The Epidemic Agues of 1780-85.
Let us now take up the strange history of epidemic agues for two or three years preceding and following the influenza of June, 1782. Sir George Baker begins his account of them thus[669]: “The predominance of certain diseases observable in some years, and the total or partial disappearance of the same in other years, constitute a subject worthy of our contemplation.”
These agues were first noticed in London in the spring and autumn of 1780, but they infested various parts of England a little earlier. In the more inland counties the agues were “often attended with peculiarities extraordinary and alarming. For the cold fit was accompanied by spasm and stiffness of the whole body, the jaws being fixed, the eyes staring and the pulse very small and weak.” When the hot fit came on the spasms abated, and ceased in the sweating stage; but sometimes the spasm was accompanied by delirium, both lasting to the very end of the paroxysm. Even in the intermissions a convulsive twitching of the extremities continued to such a degree that it was not possible to distinguish the motion of the artery at the wrist. “This fever had every kind of variety, and whether at its first accession it were a quotidian, a tertian or a quartan, it was very apt to change from one type to another. Sometimes it returned two days successively, and missed the third day; and sometimes it became continual. I am not informed that any died of this fever whilst it intermitted. It is, however, certain that many country people whose illness had at its beginning put on the appearance of intermission, becoming delirious, sank under it in four or five days.”
Reynolds, another London physician, in a letter to Sir George Baker confirms all that the latter says of these singular epidemic agues: “No two cases resembled each other except in very few circumstances[670]”—the remark commonly made about the influenza itself. If these descriptions of the epidemic ague had not been given by physicians living as late as 1782, and altogether modern in their methods, we might have supposed that they were confusing influenzas with agues, or using the latter term inexactly. “The ague with a hundred names” is the striking phrase of Abraham Holland, in his poem on the plague of 1625. Whitmore, describing the fatal epidemic ague (with an episode of influenza) in 1658-59, does not say that it had a hundred names, but that it assumed a hundred shapes, “which render it such a hocus-pocus to the amazed and perplexed people, they being held after most strange and diverse ways with it.... So prodigious in its alterations that it seems to outvie even Proteus himself[671].”
As farther showing the anomalous character of these epidemic agues, or their difference from the endemic, Baker adds:—
“It is a remarkable fact, and well attested, that in many places, whilst the inhabitants of the high grounds were harassed by this fever, in its worst form, those of the subjacent valleys were not affected by it. The people of Boston and of the neighbouring villages in the midst of the Fens were in general healthy at a time when fever was epidemic in the more elevated situations of Lincolnshire.” Women were nearly exempt, but few male labourers in the fields escaped it.
Baker heard from all parts that the same constitution continued through 1781 and 1782; and that since that time, though it seemingly abated, yet agues had been much more prevalent than usual, and had even been frequent in places where before that period they were uncommon. They were very noticeable in London from 1781 to 1785, not least so during the very severe cold of the winter and spring of 1783-84. We hear of great numbers attacked at Hampstead with common intermittents in February and the following months of 1781, during which time even the measles, in the greater number of cases, “ended in very troublesome intermittents[672]”—just as they were apt to end often in troublesome coughs.
The annals of Barker, of Coleshill, are full of references to agues, among other fevers, from 1780 onwards. Under 1781 he writes:—
“This spring that very peculiar, irregular, dangerous and obstinate disease, the burning, or as the people in Kent properly enough called it, the Plague-ague, made its appearance, became very epidemical in the eastern part of the kingdom, and raged in Leicestershire, the lower part of Northamptonshire, Bedfordshire, and in the fens throughout the year.... This strongly pestilential disease had such an effect upon them that the complexion of their faces continued for a time as white as paper, and they went abroad more like walking corpses than living subjects.”
As many as five persons in an evening were buried from it in some large towns in Northamptonshire; and about Boston it was so general and grievous that out of forty labourers hired for work in harvest, half of them, it was said, would be laid up in three days[673]. In 1783 the “pestilential agues” were as bad in Northamptonshire and eastern parts as the year before. A Liverpool writer says:
“In the autumn of 1782 the quartan ague was very prevalent on the opposite shore of the river in Cheshire: it was universal in the neighbourhood of Hoylake, where many died of it. Yet it was scarcely heard of in Liverpool, although from the uncommon wetness of the season it prevailed throughout the kingdom[674].”
