1809. The _Edin. Med. and Surg. Journal_ (VI. 231), in a long review of

this essay, declared that Adams was inconsistent in reaffirming his old faith in cowpox and at the same time demanding liberty for the inoculators. [1170] J. C. Steele, M.D., “Increase of Smallpox in Glasgow.” _Glas. Med. Journ._ N. S. I. 59. The Paris figures are cited from the _Annuaire pour l’an 1852-53_. [1171] I do not, of course, answer for the correctness of Gregory’s statements. [1172] _Lancet_, 12 Dec. 1838. [1173] 409 of these in Sheffield. [1174] There are two notable exceptions, marked †, Lancashire and Yorkshire; but, in regard to their higher mortality from smallpox in 1837-40, it should be kept in mind that they were the chief scenes of the great distress among the working class in those years, the same causes which produced an enormous mortality from typhus fever in adults having tended to increase the fatality of smallpox among the children. [1175] In the first universal and very fatal epidemic of measles, that of 1808, a good many adults, who had not had measles before, were attacked. See the chapter on Measles. [1176] The accounts by Fothergill, Wall and others, of the malignant sore-throat with scarlet rash about 1740 give prominence to cases in early manhood or womanhood. [1177] _Supplement (Decennial) to the 45th Report of the Regr.-Genl._ 1885, p. cxii. [1178] The figures for 1721 are cited above (p. 485) from Douglass and others. Those for 1752 are given in the _Gent. Magaz._ 1753, Sept., p. 413, as “collected from the Accounts of the Overseers in the Twelve several Wards,” and sent by the Rev. T. Prince. [1179] _Supplementary Report of the Registrar-General_, 1883. The mean death rate per 1000 living, for the period 1838-82, has been 71·0 males, and 61·2 females under five years of age; but as late as 1878 the annual average was the mean of the period, namely 71·2 males and 61·1 females. [1180] Lettsom (_Gent. Magaz._ 1804, Aug. p. 701), in a preface to Neild’s papers on the state of the prisons, estimated that 40,000 lives might be saved every year in England by preventing infectious fevers, “for in this metropolis my respectable friend Thomas Bernard, Esq., whose caution and accuracy no person will doubt, calculates the number of victims at 3000 each year [doubtless from the London Bills of Mortality].... If to this pleasing view we add the preservation of 48,000 victims to the smallpox, which may now be preferred by the cowpox, we have in our power to possess the sublime contemplation of forming a saving fund of human life of nearly 88,000 persons annually in this empire, by the exercise of reason, philanthropy and judicious policy.” [1181] Duvillard, _Tableaux etc._ Paris, 1806. [1182] _Essay on the Principle of Population._ Bk. IV. chap. 5. [1183] Robert Watt, M.D. _Treatise on Chincough, with Inquiry into the Relative Mortality of the Diseases of Children in Glasgow._ Glasgow, 1813. [1184] John Graunt, _Natural and Political Observations upon the Bills of Mortality_, London, 1662, says: “The original entries in the Hall books were as exact in the very first year [he probably means 1629, which is the first year of his own extracts from them, but the classification of deaths began in 1604] as to all particulars, as now; and the specifying of casualties and diseases was probably more.” The searchers, he explains, were in many cases able to report the opinions of the physicians, receiving the same from the friends of the deceased; while for certain causes of death, among which he includes smallpox, “their own senses are sufficient.” [1185] _Cal. Coke MSS._ (Hist. MSS. Commis.) I. 21 June, 1628. [1186] Sutherland Letters, in _Rep. Hist. MSS. Com._ V. 152. [1187] _Cal. State Papers, Domestic. Charles II._ s. d. It appears from the _Pyretologia_ by Drage, of Hitchin (1665), that the natural history of measles must have been familiar, for he mentions that its incubation period was from fourteen to fifteen days: p. 20. [1188] _Obs. Med._ 3rd ed. (1675), Bk. IV. chap. 5. [1189] Sydenham, _Obs. Med._ 1675, V. 3. “Morbilli anni 1674.” It entered almost every household, as on the last occasion, attacking infants more especially. It had some points of difference from the measles of 1670. The rash was less uniformly on the fourth day, now sooner, now later; it would come on the arms or trunk before the face; nor was it followed by the branny powdering which was as obvious in the measles of 1670 as it was usual to see it after scarlatina. Along with these anomalies of the rash, the consecutive fever and peripneumonia were also more severe, and a more frequent cause of death. But in the principal characters of measles the disease of 1674 was the same as that of 1670, and called for no fresh description. Among Sydenham’s patients were the children of the Countess of Salisbury, who all took measles in turn, and all passed through the attack and its sequelae without danger, under a particular regimen which is detailed. It is of great interest to see how this season of anomalous measles looks in the weekly bills, as in the above table. [1190] Richard Morton, M.D. _Pyretologia._ 2 vols. Lond. 1692-94, I. 427. He places it in the year 1672 and in the six months of autumn and winter; and in another place (II. 71), where he cites clinical cases, he again gives the year 1672 as that in which measles “epidemice Londini publice grassabantur.” He compares the epidemic to a _pestis mitior_, and says that the disease had never been epidemic again to the date of his writing (1692-94). It is tolerably clear that, in writing twenty years after, he had forgotten the year and even the season--not the only error in dates in his work. Sydenham’s account of the great measles epidemic of spring and summer, 1674, was published the year after, and is exactly borne out by the weekly bills of mortality. Morton’s obvious mistake of the date is the subject of a refutation four pages long by Thomas Dickson, M.D., F.R.S., physician to the London Hospital, in _Med. Obs. and Inquiries_, IV. (1771), p. 266. [1191] Fothergill (_Gentleman’s Magazine_, Dec. 1751) says, in a criticism of the Bills of Mortality: “If the body is emaciated, which may happen even from an acute fever, ’tis enough for them to place it to the article of consumption.” And of course they would do so the more readily if the acute fever, say measles, were past, and its sequelae had been the cause of death. Referring to Kidderminster in 1756, Johnstone says: “Measles at this time went through our town and neighbourhood: vast numbers of children died tabid.” It is to be remarked that the fever column is augmented but little during the measles of 1674, a fact which shows that the inflammatory causes of death, such as capillary bronchitis and pneumonia (specially recorded by Sydenham for this epidemic), were more apt to be entered under “consumption” than under “fevers.” [1192] See Watson’s account of smallpox following measles at the Foundling Hospital, _supra_, p. 550. [1193] It may have been this high mortality that Dover had in mind when he wrote, in 1733: “I do not remember I ever heard of anyone’s dying of this disease [measles] till about twenty-five years since; but of late, by the help of Gascoin’s powder and bezoartic bolusses, together with blisters and a hot regimen, the blood is so highly inflamed and the fever encreased to that degree that it is become equally mortal with the smallpox.” _Physician’s Legacy_, 1733, p. 116. [1194] Memorial to the House of Commons, _supra_, p. 84. [1195] _Edin. Med. Essays and Obs._ V. 26. [1196] Pronounced by Sims to have been wholly scarlatina, and by Willan to have been in part that disease. [1197] Monthly reports in the _Gentleman’s Magazine_, under the dates. [1198] Heberden’s paper on measles in _Trans. Col. Phys._ III. (1785), pp. 389, 395. [1199] W. Black, M.D., _Obs. Med. and Political on the Smallpox, &c._ London, 1781, p. 207: “Few escape measles in infancy or childhood, and as we find one-tenth fewer to die of measles than of smallpox, etc.... In their future consequences, measles, especially in cities, are not without hazard, and are not unfrequently followed by hecticks.” [1200] Percival, in _Med. Obs. and Inquiries_, V. (1776), p. 282. [1201] Omitting the year 1760. [1202] Compiled from the tables in the _Gentleman’s