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

From 1803 to 1816 there was comparatively little fever in this country. This was notably the case in London, but it was also true of all the larger towns where fever-hospitals had been established, and it was as true of Ireland as of England. This was, indeed, a time of great prosperity, which reached to all classes, the permanent rise of wages having more than balanced the increased cost of the necessaries of life. The following prices of wheat will show that a dear loaf did not necessarily mean distress while the war-expenditure lasted:

Prices of wheat (from Tooke).

s. d.
1802 57 1
1803 52 3
1804Lady Day 49 6
Dec. 86 2
1805Aug. 98 4
Dec. 74 5
1806 73 5
1807Nov. 66
1808May 73 6
Dec. 92
1809March 95
July 86 6
Dec. 102 6
1810June 113 5
Dec. 94 7
1811June 86 11
Nov. 101 6
1812Aug. 155
Nov. 113 6
1813Aug. 112
Dec. 73 6
1814July 66 5
1815Dec. 53 7
1816May 74
Dec. 103
1817June 111 6
1817Sept. 77 7
1818Dec. 78 10
1819Aug. 75
1820 72
1821July 51
Dec. 50
1822 42
1823Feb. 40 8
June 62 5
Oct. 46 5
Dec. 50 8
1824 65

The only years in the period from 1803 to 1816 in which there was some slight increase of fever were about 1811-12. There was undoubtedly some distress in the manufacturing districts at that time, owing to the much talked-of Orders in Council, which had the effect of closing American markets to British manufactures[295].

The small amount of fever in London between the year 1803 and the beginning of the epidemic of 1817-19 rests on the testimony of Bateman[296], who in 1804 took up Willan’s task of keeping a systematic record of the cases at the Carey Street Dispensary. He has only two special entries relating to typhus: one in the autumn of 1811, when some cases occurred in the uncleanly parts of Clerkenwell and St Luke’s (“but I have not learned that it has existed in any other districts of London”); the other in October and November 1813, when there was more typhus among the Irish in some of the filthy courts of Saffron Hill, near Hatton Garden, than for several years past, the infection having spread rapidly and fatally in several houses. The best evidence of this lull in typhus in London is the almost empty state of the new fever-hospital:

Year Admissions
1802 164
1803 176
1804 80
1805 66
1806 93
1807 63
1808 69
1809 29
1810 52
1811 43
1812 61
1813 85
1814 59
1815 80
1816 118
1817 760

Until it was removed to Pancras Road, in September, 1816, the London fever-hospital had only sixteen beds. But Bateman says that no one was refused admission, and that for several years the house was frequently empty three or four weeks together. Also at the Dispensary, in Carey Street, he had an opportunity during the period 1804-1816,

“Of observing the entire freedom from fevers enjoyed by the inhabitants of the numerous crowded courts and alleys within the extensive district comprehended in our visits from that charity.” And again, writing in the winter of 1814-15, Bateman says: “To those who recollect the numerous cases of typhoid fevers [this term did not then mean enteric] which called for the relief of dispensaries twelve or fourteen years ago, and the contagion of which was often with great difficulty eradicated from the apartments where it raged, and even seized the same individuals again and again when they escaped its fatal influences, the great freedom from these fevers which now exists, even in the most close and filthy alleys in London, is the ground of some surprise.” And once more, in the summer of 1816, just as the new epidemic period was about to begin, he says: “The extraordinary disappearance of contagious fever from every part of this crowded metropolis during the long period comprehended by these Reports [since 1804], cannot fail to have attracted the attention of the reader.”

Bateman concluded, not without reason, that this immunity of London from fever was due to the high degree of well-being among the poorer classes in times of plenty; and although he made out that the poor of Dublin, Cork and some Scotch towns did not profit by times of plenty so much as those in London, yet his reason for the abeyance of fever from 1804 to 1816 applied to England, Ireland and Scotland at large, and was doubtless the true reason.

The following figures from Manchester[297], Leeds[298] and Glasgow[299] hospitals, as well as the Irish statistics elsewhere given, are closely parallel with those of London:

Manchester House of Recovery.

Year Cases Deaths
1796-7 371 40
1797-8 339 16
1798-9 398 27
1799-1800 364 41
1800-1 747 63
1801-2 1070 84
1802-3 601 53
1803-4 256 33
1804-5 184 34
1805-6 268 29
1806-7 311 33
1807-8 208 15
1808-9 260 21
1809-10 278 30
1810-11 172 15
1811-12 140 18
1812-13 126 13
1813-14 226 17
1814-15 379 29
1815-16 185 14
1816-17 172 6

Leeds House of Recovery.

