Both for the country and the town the history of the public health does not harmonize well with the optimist views of the 18th century. The historians are agreed that, under the two first Georges, during the ministries of Walpole, the Pelhams and Pitt, the prosperity of Britain was general. Adam Smith speaks of “the peculiarly happy circumstances of the country” during the reign of George II. (1727-60). Hallam characterizes the same reign as “the most prosperous that England had ever experienced.” The most recent historian of England in the 18th century is of the same opinion[96]. The novels of Fielding give us the concrete picture of the period with epic fidelity, and the picture is of abundance and prodigality. Agriculture and commerce with the Colonies, India and the continent of Europe, were the sources of the country’s wealth. Farming and stock-raising had been greatly improved by the introduction of roots and sown grasses. In some country parishes the baptisms were three times the burials. But the public health during this period will not appear in a favourable light from what follows. More particularly there were three occasions, about the years 1718, 1728 and 1741, when a single bad harvest in the midst of many abundant ones brought wide-spread distress, with epidemics of typhus and relapsing fever; from which fact it would appear that the common people had little in hand. Thorold Rogers, among economists, was of the opinion that the prosperity was all on the side of the governing and capitalist classes, that the labourers were in “irremediable poverty” and “without hope,” and that the law of parochial settlement, with the artificial fixing of wages by the Quarter Sessions and the bonuses out of the poor-rates, had the effect of keeping the mass of the people on the land “in a condition wherein existence could just be maintained[97].” I shall not attempt an independent judgment in economics, but proceed to those illustrations of national well-being which belong to my subject, leaving the latter to have their due weight on the one side of economical opinion or on the other. Besides the economical question there is of course also an ethical one. When the pinch came about 1766, there was the usual diversity of opinion expressed on the “condition of England” problem, one holding that the labourers were unfairly paid, another that the nation had been made “splendid and flourishing by keeping wages low,” and that the distress was due to “want of industry, want of frugality, want of sobriety, want of principle” among the common people at large. “If in a time of plenty,” wrote one austere moralist, “the labourers would abate of their drunkenness, sloth, and bad economy, and make a reserve against times of scarcity, they would have no reason to complain of want or distress at any time[98].” But there must have been something wrong in the economics and morals of their betters if it were the case that the working class as a whole, and not merely a certain number of individuals in it, was drunken, thriftless and slothful. The familiar proof of this is the apathy of the Church, broken by the Methodist revival of religion.
The epidemic fevers of 1718-19.
In the fifty years from 1715 to 1765, the three worst periods of epidemic fever in England and Scotland correspond closely to the three periods of actual famine and its attendant train of sicknesses in Ireland, namely, the years 1718-19, 1727-29, and 1740-42. The three divisions of the kingdom suffered in common, Ireland suffering most. The first period, 1718-19, was an extremely slack tide in medical writing, insomuch that hardly any accounts of the reigning maladies remain, except those by Wintringham, of York, and Rogers, of Cork. The whole of the Irish history of fevers and the allied maladies is dealt with in a chapter apart. Of the Scots history, little is known for the first of the three periods beyond a statement that there was a malignant fever and dysentery in Lorn, Argyllshire, in January and February, 1717[99].
Wintringham gives the following account of the synochus, afterwards called typhus, which attracted notice in the summer of 1718 and became more common in the warm season of 1719: in each year it began about May, reached its height in July and lasted all August, carrying off many of those who fell into it.
It began with rigors, nausea and bilious vomiting, followed by alternate heats and chills, with great lassitude and a feeling of heaviness: then thirst and pungent heat, a dry and brown tongue, sometimes black. The patient slept little, did not sweat, and was mostly delirious, or anxious and restless, tossing continually in bed. About the 12th day it was not unusual for profuse and exhausting diarrhœa to come on. In a favourable case the fever ended in a crisis of sweating about the 16th day. Those who were of lax habit, unhealthy, hysteric, or cachectic, were apt to have tremors, spasms and delirium, while others were so prostrated as to have no control over their evacuations, lying in a stupor and raving when roused out of it. In these the fever would continue to the 20th day; in some few it ended without a manifest crisis, and with a slow convalescence[100].
This applies to the city of York, but in what special circumstances we are not told. However, it happens that a physician of York, two generations after, in giving an account of the great improvement that had taken place in its public health, throws some light on its old-world state: “The streets have been widened in many places by taking down a number of old houses built in such a manner as almost to meet in the upper stories, by which the sun and air were almost excluded in the streets and inferior apartments[101].”
In London the fever-deaths, with the deaths from all causes, rose decidedly in 1718, and reached a very high figure in 1719, of which the summer was excessively hot. One cause, at least, was want of employment, especially among weavers in the East End[102]. But the epidemic fever of 1718-19 was not limited to the distressed classes; we have a glimpse of it, under the name of “spotted fever,” in the family of the archbishop of Canterbury:
“On Friday night the archbishop of Canterbury’s sixth daughter was interred in our chancel, with four others preceding, she dying on Monday after three days of the spotted fever. The fourth and seventh are recovered, and hoped past danger[103].”
The following table shows the fever-mortalities for London, from 1718 onwards, and, for comparison, the excessive mortalities in the epidemics of 1710 and 1714: