For a good many years after the period last dealt with, nothing is heard in Britain either of epidemic agues or of influenza[691]. Writing in 1800, Willan said that intermittents had not, to his knowledge, been epidemic in London at any time within twenty years. He explains this by “the practice of draining, and the improved modes of cultivating land in Essex, Kent, and some other adjoining counties, from which either agues were formerly imported, or the effluvia causing them were conveyed by particular winds”—the latter being the doctrine of Lancisi for the country round Rome. But he forgets that their appearance nearly twenty years before was a strange phenomenon to the practitioners of that generation, and that Sydenham, whom he cites to prove agues in London in former times, had also remarked their absence, except in occasional cases, for as long a period as thirteen years. Of such occasional agues acquired in London, Willan and Bateman had each one or two examples in the autumn of 1794, and the spring of 1805.
As in the case of epidemic agues, so also in the case of influenzas, there was immunity in Britain for a good many years after 1788; and, as the slight epidemic catarrh of 1788 was something less than universal, the clear interval may almost be reckoned from the summer of 1782, a space of over twenty years. Willan’s monthly reports of the weather and diseases in London from March, 1796, to December, 1800, twice mention epidemic catarrhs,—in February and March, 1797, and in February, 1800, the latter chiefly among children. But to neither of them will he concede the name of “influenza,” as the complaint was merely epidemical from a particular state of the atmosphere, and not propagated by contagion, nor quite general.
The symptoms, however, were headache, sometimes attended with vertigo, a thin acrid discharge from the nostrils, slight inflammation of the throat, a sense of constriction in the chest, with a frequent dry cough, pains in the limbs, a white tongue, a quick and small pulse, with a sensation of languor and general debility. These symptoms, fairly complete for influenza of the correct type, lasted about eight days and ended in a gentle sweat or in a diarrhoea. Coughs had been remarkably severe and obstinate; they were frequently attended with painful stitches and spitting of blood[692].
The Influenza of 1803.
The number of the Medical and Physical Journal for March, 1803, announced that “a cold attended by symptoms of a very alarming nature has been general in the city of Paris for some time”; but it said nothing of the alarming disorder being in London. It is in the next number, under the date of Soho Square, March 11th, that a correspondent identifies the Paris epidemic with “the complaint now general in this metropolis, and called by some the Influenza.” In a report upon the diseases “in an Eastern District of London from February 20 to March 20, 1803,” the “catarrhal fever” is thus described:
“This disease has been so general as to claim the title of the reigning epidemic, and is very similar to one which prevailed a few years ago, and was denominated Influenza. It has generally been introduced by chilliness and shivering, which have been succeeded by violent pains in the head, with some discharge from the eyes and nostrils, as in a common catarrh, together with hoarseness and cough. The pains in the head have in some cases been the first symptoms and have been succeeded by giddiness, sickness and vomiting” &c. There were also rheumatic pains in the limbs, intercostals &c.
Meanwhile the information from various sources showed that the old influenza was once more really in this country. Two collective inquiries were made on the influenza of 1803: one by Dr Beddoes of Bristol, who issued a circular of five queries, and received answers to them (with other information) from one hundred and twenty-four correspondents[693]; the other by the Medical Society of London[694]. The Medical and Physical Journal and Duncan’s Annals each received a few independent papers on it; and several pamphlets were issued, mostly devoted to treatment—two in London[695], one at Edinburgh[696], one at Bath[697], and one at Bristol[698].
In these abundant data there is little novelty and not much variety.
The attack began with chills and severe pain in the head, along with slight running of the eyes and nose, as typhus fever might have begun. After the slightly catarrhal onset the malady was mostly a fever, with dry cough, dry and hot skin, pain in the forehead and about the eyeballs, pains in the limbs, “spontaneous” weariness and extreme prostration—a group of symptoms which led Hooper to find a rheumatic character in the malady. Among other symptoms were vertigo, nausea, vomiting and diarrhoea. Much sweating is not reported; but there was often a gentle sweat in recovering after about a week, less or more. There was the usual range from mildness to severity. Pneumonia and pleurisy were not rare, and were commonly the cause of fatalities.
The deaths were for the most part among the phthisical, the asthmatic and the aged; but these were not many, certainly not so many as in 1729, 1733 and 1743, and probably in about the same proportion as in 1762, 1775 and 1782. In the London bills the weekly deaths rose in March, to an average of 537 from an average of 429 in February, and of 375 in January, falling to an average of 417 in April. In Ireland the epidemic is said to have been seen among the troops in garrisons as early as December, 1802; it became universal in spring and summer. In Edinburgh the rise in the burials at Greyfriars churchyard was in the weeks ending 5th and 12th April, making them about a half more than usual for the brief period. When the wave of influenza was past, the public health in nearly all places became unusually good, as had happened immediately after the influenza of 1782.