Whether the bark would have saved him if the aguish nature of the paroxysms (such as he had in 1679 and again in 1680) had been clear from the first, may be doubted. But his chances of recovery were certainly made worse by the halting and stumbling diagnosis, (according to Evelyn)—now apoplexy, now epilepsy, now fever[585].

The true value of cinchona bark in medicine was not seen until much that was vague in the use of the term “ague” had been swept away. In the last great epidemic period of agues in this country, as we shall see, from 1780 to 1786, bark was found, for some reason, to be ineffective. It is not in the treatment of epidemic agues, but of agues in malarious countries, that the benefits of Jesuits’ bark have been from first to last most obvious.

The practice in so-called agues was long in the hands of empirics, who, like their class in general, made business out of ignorant or lax diagnosis. I shall add here what remains to be said of specialist ague-curers in later times. They are heard of in London in the Queen Anne period, and as late as 1745.

Swift writes in his Journal to Stella, 25 December, 1710, from Bury Street, St James’s: “I tell you a good pun: a fellow hard by pretends to cure agues, and has set out a sign, and spells it egoes; a gentleman and I observing it, he said, ‘How does that fellow pretend to cure agues?’ I said, I did not know, but I was sure it was not by a spell. That is admirable.” In 1745, Simon Mason, of Cambridge, published by subscription and dedicated to Dr Mead an essay, The Nature of an Intermitting Fever and Ague considered (Lond. 1745), in which he has the following on “charm-doctors”:—“When one of these poor wretches apply to a doctor of this stamp, he enquires how many fits they have had; he then chalks so many strokes upon a heater as they tell him they have had fits, and useth some other delusions to strengthen the conceit of the patient” (p. 167). Francis Fisher, who had been upper hostler in a livery stable in Crutched Friars near forty years, “told me he seldom missed a week without several ague patients applying to him, and he cured great numbers by a charm they wore in their bosoms” (p. 239). Another, who kept a public-house near St George’s Fields, Southwark, sold “febrifuge ale” at a shilling a pint. It was a small ale brewed without hops, but with bark, serpentery, rhubarb and cochineal mixed in the brewing. The receipt was given him by an old doctor who was a prisoner in the King’s Bench. His customers came in the morning fasting, and drank their shilling’s worth after the publican had given them faith by a cordial grip of the hand. “By this means,” he told Mason, “I got a good trade to my house, and a comfortable maintenance too.”

We may now return to the actual history of the epidemic fevers upon which the Peruvian bark was first tried on a large scale in England. The “intermittent” constitution which began in 1677 and lasted year after year until 1781 or even longer was a very remarkable one. It was called at the time the new fever, or the new ague, and it had at least one short interlude of influenza or epidemic catarrhal fever in the winter of 1679, just as the last epidemic of the kind, in 1657-59, had at least one, and probably two, short and swift epidemic catarrhs in spring. But before we come to that epidemic of 1678-81, there falls to be noticed an epidemic in the month of November, 1675, which has always been counted among the influenzas proper. After giving the particulars of it from Sydenham and from the London bills of mortality, I shall show from Sydenham and the bills of mortality that there was an exactly similar epidemic in the month of November, 1679, which has not been admitted into the conventional list of influenzas. Thereafter I shall proceed to the epidemic constitution of 1678-81 as a whole, which has been reckoned among the epidemic agues or malarious epidemics.

The Influenza of 1675.

The first that we hear of the universal cold of 1675 is an entry which Evelyn makes in his diary under 15 October: “I got an extreme cold, such as was afterwards so epidemical as not only to afflict us in this island, but was rife over all Europe, like a plague. It was after an exceeding dry summer and autumn.” It was not until November that the epidemic cold made an impression upon the death-rate in London; the deaths mounted up from 275 in the week ending 2 November, to 420 and 625 in the two weeks following, and thereafter gradually declined to an ordinary level. Part of the excess, but by no means the greater part of it, was set down under fevers, as the following section from the weekly bills of the year will show:

1675

Week
Ending		 Fever Smallpox Griping in
the Guts		 All causes
Nov.2 42 9 29 275
9 60 12 42 420
16 130 13 43 625
23 99 2 28 413
30 61 6 29 349
Dec.7 54 7 25 308
14 43 5 12 266

This shows the characteristic rise and fall of an epidemic catarrh both in the article of fever deaths and in the column of deaths from all causes. The other excessive articles besides fever in the two worst weeks are also characteristic of influenza mortality: