The fever in Manchester was not always malignant typhus: sometimes it had the symptoms and low rate of mortality that suggest relapsing fever. Thus, in the winter epidemic of 1789-90, very prevalent in Manchester and Salford, out of Ferriar’s first ninety patients only two died; in some the skin had a remarkable, pungent heat, in others there were profuse watery sweats; women were commonly affected with hysterical symptoms during convalescence, which was often tedious[267]. A certain number of these cases would run into “a formed typhus,” with petechiae and all the other signs of malignity; and in some seasons, as in the distressful year 1794, typhus was the usual form. Two fatal cases in children, examined after death, had peritonitis; “in the one no marks of the disease were discernible within the cavity of the [intestinal] tube;” in the other, the patient was covered with petechiae[268]. These cases of localized inflammation in typhus he compares with Pringle’s cases of spotted fever complicated with abscess of the brain.
The years 1792 and 1793 passed, says Ferriar, without any extraordinary increase of fever patients, although the noxious influences were always present. But in the summer and autumn of 1794 “the usual epidemic fever” became very prevalent among the poor in some quarters of the town, particularly after a bilious colic had raged among all ranks of people. This was a time when work was slack; many workmen enlisted and left their families. In November and December 1794, as many as 156 sent applications to the Infirmary in a week to be visited in fever at their homes.
This was a memorable time of scarcity and distress all over the country, the beginning of a twenty-years’ period of so-called “war-prices,” when farmers’ profits were so large that they could afford to double or treble their rents to the landlords. The history of epidemics comes at this point into close contact with the economic history, which I shall touch on in the sequel, after giving a few more particulars of typhus in England and Scotland generally, previous to the outbreak of the war with France in 1793.
Typhus in England and Scotland generally, in the end of the 18th century.
The introduction of machinery and the building of mills brought typhus fever to places much less crowded than Leeds, or Manchester, or Carlisle.
Dr David Campbell of Lancaster saw much of typhus in that town, and in mill villages near it, in the years 1782, 1783, and 1784. In Lancaster town he saw about 500 cases, of which 168 were in men, with 20 deaths, 236 in women, with 11 deaths, and 94 in children under fourteen, with 3 deaths. At Backbarrow cotton mill, twenty miles from Lancaster, there were 180 cases, of which 38 were in men, with 5 deaths, 11 in women, with 2 deaths, and 131 in children under fourteen, with no deaths[269]. At this mill there was an extremely offensive smell in the rooms, which came from the privy; the doors of the latter, “for indispensable reasons in the economy of these works, where so many children are employed, always communicate with the workrooms.” Every care had been taken to keep the air sweet, but without effect. The offensive smell was in all the cotton mills from the same cause; and in the Radcliffe mill belonging to Mr Peel, the typhus was ascribed to that source, the nuisance having been at length got rid of. Both at Backbarrow and Radcliffe the houses of the workpeople were new, airy and comfortable. In the same years typhus raged with uncommon severity at Ulverston and in various parts of Lancashire, where cotton-mills had been set up[270].
The typhus of Liverpool and Newcastle was reproduced in Whitehaven and Cockermouth on a scale proportionate to their size. Whitehaven, the port of the Cumberland coal-field, was the Newcastle of the west coast, and had a large trade with Ireland. Many of the labourers lived in cellars. Brownrigg’s experiences of typhus fever in it went back to near the middle of the 18th century. The Whitehaven Dispensary was opened in 1783, the occasion for it being thus explained:—
“Previous to the establishment of dispensaries Whitehaven and Cockermouth were infested by nervous and putrid fever. Many of their respectable inhabitants became its victims; and among the lower class of people it prevailed with deplorable malignancy. The present period happily exhibits a different picture. Notwithstanding our connection with the metropolis of Ireland, and other commercial places, contagion rarely appears; or, when accidentally introduced, is readily suppressed[271].”
The following is the abstract of “contagious fever cases” from the records of the Whitehaven Dispensary from 30 June, 1783, to 9 June, 1800[272]: