have been those in which relapsing fever has been scarce or absent.” (Murchison.)
In the article ‘Typhoid fever’ it has been stated that its propagation was mainly due, and had been very clearly traced, to the drinking of water contaminated by the alvine discharges of typhoid patients; in the dissemination of typhus, on the contrary, the air in the neighbourhood of the infected person appears to be the great medium for the conveyance of the disease, the poison, it is conceived, being disseminated into the surrounding atmosphere from the surface of the body or the lungs of the patient, or from the cloths, body linen, &c., worn and discarded by him. Hence it is we find, as we should expect, in the past no less than in the present, that the spread and degree of virulence of the malady have always been associated with overcrowding and bad ventilation. Although amongst the causes that predispose and induce susceptibility to its attacks, as shown above, are poverty and consequent deficiency of food and clothing, and squalor, it has been demonstrated that, with all these unfavorable conditions, patients may often recover from typhus provided they are supplied with a sufficiency of fresh air.
The fact that of late years typhus has rarely visited the inmates of our prisons, barracks, or shops, and that their comparative immunity from it has been coincident with improved ventilation and the avoidance of overcrowding, can lead to no other deduction than that previous to this reform these sanitary conditions were altogether neglected. We may narrate some of these outbreaks of typhus that have taken place previous to the application of hygienic principles to the treatment of the disease. During an assize held at Cambridge in 1522, the disease which had broken out amongst the prisoners, spread to the justices, the bailiffs, and other officers, as well as to many people frequenting the court-house, with the result that many of those so seized died.
Another outbreak of a very malignant character occurred at Exeter in 1586. Some Portuguese were captured at sea, and (the words of the old historian who records the fact clearly indicate the cause of the virulent nature of the malady) were “cast into the deep pit and stinking dungeon.” When brought into court they imparted the contagion to those around them. The judge and eleven out of the twelve jurymen who were thus attacked died, whilst the disease spread through and devastated the whole country.
A fourth case is recorded by Howard “at the Lent assizes in Taunton in 1730. Some prisoners who were brought there from Ivilchester Jail infected the court, and Lord Chief Baron Pengelly, Sir James Shepherd, serjeant, John Pigot, Esq., sheriff, and some hundreds besides, died of the jail distemper.”
Another eruption, which broke out during an assize held at the Old Bailey in 1750,
resulted in the contraction of the disease by the Judge, the Lord Mayor, and the Alderman, and caused the death of forty persons who were present in the close and narrow court-house during the judicial proceedings. One circumstance recorded in connection with this last attack needs no comment. It is to the effect that “a hundred prisoners were put into two rooms measuring fourteen feet by eleven feet, and seven feet high.” The instances above quoted explain why it was this disease acquired the name of jail fever.
During the present century six different epidemics of typhus have broken out amongst the convicts on board the Toulon Galleys. They occurred in 1820, 1829, 1833, 1845, 1855, and 1856. Although the above statement of facts indisputably points to the intimate connection existing between the prevalence and violent character of typhus and overcrowding, and consequent contamination and vitiation of the air breathed by the patient, it is still a moot point with pathologists whether the disease can be generated de novo by these conditions, or whether they merely assist to disseminate and intensify it. Dr Parkes, writing on this subject, says:—“With reference to the particular kind of fever in Metz, it may be noticed that an important argument against the production of exanthematic typhus from simple overcrowding has been drawn from the experience both of Metz and Paris. In both places during the sieges there was overcrowding, wretchedness, and famine, particularly at Metz; yet, as pointed out by Professor Chauffard to the Académie de Médicine, there was scarcely any or no typhus, as there had been in the wars of the first Napoleon. There was typhus in the German besieging force, but so strict was the blockade that it was not imported into Metz, and was not generated there.”[245]
[245] Blyth.
The mortality which has been caused in large armies by the ravages of typhus has been enormous. During the ‘thirty years’ warfare that desolated Germany from 1619 to 1648, innumerable soldiers fell victims to it, the Bavarian army alone having lost 20,000 men from this cause. Typhus also committed appalling havoc among the legions of the first Napoleon, the Bavarian contingent of the French army in the Campaign in 1812, lost nearly 26,000 men from this cause; whilst in Mayence 25,000 of Napoleon’s soldiers in garrison perished from the same cause in six months. More lately, viz. during the Crimean campaign (in 1856), typhus slew more than 17,000 French soldiers.