Comparative immunity from Fevers during the War and high prices of 1803-15

From 1803 to 1816 there was comparatively little fever in this country. This was notably the case in London, but it was also true of all the larger towns where fever-hospitals had been established, and it was as true of Ireland as of England. This was, indeed, a time of great prosperity, which reached to all classes, the permanent rise of wages having more than balanced the increased cost of the necessaries of life. The following prices of wheat will show that a dear loaf did not necessarily mean distress while the war-expenditure lasted:

Prices of wheat (from Tooke).

s. d.

1802 57 1

1803 52 3

1804 Lady Day 49 6

Dec. 86 2

1805 Aug. 98 4

Dec. 74 5

1806 73 5

1807 Nov. 66

1808 May 73 6

Dec. 92

1809 March 95

July 86 6

Dec. 102 6

1810 June 113 5

Dec. 94 7

1811 June 86 11

Nov. 101 6

1812 Aug. 155

Nov. 113 6

1813 Aug. 112

Dec. 73 6

1814 July 66 5

1815 Dec. 53 7

1816 May 74

Dec. 103

1817 June 111 6

1817 Sept. 77 7

1818 Dec. 78 10

1819 Aug. 75

1820 72

1821 July 51

Dec. 50

1822 42

1823 Feb. 40 8

June 62 5

Oct. 46 5

Dec. 50 8

1824 65

The only years in the period from 1803 to 1816 in which there was some slight increase of fever were about 1811-12. There was undoubtedly some distress in the manufacturing districts at that time, owing to the much talked-of Orders in Council, which had the effect of closing American markets to British manufactures.

The small amount of fever in London between the year 1803 and the beginning of the epidemic of 1817-19 rests on the testimony of Bateman, who in 1804 took up Willan’s task of keeping a systematic record of the cases at the Carey Street Dispensary. He has only two special entries relating to typhus: one in the autumn of 1811, when some cases occurred in the uncleanly parts of Clerkenwell and St Luke’s (“but I have not learned that it has existed in any other districts of London”); the other in October and November 1813, when there was more typhus among the Irish in some of the filthy courts of Saffron Hill, near Hatton Garden, than for several years past, the infection having spread rapidly and fatally in several houses. The best evidence of this lull in typhus in London is the almost empty state of the new fever-hospital:

Year Admissions

1802 164

1803 176

1804 80

1805 66

1806 93

1807 63

1808 69

1809 29

1810 52

1811 43

1812 61

1813 85

1814 59

1815 80

1816 118

1817 760

Until it was removed to Pancras Road, in September, 1816, the London fever-hospital had only sixteen beds. But Bateman says that no one was refused admission, and that for several years the house was frequently empty three or four weeks together. Also at the Dispensary, in Carey Street, he had an opportunity during the period 1804-1816,

“Of observing the entire freedom from fevers enjoyed by the inhabitants of the numerous crowded courts and alleys within the extensive district comprehended in our visits from that charity.” And again, writing in the winter of 1814-15, Bateman says: “To those who recollect the numerous cases of typhoid fevers [this term did not then mean enteric] which called for the relief of dispensaries twelve or fourteen years ago, and the contagion of which was often with great difficulty eradicated from the apartments where it raged, and even seized the same individuals again and again when they escaped its fatal influences, the great freedom from these fevers which now exists, even in the most close and filthy alleys in London, is the ground of some surprise.” And once more, in the summer of 1816, just as the new epidemic period was about to begin, he says: “The extraordinary disappearance of contagious fever from every part of this crowded metropolis during the long period comprehended by these Reports [since 1804], cannot fail to have attracted the attention of the reader.”

Bateman concluded, not without reason, that this immunity of London from fever was due to the high degree of well-being among the poorer classes in times of plenty; and although he made out that the poor of Dublin, Cork and some Scotch towns did not profit by times of plenty so much as those in London, yet his reason for the abeyance of fever from 1804 to 1816 applied to England, Ireland and Scotland at large, and was doubtless the true reason.

The following figures from Manchester, Leeds and Glasgow hospitals, as well as the Irish statistics elsewhere given, are closely parallel with those of London:

Manchester House of Recovery.

Year Cases Deaths

1796-7 371 40

1797-8 339 16

1798-9 398 27

1799-1800 364 41

1800-1 747 63

1801-2 1070 84

1802-3 601 53

1803-4 256 33

1804-5 184 34

1805-6 268 29

1806-7 311 33

1807-8 208 15

1808-9 260 21

1809-10 278 30

1810-11 172 15

1811-12 140 18

1812-13 126 13

1813-14 226 17

1814-15 379 29

1815-16 185 14

1816-17 172 6

Leeds House of Recovery.

