As the two first chapters are pervaded by social and economic history, so each of the others will be found to have one or more points of distinctive interest besides the strictly professional. Smallpox is perhaps the most suitable of all the subjects in this volume to be exhibited in a continuous view, from the epidemics of it in London in the first Stuart reigns to the statistics of last year. While it shares with Plague the merit, from a historical point of view, of being always the same definite item in the bills of mortality, it can be shown to have experienced, in the course of two centuries and a half, changes in its incidence upon the classes in the community, upon the several age-periods and upon town and country, as well as a very marked change relatively to measles and scarlatina among the infective scourges of infancy and childhood. For certain reasons Smallpox has been the most favoured infectious disease, having claimed an altogether disproportionate share of interest at one time with Inoculation, at another time with Vaccination. The history of the former practice, which is the precedent for, or source of, a whole new ambitious scheme of prophylaxis in the infectious diseases of men and brutes, has been given minutely. The latter practice, which is a radical innovation inasmuch as it affects to prevent one disease by the inoculation of another, has been assigned as much space in the chapter on Smallpox as it seems to me to deserve. Measles and Whooping-cough are historically interesting, in that they seem to have become relatively more prominent among the infantile causes of death in proportion as the public health has improved. Whooping-cough is now left to head the list of its class by the shrinkage of the others. It is in the statistics of Measles and Whooping-cough that the principle of population comes most into view. The scientific interest of Scarlatina and Diphtheria is mainly that of new, or at least very intermittent, species. Towards the middle of the 18th century there emerges an epidemic sickness new to that age, in which were probably contained the two modern types of Scarlet Fever and Diphtheria more or less clearly differentiated. The subsequent history of each has been remarkable: for a whole generation Scarlatina could prove itself a mild infection causing relatively few deaths, to become in the generation next following the greatest scourge of childhood; for two whole generations Diphtheria had disappeared from the observation of all but a few medical men, to emerge suddenly in its modern form about the years 1856-59.

The history of Dysentery, as told by the younger Heberden, has been a favourite instance of the steady decrease of a disease in London during the 18th century. I have shown the error in this, and at the same time have proved from the London bills of mortality of the 17th and 18th centuries that Infantile Diarrhoea, which is now one of the most important causes of death in some of the great manufacturing and shipping towns, was formerly still more deadly to the infancy of the capital in a hot summer or autumn. Asiatic Cholera brings us back, at the end of the history, to the same great problem which the Black Death of the 14th century raised near the beginning of it, namely, the importation of the seeds of pestilence from some remote country, and their dependence for vitality or effectiveness in the new soil upon certain favouring conditions, which sanitary science has now happily in its power to withhold. I have left Influenza to be mentioned last. Its place is indeed unique among epidemic diseases; it is the oldest and most obdurate of all the problems in epidemiology. The only piece of speculation in this volume will be found in the five-and-twenty pages which follow the narrative of the various historical Influenzas; it is purely tentative, exhibiting rather the disjecta membra of a theory than a compact and finished hypothesis. If there is any new light thrown upon the subject, or new point of view opened, it is in bringing forward in the same context the strangely neglected history of Epidemic Agues.

Other subjects than those which occupy the nine chapters of this volume might have been brought into a history of epidemics, such as Mumps, Chickenpox and German Measles, Sibbens and Button Scurvy, together with certain ordinary maladies which become epidemical at times, such as Pneumonia, Erysipelas, Quinsy, Jaundice, Boils and some skin-diseases. While none of these are without pathological interest, they do not lend themselves readily to the plan of this book; they could hardly have been included except in an appendix of miscellanea curiosa, and I have preferred to leave them out altogether. It has been found necessary, also, to discontinue the history of Yellow Fever in the West Indian and North American colonies, which was begun in the former volume.

I have, unfortunately for my own labour, very few acknowledgements to make of help from the writings of earlier workers in the same field. My chief obligation is to the late Dr Murchison’s historical introduction to his ‘Continued Fevers of Great Britain.’ I ought also to mention Dr Robert Willan’s summary of the throat-distempers of the 18th century, in his ‘Cutaneous Diseases’ of 1808, and the miscellaneous extracts relating to Irish epidemics which are appended in a chronological table to Sir W. R. Wilde’s report as Census Commissioner for Ireland. For the more recent history, much use has naturally been made of the medical reports compiled for the public service, especially the statistical.

September, 1894.

