The Epidemic of 1817-19 in Scotland: Relapsing Fever.

Let us now turn to the epidemic in Scotland, where the relapsing type was as marked as in Ireland, if not more so. The destitution in the Scots towns in the autumn of 1816, and following years, was fully as great as anywhere in the kingdom, although the peasantry of Scotland were not famine-stricken, as those of Ireland were. The state of the poorer classes in Edinburgh was graphically set forth in an essay by Dr Yule, in 1818[321], and in an article in Blackwood’s Magazine the year after. Vigorous efforts to relieve the distress were made by the richer classes, and a special fever-hospital was opened at Queensbery House, the admissions to which, together with the fever-cases at the Royal Infirmary, were as follows:[322]

Year Admitted Died Ratio of deaths
1817 511 33 1 in 1516⁄33
1818 1572 75 1 in 21
1819 1027 30 1 in 34
(to 1 Dec.)

Of this epidemic several accounts were published at the time, including one by Welsh, superintendent of the fever hospital, which is dominated, like the Bristol account of Prichard, by the idea that blood-letting cut short the fever[323]. Christison, who had experience of the relapsing form in his own person[324], describes also two other forms mixed with the cases of relapsing fever: a mild typhus, the typhus mitior (typhus gravior being exceedingly rare in that epidemic), and a form which began like the inflammatory relapsing synocha, and gradually after a week put on the characters of mild typhus.

The admissions for fever to the Glasgow Infirmary, which was then the only charity that received fever cases, had been at a somewhat low level since the last epidemic in 1799-1801. They began to rise again with the distress of 1816:—

Admissions for Fever, Glasgow Infirmary.

Year Cases
1814 90
1815 230
1816 399
1817 714
1818 1371
1819 630
1820 289
1821 234
1822 229
1823 269

At the height of the epidemic in 1818 an additional fever hospital was opened at Spring Gardens, to which 1929 cases were admitted in that and the following year. Great efforts were made in Glasgow to “stamp out” the contagion by disinfectants and removal to hospital[325]; but the course of the epidemic seemed to follow the economic conditions more than anything else.

The outbreak at Aberdeen was later than in the south of Scotland, having begun in August, 1818. The infection was said to have been brought to the city by a woman who found a lodging in Sinclair’s Close. A group of houses in the close, covering an area of seventy by fifty feet and containing one hundred and three inmates, became the first centre of the fever. The scenes described are like those of the Irish epidemics: in one room, a man, his wife, and five children were lying ill on the floor; in another, a man, his wife and six children; in a third, a young girl, whose mother had just died of fever, was left with three infant brothers or sisters. More than three-fourths of the denizens of the close were “confined to bed in fever, and all the others crawling about during the intervals of their relapses.” The value of all the furniture and clothing belonging to 103 persons could little exceed £5. There was a horrible stench both within and without the houses (relapsing fever being remarkable for its odour). Yet this close was usually as healthy as any other part of the town. A House of Recovery, with sixty beds, was opened in the Gallowgate, and thirty beds were given up to fever-cases in the Infirmary of the city. Besides those ninety hospital cases at the date of 17 December, 1818, it was estimated that were three hundred more. Begging had been put down, so that the contagion had not spread to the richer classes. Despite these removals to hospital, the epidemic became more general about the New Year, 1819, and of a worse type; two physicians died of it, and some others had a narrow escape. At the outset, the fever had been of the relapsing kind—“subject to relapses for a third and fourth time, more especially when they return too early to their usual labour[326].” At a later period the epidemic seems to have become ordinary typhus, as it did also in Ireland and elsewhere; and it was called typhus in the essay upon it by Dr George Kerr[327].

The extent of this epidemic of 1818-19 over Scotland generally is not known; but the following notice of it in a country parish of Forfarshire was probably a sample of more that might have been given.