Magazine_, 1742-57. All Saints parish contained more than half the population. [1203] Pearce, writing from St Croix, West Indies, 12 Oct. 1782, to Lettsom (_Memoirs_, III. 429), says the measles had been “very rife and fatal” there. [1204] MS. Apothecary’s Books at the Foundling Hospital. [1205] R. Willan, M.D., _On Cutaneous Diseases_. Vol. I. 1808, p. 244. [1206] Heysham, u. s., p. 538. [1207] James Lucas, “On Measles.” _Lond. Med. Journ._ XI. 325, dated 22 Aug. 1790. [1208] _Reports on the Diseases of London, 1796-1800._ Lond. 1801, pp. 2, 13, 18, 32, 229. [1209] John Roberton, in _Med. and Phys. Journ._ XIX. 185. Measles seems to have been more usual than scarlatina in Scotland as well as in Ireland. In the accounts of the several parishes written for the _Statistical Account_, about 1791-99, measles is often mentioned (and would appear at that time to have been more usual in country districts than smallpox), while hardly anything is said of scarlatina under that name, and not much of sore-throat. [1210] _Med. and Phys. Journ._ VII. (1802), p. 316. [1211] “Observations on Measles.” By Mr Edlin, surgeon, Uxbridge. _Med. and Phys. Journ._ VIII. (July-Dec. 1802), p. 28. An earlier epidemic of anomalous eruptive fever (“dark coloured eruption of the neck and breast which spread at length over the whole body”) was described for Uxbridge and its vicinity in the summer and autumn of 1799, in an essay reviewed in _British Critic_, XV. 435. [1212] T. Bateman, M.D., _Report on the Diseases of London, 1804-16_. Lond. 1819, p. 90-91. [1213] Samuel Fothergill, M.D., and others, in _Med. and Phys. Journ._ XVIII. (Dec. 1807), pp. 569, 572; XIX. 91, 185. [1214] “The Epidemic Measles of 1808.” By Dr Ferguson. _Med. and Phys. Journ._ XXI. 359. [1215] John Roberton, _Med. and Phys. Journ._ XIX. 182, 272, 278, 471. [1216] Roberton, _loc. cit._ XIX. 471. [1217] In the earlier period, according to Grainger, Lind and others, numerous cases of measles sometimes occurred on board ships of war. [1218] Published as an Appendix to his _Treatise on the History, Nature and Treatment of Chincough_. Glasgow, 1813. Reprinted by John Thomson, Glasgow, 1888. Dr Watt is best known by his _Bibliotheca Britannica_ (Edinburgh, 1819. 4 vols. 4to.), a wonderfully complete bibliography under the dual arrangement of subjects and authors, which is still indispensable for research in every branch of knowledge. Perhaps the many who use it are not all aware that it was the labour of a physician in Glasgow (originally a surgeon at Paisley), who died (in 1819) at the age of forty-five, having reached such professional distinction in his own city as to be elected President of the Faculty of Physicians and Surgeons. [1219] _De Febribus_, 1659. Cap. XV. [1220] _Sketch of a Plan to exterminate the Casual Smallpox, &c._ London, 1793, p. 152. [1221] It was believed that smallpox left ill effects in some constitutions. William III. is said to have had the dregs of smallpox in his lungs. Roberton (u. s.) cites Saunders as teaching that smallpox caused scrofula, and he is himself doubtful whether an attack of it ever improved the constitution. Dr Moses Younghusband, of New Lebanon Springs, _Med. Phys. Journ._ XI. (1804), 317, wrote: “I see no more of the glandular suppurations formerly so frequent and unavoidable” after smallpox. [1222] Johnstone, _Malignant Epidemic Fever of 1756_, London, 1757, says of Kidderminster during a season of high mortality from fever and other diseases: “The measles at this time went through our town and neighbourhood. The children commonly got over the usual course of this distemper; but vast numbers died tabid of its consequences. The chincough succeeded the measles.” [1223] The _Edin. Med. and Surg. Journ._ XXVI. 177, cites from Cleland, with a reference which I have not succeeded in verifying, the following Glasgow figures for the period 1813-19: all deaths 22,060, smallpox 236 (1·07 per cent.), measles 614 (3·69 per cent.). But see Cowan, _Glas. Med. Journ._ V. 358, _supra_, p. 597. [1224] Cowan, _Journ. Statist. Soc._ III. [1225] Griffin, _ibid._ III. [1226] Macmichael, in an essay on scarlatina and other contagions, 1822, says: “Parents considering the measles as a disease almost inevitable have wisely chosen to expose their children to the contagion at such auspicious times [summer season]; so that the disorder may be once well over, and all further anxiety at an end.” p. 30. [1227] P. Macgregor, _Med. Chir. Trans._ V. 436, obtained from Henry, of Manchester, the burials from measles at the Collegiate Church and St John’s Church for two years, 1812-13, which when compared with those abstracted by Percival from the former register for twenty years, 1754-74, showed a higher ratio of measles to the burials from all causes. [1228] Cross, u. s. [1229] Delagarde, _Med. Chir. Trans._ XIII. 163. [1230] A. Campbell Monro, M.D., “Measles: an Epidemiological Study.” Chiefly from the Jarrow statistics. _Trans. Epid. Soc._ N. S. X. (1890-91), p. 94. The author connects the recent increase with the greater concourse of children to infant and elementary schools under the Education Act. [1231] _Rep. Reg.-Genl._ LIV. p. xviii, and LV. p. xi. The explanation given is as follows: “When a county or other area has been visited by a severe epidemic [of measles] there is for several succeeding years scarcely sufficient material, in the shape of unprotected children, for another considerable outbreak, unless it be in very populous areas such as London or Liverpool; and in such places the disease is endemic.” [1232] Buchan and Mitchell, _Journ. Scot. Meteor. Soc._ July, 1874, p. 194. [1233] Ogle, in the 47th Report of the Registrar-General (for 1884), p. xv. [1234] Cited by Hirsch, _Geogr. and Histor. Pathology_. Eng. transl. III. 28. [1235] _Harl. MSS._ No. 2378. Moulton’s _This is the Myrour or Glasse of Health_, circa 1540, is in the main a printed reproduction of this manuscript prescription-book. The same receipt which is “for ye kink” in the one, is “for the chyncough” in the other (formula LXXIX.). [1236] “Sycknesses happenynge to children:--When they be new borne, there do happen to them sores of the mouth called aphte, vometyng, coughes, watchinge, fearefulness, inflamations of the nauelle, moysture of the eares. When they brede tethe, ytchinge of the gummes, fevers, crampes and laskes. When they waxe elder, than be they greved with kernelles, opennesse of the mould of the head, shortnesse of wynde, the stone of the bladder, wormes of the bealy, waters, swellynges under the chynne, and in Englande commonly purpyles, measels and small pockes.” [1237] _Obs. Med._ 3rd ed. Bk. IV. chap. V. § 8; _Epist. Respons._ I. § 42. [1238] Mary Barker at Hambleton, to Abel Barker at the Dog and Ball in Fleet Street. _Hist. MSS. Commis._ V. 398. [1239] _Tractatus de morbis acutis infantum._ Lond. 1689. Englished by W. Cockburn, M.D. London, 1693, pp. 38, 78, 87. [1240] _Gent. Magaz._ 1751, pp. 195, 578. [1241] _Treatise on Chincough._ Glasgow, 1813. [1242] Vierordt, _Physiologie des Kindesalters_, Tübingen, 1877, p. 82, without adducing evidence that the larynx is congenitally different in the two sexes (a matter of very nice measurements which even Beneke does not appear to have attempted), says that the development of the posterior glottidean space has advanced before puberty much more in boys than in girls. Stark, a former Superintendent of Statistics for Scotland (_Rep. Reg. Gen. Scot. for 1856_, p. xxxviii), has raised the question thus: “The causes of this greater liability of the female sex to death while suffering from whooping-cough are worthy of being investigated. So far as one’s own limited experience goes, it would appear to be produced by the greater tendency which the female sex exhibits to have fits or convulsions when attacked by a paroxysm or fit of coughing in that disease.” [1243] _Changes in the Air, &c. ... in Barbadoes._ Lond. 1760. [1244] In the Irish Decennial Summary for 1871-80 (_Suppl. to 17th Report of Reg.