English practice from medieval times of living on the dearest kind of corn; but he seems to have overlooked the priority of Malthus throughout the whole of the eleventh chapter of his fourth book. InSix Centuries of Work and Wages(p. 62), Rogers says: “Hence a high standard of subsistence is a more important factor in the theory of population than any of those checks which Malthus has enumerated.”

[503]Cited in Thomas Doubleday’sPolitical Life of Sir Robert Peel. London, 1856,II.398note.

[504]It is a doctrine of economics that the higher standard of living checks population. Thus Marshall says of England: “The growth of population was checked by that rise in the standard of comfort which took effect in the general adoption of wheat as the staple food of Englishmen during the first half of the 18th century.”Economics, p. 230.

[505]Vol.VII.(1849) pp. 64-126, 340-404, and Vol.VIII.pp. 1-86, 270-339 of theDublin Quart. Journ. of Medical Science,N. S.contain numerous reports collected by the editors from all parts of Ireland, and published either in abstract or in full. These are the chief medical sources. Some particulars are given also in theDublin Med. Press, 1846 to 1849 in several papers on dysentery.

[506]John Popham, M.D.,Dub. Quart. Journ. Med. Sc.N. S. VIII.279.

[507]Cited by Dr Jones Lamprey,Dub. Quart. Journ.VII.101.

[508]Lamprey,Dub. Quart. Journ.VII.101.

[509]O’Rourke.

[510]Ormsbey,Dub. Quart. Journ.VII.382.

[511]Pemberton,ibid.VII.369.

[512]Lalor, u. s.

[513]This epidemic called forth two pamphlets on the relation of famine to fever, one by Dominic Corrigan, M.D.,On Famine and Fever as Cause and Effect in Ireland(“no famine, no fever”), and a reply to it by H. Kennedy, M.D.,On the Connexion of Famine and Fever.

[514]Pains resembling those of rheumatism were common in the fever of 1817-18 at Limerick. Barker and Cheyne,I.432.

[515]Lamprey, u. s.

[516]Dr Kelly of Mullingar compared the smell of relapsing fever to that of burning musty straw.Dub. Quart. Journ. Med., Aug. 1863, p. 341.

[517]Cusack and Stokes,ibid.IV.134.

[518]Barker and Cheyne, Harty, and Rogan have been cited to this effect for earlier epidemics. Graves (Clin. Med.pp. 59-60) says: “In the epidemics of 1816, 1817, 1818 and 1819, it was found by accurate computation that the rate of mortality was much higher among the rich than among the poor. This was a startling fact, and a thousand different explanations of it were given at the time.” He cites Fletcher (Pathology, p. 27) an Edinburgh observer, as follows: “The rich are less frequently affected with epidemic fevers than the poor, but more frequently die of them. Good fare keeps off diseases, but increases their mortality when they take place.”

[519]Dub. Quart. Journ. Med. Sc.N. S. VII.388.

[520]Census of Ireland, 1851.

[521]The Census of Ireland of 1851.Part V. Table of Deaths. 2 vols. Dublin, 1856. Upwards of two hundred pages are occupied with a chronological “Table of Cosmical Phenomena, Epizootics, Epiphitics, Famines and Pestilences in Ireland” from the earliest times. This retrospect, which is very replete but tedious and uncritical, is followed by a summary report of twenty pages on “The Last General Potato Failure, and the Great Famine and Pestilence of 1845-50,” and by a long series of tabulated extracts from contemporary writings on all matters relating to the famine.

[522]Of this total, 18,430 deaths were from dysentery and 7,264 from diarrhoea.

[523]The increase in 1849 was doubtless owing to choleraic diarrhoea during the epidemic of Asiatic cholera, the deaths from dysentery being one-half of the total.

[524]R. Mayne, M.D., “Observations on the late Epidemic Dysentery in Dublin.”Dub. Quart. Journ. Med. Sc.VII.294. See also papers inDubl. Med. Press, 1849.

[525]17th and 26th Reports of the Regr.-Genl. Ireland.

[526]Review of Murchison inDub. Quart. Journ. Med. Sc., Aug. and Nov. 1863, pp. 169 and 339: “We are able, from extensive opportunities of observing the epidemic [of 1846-48] in Dublin, to verify the statement of Dr H. Kennedy as to the infrequency of enteric fever.”

[527]Dub. Quart. Journ. Med. Sc.Nov. 1865, p. 285.

[528]See p. 273,supra.

[529]O’Connor, u. s. p. 286, “Typhoid has scarcely appeared in this locality, which cannot boast of the excellence of its sewerage.”

[530]“On Atmospheric Conditions influencing the Prevalence of Typhus Fever.”Dub. Quart. Journ. Med. Sc., May, 1866, p. 309.

[531]H. Kennedy, M.D., “Further Observations on Typhus and Typhoid Fevers as seen in Dublin.”Ibid., Aug. 1862, p. 50.

[532]Nearly one-half of all the enteric fever deaths in Ulster and Leinster come respectively from Belfast and Dublin:

[533]Higden’sPolychronicon. Rolls Series,I.332.

[534]Dyall of Agues.London, [1564].

