Carlisle. During the gaol-fever which some years ago carried off many of the prisoners, Mr Farish, the chaplain, visited the sick every day.
I shall add some medical experiences of gaol-fever in London from the notes of Lettsom[172]:—
May, 1773. A person released from Newgate “in a malignant or jail-fever” was brought into a house in a court off Long Lane, Aldersgate Street; soon after which fourteen persons in the same confined court were attacked with a similar fever: one died before Lettsom was called in, one was sent to hospital, eleven attended by him all recovered, though with difficulty. Two deaths in Wood Street Compter: 1. Rowell, an industrious, sober workman, who had supported for many years a wife and three children; some of these having been lately sick, he fell behind with his rent, a little over three guineas; he offered all he had (more than enough) to the landlord, but the latter preferred to throw the man and his family into the Compter, where Rowell died of fever. 2. Russell, once a reputable tradesman on Ludgate Hill, fell into a debt of under three guineas, sent to the Compter with his wife and five children, took fever and died; attended in his sickness in a bare room by his eldest daughter, elegant and refined, aged seventeen; his son, aged fourteen, took the fever and recovered.
There was one Black Assize at this period, at Dublin in April 1776. A criminal, brought into the Court of Sessions without cleansing, infected the court and alarmed the whole city. Among others who died of the contagion were Fielding Ould, High Sheriff, the counsellors Derby, Palmer, Spring and Ridge, Mr Caldwell, Messrs Bolton and Eriven, and several attorneys and others whose business it was to attend the court[173].
There were two notorious outbreaks of malignant fever among foreign prisoners of war, one in 1761[174] and another in 1780[175], the first among French and Spaniards at Winchester and Portchester, the second among Spaniards at Winchester.
Howard found so little typhus in the gaols in his later visits that it seemed as if banished for good. But it was heard of frequently about 1780-85—at Maidstone, at Aylesbury, at Worcester, costing the lives of some of the visiting physicians.
Circumstances of severe and mild Typhus.
The circumstances of the gaol distemper bring out one grand character of typhus which will have to be stated formally before we go farther. Ordinary domestic typhus was not a very fatal disease. Haygarth says that of 285 attacked by it in the poorer quarters of Chester in the autumn of 1774, only twenty-eight died. Ferriar, in Manchester, had sometimes an even more favourable experience than that: “The mortality of the epidemic was not great, ... out of the first ninety patients whom I attended, only two died.” This was before the House of Recovery was opened; so that the low mortality was of typhus in the homes of the people.
The fever was often an insidious languishing, without great heat, and marked most by tossing and wakefulness, which might pass into delirium; when it went through the members of a family or the inmates of a house, there would be some cases concerning which it was hard to say whether they were cases of typhus or not. Misery and starvation brought it on, and often it was itself but a degree of misery and starvation. “I have found,” says Ferriar, “that for three or four days before the appearance of typhus in a family consisting of several children, they had subsisted on little more than cold water.” “It has been observed,” says Langrish, “that those who have died of hunger and thirst, as at sieges and at sea, etc., have always died delirious and feverish.” The fever was on the whole a distinct episode, but in many cases it had no marked crisis. “Those women who recovered,” says Ferriar, “were commonly affected with hysterical symptoms after the fever disappeared;” and again: “Fevers often terminate in hysterical disorders, especially in women; men, too, are sometimes hysterically inclined upon recovering from typhus, for they experience a capricious disposition to laugh or cry, and a degree of the globus hystericus.” These were probably the more case-hardened people, inured to their circumstances, their healthy appetite dulled by the practice of fasting or “clemming,” or by opium, and their blood accustomed to be renovated by foul air. If the limit of subsistence be approached gradually, life may be sustained thereat without any sharp crisis of fever, or with only such an interlude of fever as differs but little from a habit of body unnamed in the nosology.
The worst kind of typhus, often attended with delirium, crying and raving, intolerable pains in the head, and livid spots on the skin, ending fatally perhaps in two or three days, or after a longer respite of stupor or waking insensibility, was commonly the typhus of those not accustomed to the minimum of well-being—the typhus of hardy felons newly thrown into gaol, of soldiers in a campaign crowded into a hospital after a season in the open air, of sailors on board ship mixing with newly pressed men having the prison atmosphere clinging to them, of judges, counsel, officials of the court and gentlemen of the grand jury brought into the same atmosphere with prisoners at a gaol-delivery, of the wife and children of a discharged prisoner returned to his home, of the gaol-keeper, gaol-chaplain, or gaol-doctor, of the religious and charitable who visited in poor localities even where no fever was known to be, and most of all of country people who crowded to the towns in search of work or of higher wages or of a more exciting life.