Year Cases Deaths
1804 (2 mo.) 10 0
1805 66 6
1806 75 2
1807 35 1
1808 80 3
1809 93 8
1810 75 14
1811 92 4
1812 80 12
1813 137 11
1814 79 4
1815 146 15
1816 121 13
1817 178 8
1818 (10 mo.) 254 20

Glasgow Royal Infirmary (Fever Wards).

Year Cases
1795 18
1796 43
1797 83
1798 45
1799 128
1800 104
1801 63
1802 104
1803 85
1804 97
1805 99
1806 75
1807 25
1808 27
1809 76
1810 82
1811 45
1812 16
1813 35
1814 90
1815 230
1816 399
1817 714
1818 1371

Even such fever as there was in Britain from 1804 to 1817 was not all certainly typhus. The high death-rates at the Manchester fever-hospital in 1804 and 1805 (1 death in 7·5 cases and 1 death in 5·25 cases) may mean a certain proportion of enteric cases in those years. “From 1804 to 1805,” says Ferriar, “many cases were admitted of a most lingering and dangerous kind.... Many deaths took place from sudden changes in the state of the fever, contrary to the usual course of the disease, and only imputable to the peculiar character of the epidemic. Similar cases occurred at that time in private practice.” Next year, 1806, there was an epidemic among the troops at Deal, described under the name of “remittent fever,” which Murchison claims to have been enteric[300]. In September, 1808, says Bateman, several were admitted into the London House of Recovery, with malignant symptoms; “and some severe and even fatal instances occurred in individuals in respectable rank in life.” He still uses the name of typhus; but he is aware that the cases of continued fever, especially in the summer and autumn of 1810, had often symptoms pointing to a bowel-fever rather than to a head-fever[301].

The years 1807 and 1808 appear to have been the most generally unwholesome during this period of comparative immunity from fever; they were marked by the occurrence of dysenteries, agues, and infantile remittents, as well as of fevers of the “typhus” kind. The chief account comes from Nottingham[302]. The cases of “typhus” there were very tedious, but not violent, nor attended with any unfavourable symptoms, only one case having petechiae, and all having diarrhoea. The following table of admissions for various kinds of fever (as classified by Cullen) at the Nottingham General Hospital, 25 March, 1807, to 25 March, 1808, shows the preponderance of “synochus” and next to it, of infantile remittent:

Admitted to the Nottingham General Hospital, 1807.

Intermittent fever 7
Synocha 10
Typhus 27
Febris nervosa 26
Synochus 155
Febris infantum remittens 88
Dysentery 5

The state of war in the Peninsula was favourable to epidemic or spreading diseases, and there is a good deal to show that such diseases did exist among the British troops[303]. But there is only one good instance of England getting a taste of that experience of war-typhus which the Continent had to endure for many years. This was on the return of the remnant of the army after the defeat at Corunna on 16 January, 1809. The troops were crowded pell-mell on board transports, which had a very rough passage home. Dysentery broke out among them, and was the most urgent malady when they landed at Plymouth in a state of filth and rags. Typhus fever followed, but in the first three weeks at Plymouth, to the 18th of February, it was not of a malignant type, only 8 dying of it in the Old Cumberland Square Hospital; in the next three weeks, 28 died of it there. Up to the 27th of March, 1809, the sick at Plymouth from the Corunna army numbered 2432, of whom 241 died. Of 4 medical officers, 3 took the contagion, of 29 orderlies, 25 took it. The fever was in some cases followed by a relapse, which was more often fatal than the original attack[304]. This was a typical instance of typhus bred from dysentery or other incidents of campaigning, a contagion more dangerous to others than to those who had engendered it. “Within a few yards of the spot where I now write,” says Dr James Johnson, of Spring Gardens, London, “the greater part of a family fell sacrifices to the effects of fomites that lurked in a blanket purchased from one of these soldiers after their return from Corunna[305].” In August, 1813, an Irish regiment passing through Leyburn, a small market-town of the West Riding of Yorkshire, in an airy situation, was obliged to leave behind a soldier ill of typhus, who died of the fever after a few days. The infection appeared soon after in the cottages adjoining, and remained in that end of the town for several months, choosing the clean and respectable houses. In a farmer’s family, a son, aged twenty-nine, died of it, while another son and two daughters had a narrow escape. The disease appeared also in the village of Wensby, a mile distant, and in other villages. Few lives were lost[306].

These were, perhaps, not altogether solitary instances in Britain of typhus spread abroad by the movements of troops during the great French war. Let us multiply such instances by hundreds, and we shall vaguely realize the meaning of the statement that the period of the Napoleonic wars, and more particularly the period from the renewal of the war in 1803 until its close in 1815, was one of the worst times of epidemic typhus in the history of modern Europe. It was precisely in those years that England, Scotland and Ireland enjoyed a most remarkable degree of freedom from contagious fever.