[535]Essay on Epidemic Diseases.Dublin, 1734.

[536]Dissert. Epistol.§ 93. Greenhill’s ed. p. 378.

[537]One regrets to find the above mistake in the learned pages of Murchison (p. 8). The following by Dr Robert Williams (Morbid Poisons,II.423) is absolutely erroneous: “In Sydenham’s time, intermittent fever and dysentery were constantly endemic in London; and the mortality from the former cause alone averaged, in a comparatively small population, from one to two thousand persons annually.” What Sydenham says is that dysentery was endemic in Ireland (on the authority of Boate, no doubt), that it was epidemic in London in the end of 1669 and in the three years following, and that for the space of ten years it had appeared quite sparingly (quae per decennium jam parcius comparuerat). As to intermittents, he says they were absent from London for thirteen years, from 1664 to 1677, except in sporadic or imported cases. In the London bills the deaths from “agues” are sometimes distinguished from “fevers,” and are then seen to be only some dozen or twenty in two thousand.

[538]It is used in the Latin title of an Edinburgh graduation thesis, “De Catarrho epidemio, vel Influenza, prout in India occidentali sese ostendit,” by J. Huggar, which is assigned in Häser’s bibliography to the year 1703. Having been unable to find the thesis, I have not verified the date.

[539]Annales Monastici(St Albans), Rolls Series, No. 191, under the year 1427;Hist. MSS. Commiss.IX.pt. 1, p. 127, records of Canterbury Abbey.—An epidemic in Ireland a century before, in 1328, has been given by Sir W. R. Wilde, and by Dr Grimshaw following him, under the name of “murre,” as if that had been its name at the time. The explanation seems to be that the contemporary Irish nameslaedanwas rendered by Macgeoghegan, in his translation of the Annals of Clonmacnoise, by the 15th century English term “murre.” The “mure” of 1427 was a universal influenza; but the word was afterwards used for a common cold, along with poss, as in Gardiner’sTriall of Tabacco, 1610, fol. 12 and 15: “stuffings in the head, murres and pose, coughs”; and “the poze, murre, horsenesse, cough” etc.

[540]Cal. Cecil. MSS.I.under the dates.

[541]Munk,Roll of the College of Physicians,I.32.

[542]Cited in Southey’sCommonplace Book, from Fuller’sPisgah Sight, p. 54.

[543]Southey,Commonplace Book, from Strype’sMemorials of Cranmer, p. 284.

[544]Thoresby,Ducatus Leodiensis, ed. Whitaker, App. p. 152.

[545]Baines,Lancashire,II.679: 39 deaths from 17 to 24 August, 1551, set down to “plague,” i.e. sweat.

[546]Lest it may be supposed that there has been adequate discussion of the differences between epidemic agues and influenzas, I quote from Hirsch’sHandbuch der historisch-geographischen Pathologiethe passage in which these epidemics or pandemics of “malarial fever” are referred to: “These epidemics of malaria, which extend not unfrequently over large tracts of country, and sometimes even over whole divisions of the globe, forming true pandemics, correspond always in time with a considerable increase in the amount of sickness at the endemic malarious foci, whether near or distant; they either die out after lasting a few months, or they continue—and this applies particularly to the great pandemic outbreaks—for several years, with regular fluctuations depending on seasonal influences. On the very verge of the period to which the history of malarial epidemics can be traced back, we meet with a pandemic of that sort, in the years 1557 and 1558, which is said to have overrun all Europe (Palmarius,De morbis contagiosis. Paris, 1578, p. 322).... It is not until the years 1678-82 that we again meet with definite facts relating to an epidemic extending over a great part of Europe....” (Eng. Transl.I.229.)

[547]Queen Elizabeth and her Times.Ed. Wright, 2 vols. Lond. 1838,I.113. Sir W. Cecil writing from Westminster to Sir T. Smith on 29th December [1563] says: “The cold here hath so assayled us that the Queen’s majestie hath been much troubled, and is yet not free from the same that I had in November, which they call a pooss, and now this Christmas, to keep her Majestie company, I have been newly so possessed with it as I could not see, but with somewhat ado I wryte this. We have had perpetuall frosts here sence the 16th of this month. Men doo now ordinarily pass over the Thamiss, which I thynk they did not since the 8th yere of the reign of King Henry the VIII.”Ibid.I.157. For “poss,” see note p. 305.

[548]Ephemer. Meteorol. anni 1561[for the latitude of Brabant]. Antwerp, 1561: “Tusses numero infinitae atque tanta contagionis vi praestabunt ut pauci immunes reliquant, praecipuè circa mensis finem.” The almanacks of those times must have been constructed on the same principle as the weather forecasts of our own time—namely, that of using the experience of one year for the next, just as the weather of one day is an indication for the next. In 1575 Dr Richard Foster (who became president of the College of Physicians in 1601) issued an almanack in which he foretold “sweating fevers” for the month of July (Ephemer. meteorol. ad ann. 1575.Lond. 1575). Cogan says that Francis Keene, an astronomer, also prophesied the return of the sweating sickness in 1575, “wherein he erred not much, as there were many strange fevers and nervous sickness.”