CONTENTS.

PAGE
[CHAPTER I.]
TYPHUS AND OTHER CONTINUED FEVERS.
The Epidemic Fever of 1661, according to Willis[4]
Sydenham’s epidemic Constitutions[9]
Typhus Fever perennial in London[13]
The Epidemic Constitutions following the Great Plague[17]
The Epidemic Fever of 1685-86[22]
Retrospect of the great Fever of 1623-25[30]
The extinction of Plague in Britain[34]
Fevers to the end of the 17th Century[43]
Fevers of the seven ill years in Scotland[47]
The London Fever of 1709-10[54]
Prosperity of Britain, 1715-65[60]
The Epidemic Fevers of 1718-19[63]
The Epidemic Fevers of 1726-29: evidence of Relapsing Fever[66]
The Epidemic Fever of 1741-42[78]
Sanitary Condition of London under George II.[84]
The Window-Tax[88]
Gaol-Fever[90]
Circumstances of severe and mild Typhus[98]
Ship-Fever[102]
Fever and Dysentery of Campaigns: War Typhus, 1742-63[107]
Ship-Fever in the Seven Years’ War and American War[111]
The “Putrid Constitution” of Fevers in the middle third of the 18th Century[120]
Miliary Fever[128]
Typhus Fever in London, 1770-1800[133]
Typhus in Liverpool, Newcastle and Chester in the last quarter of the 18th century[140]
Fever in the Northern Manufacturing Towns, 1770-1800[144]
Typhus in England and Scotland generally, in the end of the 18th century[151]
Fevers in the Dearth of 1799-1802[159]
Comparative immunity from Fevers during the War and high prices of 1803-15[162]
The Distress and Epidemic Fever (Relapsing) following the Peace of 1815 and the fall of wages[167]
The Epidemic of 1817-19 in Scotland: Relapsing Fever[174]
The Relapsing Fever of 1827-28[181]
Typhoid or Enteric Fever in London, 1826[183]
Return of Spotted Typhus after 1831: “Change of Type.” Distress of the Working Class[188]
Enteric Fever mixed with the prevailing Typhus, 1831-42[198]
Relapsing Fever in Scotland, 1842-44[203]
The “Irish Fever” of 1847 in England and Scotland[205]
Subsequent Epidemics of Typhus and Relapsing Fevers[208]
Relative prevalence of Typhus and Enteric Fevers since 1869[211]
Circumstances of Enteric Fever[216]
[CHAPTER II.]
FEVER AND DYSENTERY IN IRELAND.
Dysentery and Fever at Londonderry and Dundalk, 1689[229]
A generation of Fevers in Cork[234]
Famine and Fevers in Ireland in 1718 and 1728[236]
The Famine and Fever of 1740-41[240]
The Epidemic Fevers of 1799-1801[248]
The Growth of Population in Ireland[250]
The Famine and Fevers of 1817-18[256]
Famine and Fever in the West of Ireland, 1821-22[268]
Dysentery and Relapsing Fever, 1826-27[271]
Perennial Distress and Fever[274]
The Great Famine and Epidemic Sicknesses of 1846-49[279]
Decrease of Typhus and Dysentery after 1849[295]
[CHAPTER III.]
INFLUENZAS AND EPIDEMIC AGUES.
Retrospect of Influenzas and Epidemic Agues in the 16th and 17th centuries[306]
The Ague-Curers of the 17th Century[315]
The Peruvian Bark Controversy[320]
The Influenza of 1675[326]
The Influenza of 1679[328]
The Epidemic Agues of 1678-80[329]
The Influenza of 1688[335]
The Influenza of 1693[337]
The Influenza of 1712[339]
Epidemic Agues and Influenzas, 1727-29[341]
The Influenza of 1733[346]
The Influenza of 1737[348]
The Influenza of 1743[349]
Some Localized Influenzas and Horse-colds[352]
The Influenza of 1762[356]
The Influenza of 1767[358]
The Influenza of 1775[359]
The Influenza of 1782[362]
The Epidemic Agues of 1780-85[366]
The Influenza of 1788[370]
The Influenza of 1803[374]
The Influenza of 1831[379]
The Influenza of 1833[380]
The Influenza of 1837[383]
The Influenza of 1847-48[389]
The Influenzas of 1889-94[393]
The Theory of Influenza[398]
Influenza at Sea[425]
The Influenzas of Remote Islands[431]
[CHAPTER IV.]
SMALLPOX.
Retrospect of earlier epidemics[434]