Year Cases Deaths

1804 (2 mo.) 10 0

1805 66 6

1806 75 2

1807 35 1

1808 80 3

1809 93 8

1810 75 14

1811 92 4

1812 80 12

1813 137 11

1814 79 4

1815 146 15

1816 121 13

1817 178 8

1818 (10 mo.) 254 20

Glasgow Royal Infirmary (Fever Wards).

Year Cases

1795 18

1796 43

1797 83

1798 45

1799 128

1800 104

1801 63

1802 104

1803 85

1804 97

1805 99

1806 75

1807 25

1808 27

1809 76

1810 82

1811 45

1812 16

1813 35

1814 90

1815 230

1816 399

1817 714

1818 1371

Even such fever as there was in Britain from 1804 to 1817 was not all certainly typhus. The high death-rates at the Manchester fever-hospital in 1804 and 1805 (1 death in 7·5 cases and 1 death in 5·25 cases) may mean a certain proportion of enteric cases in those years. “From 1804 to 1805,” says Ferriar, “many cases were admitted of a most lingering and dangerous kind.... Many deaths took place from sudden changes in the state of the fever, contrary to the usual course of the disease, and only imputable to the peculiar character of the epidemic. Similar cases occurred at that time in private practice.” Next year, 1806, there was an epidemic among the troops at Deal, described under the name of “remittent fever,” which Murchison claims to have been enteric. In September, 1808, says Bateman, several were admitted into the London House of Recovery, with malignant symptoms; “and some severe and even fatal instances occurred in individuals in respectable rank in life.” He still uses the name of typhus; but he is aware that the cases of continued fever, especially in the summer and autumn of 1810, had often symptoms pointing to a bowel-fever rather than to a head-fever.

The years 1807 and 1808 appear to have been the most generally unwholesome during this period of comparative immunity from fever; they were marked by the occurrence of dysenteries, agues, and infantile remittents, as well as of fevers of the “typhus” kind. The chief account comes from Nottingham. The cases of “typhus” there were very tedious, but not violent, nor attended with any unfavourable symptoms, only one case having petechiae, and all having diarrhoea. The following table of admissions for various kinds of fever (as classified by Cullen) at the Nottingham General Hospital, 25 March, 1807, to 25 March, 1808, shows the preponderance of “synochus” and next to it, of infantile remittent:

Admitted to the Nottingham General Hospital, 1807.

Intermittent fever 7

Synocha 10

Typhus 27

Febris nervosa 26

Synochus 155

Febris infantum remittens 88

Dysentery 5

The state of war in the Peninsula was favourable to epidemic or spreading diseases, and there is a good deal to show that such diseases did exist among the British troops. But there is only one good instance of England getting a taste of that experience of war-typhus which the Continent had to endure for many years. This was on the return of the remnant of the army after the defeat at Corunna on 16 January, 1809. The troops were crowded pell-mell on board transports, which had a very rough passage home. Dysentery broke out among them, and was the most urgent malady when they landed at Plymouth in a state of filth and rags. Typhus fever followed, but in the first three weeks at Plymouth, to the 18th of February, it was not of a malignant type, only 8 dying of it in the Old Cumberland Square Hospital; in the next three weeks, 28 died of it there. Up to the 27th of March, 1809, the sick at Plymouth from the Corunna army numbered 2432, of whom 241 died. Of 4 medical officers, 3 took the contagion, of 29 orderlies, 25 took it. The fever was in some cases followed by a relapse, which was more often fatal than the original attack. This was a typical instance of typhus bred from dysentery or other incidents of campaigning, a contagion more dangerous to others than to those who had engendered it. “Within a few yards of the spot where I now write,” says Dr James Johnson, of Spring Gardens, London, “the greater part of a family fell sacrifices to the effects of fomites that lurked in a blanket purchased from one of these soldiers after their return from Corunna.” In August, 1813, an Irish regiment passing through Leyburn, a small market-town of the West Riding of Yorkshire, in an airy situation, was obliged to leave behind a soldier ill of typhus, who died of the fever after a few days. The infection appeared soon after in the cottages adjoining, and remained in that end of the town for several months, choosing the clean and respectable houses. In a farmer’s family, a son, aged twenty-nine, died of it, while another son and two daughters had a narrow escape. The disease appeared also in the village of Wensby, a mile distant, and in other villages. Few lives were lost.

These were, perhaps, not altogether solitary instances in Britain of typhus spread abroad by the movements of troops during the great French war. Let us multiply such instances by hundreds, and we shall vaguely realize the meaning of the statement that the period of the Napoleonic wars, and more particularly the period from the renewal of the war in 1803 until its close in 1815, was one of the worst times of epidemic typhus in the history of modern Europe. It was precisely in those years that England, Scotland and Ireland enjoyed a most remarkable degree of freedom from contagious fever.