[549]Johan Boekel, Συνοψιςnovi morbi quem plerique medicorum catarrhum febrilem, vel febrem catarrhosam vocant, qui non solum Germaniam, sed paene universam Europam graviss. adflixit. Helmstadtii, 1580.

[550]Hoker’s “Irish historie ... to the present year 1587,” p. 165a in Holinshed’sChronicles.

[551]This very moderate increase of the deaths in London in 1580 may be compared with the probably fabulous figures which Webster (I. 163) gives for continental cities the same year: Rome, 4000 deaths, Lübeck, 8000 deaths, Hamburg, 3000 deaths. I have given the weekly deaths and baptisms in London for five years, 1578-82, in my former volume, p. 341.

[552]There is a curious reference to “the sweat” in Shakespeare’sMeasure for Measure, Act I. scene 2, where the bawd, in an aside, says: “Thus, what with the war, what with the sweat, what with the gallows, and what with poverty, I am custom-shrunk.” It is known that Shakespeare adapted and condensed his play from Whetstone’sPromus and Cassandra, printed in 1578, who took it from an Italian romance. But Whetstone’s dialogue, which is pointless and verbose beside Shakespeare’s, gives an entirely different speech to the bawd at the same place in the action, making no reference to “the sweat.” The date ofMeasure for Measureis not certain; but it seems to belong to the earlier period of Shakespeare’s work, when he was adapting old plays most freely. Whatever its date, the war, the sweat, the gallows and poverty are evidently topical allusions pointed enough for the audience to have taken up.

[553]The year 1610 is mentioned by Short as a season of universal catarrhal fever abroad; but that epidemic is not in the modern chronologies of influenza.

[554]Chamberlain to Carleton inCourt and Times of James I.I.

[555]Same to same 4 Nov. 1612.Ibid.I.p. 201.

[556]Court and Times of James I.I.p. 206.

[557]Ibid.p. 208.

[558]Court and Times of James I.p. 197.

[559]Ibid.p. 237.

[560]Ibid.Letter of 25 Nov. 1613.

[561]Cal. Coke MSS.I.83.

[563]Graunt,Obs. upon the Bills of Mortality, 1662.

[564]Robert Boyle did not attach much importance to the name of “new disease.” “The termnew disease,” he says, “is much abused by the vulgar, who are wont to give that title to almost every fever that, in autumn especially, varies a little in its symptoms or other circumstances from the fever of the foregoing year or season.” (Boyle’sWorks. 6 vols. 1772,V.66.) But it was the name commonly given to the epidemics of catarrhal fever among others, and it does not appear, when the history is examined closely, that it was ever given except to some epidemic separated by several years from the last of the kind.

[565]Sir R. Leveson’s Letters.Hist. MSS. Commiss.V.146.

[566]Pp. 568-577.

[567]Πυρετολογιαsive Gulielmi Dragei HitchensisΙατρου καὶ ΦιλοσοφουObservationes ab Experientia de Febribus Intermittentibus. Londini, 1665.

[568]His tract is dated 1641.

[569]By Nicholas Sudell, licentiate in physick and student in chimistry. London, 1669.

[570]Πυρετολογια.A rational account of the Cause and Cure of Agues, with their signs, Diagnostick and Prognostick. Also some Specified Medicines prescribed for the Cure of all sorts of Agues, &c. Whereunto is added a short account of the Cause and Cure of Feavers and the Griping in the Guts.Authore Rto. Talbor, Pyretiatro. Londini, 1672.

[571]Sir Thomas Watson (Practice of Physic,I.725) has a story which shows how long these fancies, encouraged by quacks, may linger: “A coachman by whose side I sat while travelling from Broadstairs to Margate was speaking of the rarity of ague in that part of the Isle of Thanet. His father, he said, once had the complaint, and a fit came on while he was on a visit to him, the coachman, at Ramsgate. The son administered to his suffering parent a glass of brandy; whereupon ‘he threw the agy off his stomach; and it looked for all the world like a lump of jelly.’”

[572]Philip Guide, M.D.,A Kind Warning, &c.Lond. 1710.

[573]The best summary of the “history of the use of Peruvian bark” is by Sir George Baker, inTrans. Col. Phys.III.(1785), 173.

[574]Cited by Baker,l. c.p. 190.

[575]Lives of the Norths.New ed. by Jessopp. Lond. 1890,III.188.

[576]He fell into a kind of decline and died at his country house on 5 September, Dr Radcliffe having been summoned from London without avail.

[577]Baker,l. c., “Had not physicians been taught by a man whom they, both abroad and at home, vilified as an ignorant empiric, we might at this day have had a powerful instrument in our hands without knowing how to use it in the most effectual manner.” This was written at a time when physicians spoke of “throwing in the bark”—throwing it in “with a shovel,” as an Edinburgh professor used to say.

[578]John Barker, M.D., of Sarum, and afterwards physician to the forces, says in 1742 (in his essay on the epidemic fever of 1741, u. s. p. 112) that he had Sydenham’s letter in manuscript before him, and that it was written in October, 1677.

[579]Cited by Baker,Trans. Col. Phys.III.208.

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