A History of Epidemics in Britain, Volume 2 (of 2): From the Extinction of Plague to the Present TimeCreighton, Charles
History
A History of Epidemics in Britain, Volume 2 (of 2): From the Extinction of Plague to the Present Time
Creighton, Charles
Epidemics -- Great Britain -- History
Thus far there has been little besides Bateman’s essay to indicate the
nature or type of the fever in England. In Ireland it was to a large
extent relapsing fever, and, as we shall see, it was so also in Scotland.
Bateman found less than a tenth part of the cases at the London Fever
Hospital to have relapses, which was an unusually large proportion, in his
experience. Elsewhere in England the tendency to relapse was either
wanting or the relapses were described or accounted for in other ways; to
understand this it has to be kept in mind that the epidemic was the
occasion of a great revival of blood-letting, a practice which had fallen
into disuse in fevers since the last half of the 18th century, and was
something of a novelty in 1817. The fever of that year was undoubtedly
abrupt in its onset, strong, “inflammatory,” with full bounding pulse,
beating carotids, hot and dry skin, intense headache, suffused eyes, and
the like symptoms, which seemed to call for depletion. The common practice
was to bleed _ad deliquium_, which meant to ten, or fourteen, or twenty
ounces, at the outset of the fever. There was hardly one of the writers
upon the epidemic, unless it were Bateman, an advocate of the cordial and
supporting regimen, who did not consider the stages or duration of the
fever as artificially determined by the blood-letting, and not as
belonging to the natural history.
In order to show how much the treatment by blood-letting dominated the
view of the fever itself, of its type, its stages, or duration, I shall
take the Bristol essay of Prichard, who adopted phlebotomy, as he says, at
first tentatively and with some fear and trembling, but at length
practised it vigorously, having found it to answer well[320]. The epidemic
of fever in Bristol began about June, 1817, and lasted fully two years.
The first cases brought to St Peter’s Hospital, which was the general
workhouse of the city, were of wretched vagrants found ill by the wayside
or abandoned in hovels. About the same time forty-two felons in the
Bristol Newgate, “one of the most loathsome dungeons in Britain, perhaps I
might say in Europe,” were infected, of whom only one died, and he of a
relapse. From June, 1817, to the end of 1819, there were 591 cases in the
poor’s house, 647 in the General Infirmary, and 975 treated from the
Dispensary, making 2213 cases, of which a record was kept. But there were
also many cases in private practice among the domestics, children, and
others in good houses, such as those on Redcliff Hill. The cases in the
poor’s house were classified by Prichard as follows:
1817 1818 1819
Public-domain text, read in full here on John Shaqi.
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