On October 25, 1783, a correspondent of the Gentleman’s Magazine offered an explanation of the “present epidemic disorder, which has so long ravaged this country, and that in the most healthy situations of it,” namely, “the putrescent air caused by the number of enclosures, and the many inland cuts made for navigation[675].” Next year, 1784, appears to have been the principal season of epidemic agues on both sides of the Severn valley, one practitioner at Bridgenorth making them the subject of a special essay[676].
It was at this time that Fowler brought into use his solution of arsenic as a substitute for bark in agues, the latter having notably failed in the epidemics since 1780.
Baker says: “The distinguishing character of this fever was its obstinate resistance to the Peruvian bark; nor, indeed, was the prevalence of the disease more observable than the inefficacy of the remedy:” in that respect the epidemic agues had belied the experience with bark in ordinary agues. Again, it is singular that bark had failed most, and arsenic been especially useful in those parts of England where ordinary malarious agues were never seen. One practitioner in Dorset laid in a large stock of arsenic, wherewith he “hardly ever failed to stop the fits soon[677].” Another, at Painswick, in Gloucestershire, used it successfully in two hundred cases of epidemic agues from 1784 onwards. He gives the following account of these unusual agues at Painswick:
“This town, which is situated on the side of a hill, and is remarkable for the purity of its air, is very populous. In the year 1784 the epidemic ague, that prevailed in many parts of the kingdom, made its appearance in this place, and has continued till the present time [Nov. 1787], although previously to that period the disease was hardly ever seen here, unless a stranger came with it for the recovery of his health, on account of the healthy situation of the place. It affected whole families, and appeared to be most violent in spring and autumn. In the summer of 1786 it was followed by a fever of the kind called typhus, or low nervous fever, which not unfrequently degenerated into a putrid fever and proved very fatal[678].” In May, 1785, at a general inoculation of smallpox, “many had been afflicted with intermittents of several months’ duration attended with anasarcous swellings[679].”
It will be seen from the following table of cases treated at the Newcastle Dispensary, under the direction of Dr John Clark, during twelve years from 1 October, 1777, to 1 September, 1789, that influenza makes the smallest show among them, being far surpassed by the intermittent fevers and dysenteries, while all three together are greatly exceeded by the perennial typhus fever:
| Cases treated | ||
| Putrid fever | 1920 | |
| Intermitting fever | 313 | |
| Epidemic dysentery in 1783 and 1785 | 329 | |
| Influenza of 1782 | 53 |
In Scotland, also, agues became epidemic about the year 1780. There is no reason to suppose that their prevalence in these years was less exceptional there than in England and Ireland. It will be seen, indeed, from the following table compiled from the books of the Kelso Dispensary that the only years of their considerable prevalence were the same as the years of epidemic ague in England.
Kelso Dispensary[680].
| Year | All Cases | Cases of Ague | ||
| 1777 | 302 | 17 | ||
| 1778 | 306 | 33 | ||
| 1779 | 460 | 70 | ||
| 1780 | 675 | 161 | ||
| 1781 | 510 | 103 | ||
| 1782 | 440 | 61 | ||
| 1783 | 510 | 73 | ||
| 1784 | 459 | 40 | ||
| 1785 | 573 | 62 | ||
| 1786 | 563 | 48 | ||
| 1787 | 525 | 24 | ||
| 1788 | 577 | 25 | ||
| 1789 | 546 | 48 | ||
| 1790 | 640 | 18 | ||
| 1791 | 715 | 13 | ||
| 1792 | 570 | 16 | ||
| 1793 | 666 | 19 | ||
| 1794 | 447 | 9 | ||
| 1795 | 513 | 23 | ||
| 1796 | 355 | 12 | ||
| 1797 | 318 | 9 | ||
| 1798 | 415 | 7 | ||
| 1799 | 558 | 2 | ||
| 1800 | 665 | 4 | ||
| 1801 | 433 | 9 | ||
| 1802 | 377 | 5 | ||
| 1803 | 308 | 2 | ||
| 1804 | 422 | 5 | ||
| 1805 | 469 | 0 | ||
| 1806 | 318 | 1 |
It was doubtless the recollection of these epidemic agues that led the parish ministers who wrote in the ‘Statistical Account of Scotland’ from 1791 to 1799 to remark upon a supposed progressive decline of endemic ague, which they set down to drainage of the land[681]. It is probable, however, that each tradition of ague in Scotland dated from one of its epidemic periods; it has been shown, indeed, in the foregoing that Scotland in the end of the 17th century was reputed tolerably free from ague, and that the severe agues previous to 1728, which belonged to the epidemical kind, were thought to be something new.