There can be little doubt that England in 1727 was already suffering in a measure from the distress that was acutely felt in Ireland; it was much aggravated by the hard winter of 1728-29[117], but it had begun before that and was doubtless the indirect cause of the great prevalence of sickness. The exports of corn under the bounty system used to bring two or three millions of money into the country in a year. But in 1727 there was a debt balance of 70,757 quarters of wheat imported, and in 1728 the import exceeded the export by 21,322 quarters, the price rising at the same time from 4s. to 8s. per bushel[118]. Under the year 1727 Hillary says:
“Many of the labouring and poor people, who used a low diet, and were much exposed to the injuries and changes of the weather, died; many of whom probably wanted the necessary assistance of diet and medicines.” And after referring, under the winter of 1727-28, to the prevalence of a fatal suffocative angina, which fell, by a kind of metastasis, on the diaphragm or pleura, and sometimes on the peritoneum, he proceeds (p. 16):—
“Nor did any other method, which art could afford, relieve them: insomuch that many of the little country towns and villages were almost stripped of their poor people, not only in the country adjacent to Ripon, but all over the northern parts of the kingdom: indeed I had no certain account of what distempers those who were at a distance died of, but suppose they were the same as those which I have mentioned, which were nearer to us. Bleeding, pectorals with volatiles, and antiphlogistic diluters and blistering, were the most successful. I observed that very few of the richer people, who used a more generous way of living, and were not exposed to the inclemencies of the weather, were seized with any of these diseases at this time.... The quartans were very subject to turn into quotidians, and sometimes to continual, in which the sick were frequently delirious.”
The Yorkshire accounts by Wintringham and Hillary for the second year of this epidemic period, the year 1728, are very full, as regards the symptoms or types of the fevers; but it would be tedious to cite them at length, and unnecessary to do so unless to answer the not inconceivable cavil that the fevers were not of the nature of typhus in one or other of its forms. The chief point is that the second year, towards Midsummer, brought a fever with the symptoms of synochus, and not rarely marked with small red spots like fleabites or with purple petechiae. In the autumn of 1729, Hillary noticed a fever of a slow type, which might go on as long as thirty days and end without a perfect crisis—the nearest approach to enteric fever in any of the descriptions. For the same years, 1727-29, Huxham, of Plymouth, describes languid fevers of the “putrid” type, with profuse sweating, followed by typhus of a more spotted type. Like the Yorkshire observer, Huxham mentions also “intermittents” as mixed with the continued fevers.
The great prevalence of these fevers, “intermittents and other fevers,” in the west of England in 1728-29 was known to Dr Rutty of Dublin, who speaks especially of “the neighbourhoods of Gloucester and London, and very mortal in the country places, but less in the cities.” This is confirmed by Dover:
“I happened to live in Gloucestershire in the years 1728 and 1729, when a very fatal epidemical fever raged to such a degree as to sweep off whole families, nay almost whole villages. I was called to several houses where eight or nine persons were down at a time; and yet did not so much as lose one patient where I was concerned[119].”
Some of the cases of nervous or putrid fever in the epidemics of 1727-29 appear to have been marked by relapses in the country districts as well as in London. Huxham says under date of April, 1728, that those who had wholly got rid of the putrid fever were exceedingly apt to have relapses. Hillary does not mention relapses until March, 1733, when a fever, with many hysterical symptoms, which succeeded the influenza of that year, relapsed in several, “though seemingly perfectly recovered before.” But he seems really to be contrasting relapsing fever and typhus when he points out that, whereas the inflammatory type of fever in the first year of the epidemic (1727) was greatly benefited by enormous phlebotomies, the fever patients in the two seasons following, when the fever was more of the nature of spotted typhus, could not stand the loss of so much blood, or, it might be, the loss of any blood[120]. This was precisely the remark made by Christison and others a century later, when the inflammatory synocha, which often had the relapsing type very marked, changed to the spotted typhus.
From the year 1731 we begin to have annual accounts (soon discontinued) of the reigning maladies in Edinburgh, on the same plan as Wintringham’s, Hillary’s and Huxham’s, with which, indeed, they are sometimes collated and compared[121]. The fevers of Edinburgh and the villages near were as various as those of Plymouth, according to Huxham, and singularly like the latter. Thus, in the winter of 1731-32, there was much worm fever, comatose fever, or convulsive fever among children, but not limited to children, marked by intense pain in the head, raving in some, stupor in others, tremulous movements, leaping of the tendons, and all the other symptoms described by Willis for the fever of 1661, a fatal case of October, 1732, in a boy of ten, recorded by St Clair one of the Edinburgh professors, reading exactly like the cases of Willis already given[122]. St Clair’s case, which was soon fatal, had no worms; but in the general accounts, both for the winter of 1731-32 and the autumn of 1732, it is said that many of the younger sort passed worms, both teretes and ascarides, and recovered, the fatalities among children being, as usual, few. In March and April, 1735, there were again “very irregular fevers of children.” Huxham records exactly the same “worm-fever” of children at Plymouth in the spring of 1734—a fever with pains in the head, languor, anxiety, oppression of the breast, vomiting, diarrhoea, and a comatose state (affectus soporosus), which attacked the young mostly, and was often attended by the passage of worms. He gives the same account of the seasons as Gilchrist—the years 1734 and 1735 marked by almost continual rains, the country more squalid than had been known for some years[123].
But it is the nervous fever that chiefly engrosses attention both in Scotland and in England. In 1735, Dr Gilchrist, of Dumfries, made it the subject of an essay, returning to the subject a few years after[124]. “As our fever,” he says, “seems to be peculiar to this age, it is not a little surprising that much more has not been said upon it.” He is not sure whether its frequency of late years may not be owing to the manner of living (it was the time of the great drink-craze, which Huxham also connects with the reigning maladies) and to a long course of warm, rainy seasons; the winters for some years had been warm and open, and the summers and harvests rainy. It was only the poorer sort and those a degree above them who were subject to this fever; he knew but few instances of it amongst those who lived well, and none amongst wine-drinkers. It was in some insidious in its approach; those who seemed to be in no danger the first days for the most part died. In others the onset was violent, with nausea, heat, thirst and delirium. Among the symptoms were looseness, pains in the belly, local sweating, tickling cough, leaping of the tendons. Sometimes they were in continual cold clammy sweats; at other times profuse sweats ran from them, as if water were sprinkled upon them, the skin feeling death cold.
At Edinburgh, from October, 1735, to February, 1736, the fever became very common, and was often a relapsing fever.