Smallpox after the Restoration[437]
Sydenham’s Practice in Smallpox[445]
Causes of Mild or Severe Smallpox[450]
Pockmarked Faces in the 17th Century[453]
The Epidemiology continued to the end of the 17th century[456]
Smallpox in London in 1694: the death of the Queen[458]
Circumstances of the great Epidemic in 1710[461]
Inoculation brought into England[463]
The popular Origins of Inoculation[471]
Results of the first Inoculations; the Controversy in England[477]
Revival of Inoculation in 1740: a New Method[489]
The Suttonian Inoculation[495]
Extent of Inoculation in Britain to the end of the 18th Century[504]
The Epidemiology continued from 1721[517]
Smallpox in London in the middle of the 18th century[529]
The Epidemiology continued to the end of the 18th century[535]
The range of severity in Smallpox, and its circumstances[544]
Cowpox[557]
Chronology of epidemics resumed from 1801[567]
The Smallpox Epidemic of 1817-19[571]
Extent of Inoculation with Cowpox or Smallpox, 1801-1825[582]
The Smallpox Epidemic of 1825-26[593]
A generation of Smallpox in Glasgow[597]
Smallpox in Ireland, 1830-40[601]
The Epidemic of 1837-40 in England[604]
Legislation for Smallpox after the Epidemic of 1837-40[606]
Other effects of the epidemic of 1837-40 on medical opinion[610]
The age-incidence of Smallpox in various periods of history[622]
[CHAPTER V.]
MEASLES.
Derivation and early uses of the name[632]
Sydenham’s description of Measles in London, 1670 and 1674[635]
Measles in the 18th century[641]
Increasing mortality from Measles at the end of the 18th century[647]
Measles in Glasgow in 1808 and 1811-12: Researches of Watt[652]
Measles in the Period of Statistics[660]
[CHAPTER VI.]
WHOOPING-COUGH.
Earliest references to whooping-cough[666]
Whooping-cough in Modern Times[671]
Whooping-cough as a Sequel of other Maladies[674]
[CHAPTER VII.]
SCARLATINA AND DIPHTHERIA.
Nosological difficulties in the earlier history[678]
The Throat-distemper of New England, 1735-36[685]
Angina maligna in England from 1739[691]
An epidemic of Throat-disease in Ireland, 1743[693]
Malignant Sore-throat in Cornwall, 1748[694]
Fothergill’s Sore-throat with Ulcers, 1746-48[696]
“Scarlet Fever” at St Albans, 1748[698]
Epidemics of Sore-throat with Scarlet rash in the period between Fothergill and Withering[699]
Scarlatina anginosa in its modern form, 1777-78[708]
History of Scarlatina after the Epidemic of 1778[713]
Scarlatina (1788) and Diphtheria (1793-94) described by the same observer[715]
Scarlatinal Epidemics, 1796-1805[719]
Scarlatina since the beginning of Registration, 1837[726]
Reappearance of Diphtheria in 1856-59[736]
Conditions favouring Diphtheria[744]
[CHAPTER VIII.]
INFANTILE DIARRHOEA, CHOLERA NOSTRAS, AND DYSENTERY.
Summer Diarrhoea of Infants in London, 17th century[748]
Summer Diarrhoea of Infants, 18th century[754]
Modern Statistics of Infantile Diarrhoea[758]
Causes of the high Death-rates from Infantile Diarrhoea[763]
Cholera Nostras[768]
Dysentery in the 17th and 18th centuries[774]
Dysentery in the 19th century[785]
[CHAPTER IX.]
ASIATIC CHOLERA.
Asiatic Cholera at Sunderland in October, 1831[796]
Extension of Cholera to the Tyne, December, 1831[802]
The Cholera of 1832 in Scotland[805]
The Cholera of 1832 in Ireland[816]
The Cholera of 1832 in England[820]
The Cholera of 1848-49 in Scotland[835]
The Cholera of 1849 Ireland[839]
The Cholera of 1849 in England[840]
The Cholera of 1853 at Newcastle and Gateshead[849]
The Cholera of 1854 in England[851]
The Cholera of 1853-54 in Scotland and Ireland[855]
The Cholera of 1865-66[856]
The Antecedents of Epidemic Cholera in India[860]
Note on Cerebro-Spinal Fever[863]