-Gen. Ireland_, 1884) it is said: “A general relation has been noticed by many observers between the prevalence of whooping-cough and measles, and there is no doubt that in many localities an epidemic of measles is frequently accompanied by or followed by a prevalence of whooping-cough. A comparison of the figures in Table XV. does not point to any very close relationship. Whooping-cough was a much more fatal disease than measles, but it is more than probable that measles was equally prevalent.” [1245] _Illustrations of Unconscious Memory in Disease._ London, 1886 [1885]. Chapter VI. pp. 64-83. [1246] _Med. Times and Gaz._ 1885, II. p. 6. [1247] Preface to 3rd ed. of _Obs. Med._, Greenhill’s ed. p. 16. [1248] _Sydenhami Opera_, ed. Greenhill, 1844, p. 243. [1249] Maton, _Med. Trans. Col. Phys._ V., having seen an extensive epidemic attended by a red rash in one of the great public schools, was disposed to erect it into a new type of roseola, owing to its mildness, while he admitted that it was the same as Sydenham’s scarlatina simplex. Macmichael (_New View of the Infection of Scarlet Fever_, 1822, p. 78) thought that this was “rather a proof of extreme refinement,” and that there was no need to give it a new designation. Gee, _Brit. Med. Journ._, 1883, II. 236, cites this “refinement” of Maton’s as one of the noteworthy things in the history of the diseases of children in this country. [1250] Sir Robert Sibbald, M.D., _Scotia Illustrata, sive Prodromus Historiae Naturalis_. Edin. 1684. Lib. II. cap. 5, p. 55. [1251] Richard Morton, M.D. _Pyretologia._ 2 vols. London, 1692-94, II. 69. [1252] Engl. transl. 1737, p. 80. The reference by Dover (_Ancient Physician’s Legacy_, 1732, p. 117), is almost in the words of Sydenham, his master: “This is a fever of a milder kind than the measles [of which latter he did not remember anyone’s dying till about twenty-five years since], and does not want the assistance of a doctor. The skin seems to be universally inflamed, but the inflammation goes off in forty-eight hours.” [1253] _Edin. Med. Essays and Obs._ III. 26. [1254] _Obs. de aere et morb. epid._ [1255] H. Warren, M.D., _On the Malignant Fever in Barbados_. London, 1740, p. 73. [1256] Le Cat, in _Phil. Trans._ XLIX. 49: In 1736 and 1737, a prevalence of gangrenous sore-throats which chiefly attacked children. They reappeared in 1748 in young persons of the first distinction, not only at Rouen, but also at St Cyr, near Versailles, and at Paris. [1257] Webster, _Brief History of Epidemick and Pestilential Diseases_. Hartford, 1799, II. 253: “Away, then, with crowded cities--the thirty feet lots and alleys, the artificial reservoirs of filth, the hot-beds of atmospheric poison! Such are our cities--they are great prisons, built with immense labour to breed infection and hurrying mankind prematurely to the grave.” [1258] W. Douglass, M.D., _The Practical History of a New Epidemical Eruptive Miliary Fever, with an Angina Ulcusculosa, which prevailed in New England in the years 1735 and 1736_. Boston, N.E. 1736. This rare essay was reprinted in the _New England Journ. of Med. and Surg._ XIV. 1 (Jan. 1825). [1259] In Belknap’s _History of New Hampshire_. Boston, 1791. [1260] _Gent. Magaz._ Feb. 1752, p. 73. [1261] The account by Kearsley, of Philadelphia, written about 1769 (_Gent. Magaz._ XXXIX. 251), refers to a great epidemic of throat-disease in New England in the spring, summer and autumn of 1746; but the date is almost certainly a mistake for 1736, as no such epidemic is known on contemporary authority. [1262] Cadwallader Colden, M.D. “Letter to Dr Fothergill on the Throat Distemper,” dated New York, 1 Oct. 1753, in _Med. Obs. and Inquiries_, I. 211. [1263] Belknap, III. 421. [1264] Samuel Bard, M.D. “An Inquiry into the Nature, Cause and Cure of the Angina Suffocativa, or Sore throat Distemper, as it is commonly called by the inhabitants of this city and colony.” _Trans. Amer. Philos. Soc._ I. (1769-1771). Philad. 1771, p. 322. What purports to be a translation of this, is given in Reutte’s _Recueil d’Obs. sur le Croup_ (Paris, 1810), the name of “croup” being introduced into the title, and some strange liberties taken with the text. [1265] The impression made upon modern historians by these American accounts of the throat-distemper has not always been the same. Hecker finds in the malady described by Douglass the form of _Frieselbräune_, or miliary diphtheria, a somewhat rare and sporadic malady; in the account by Bard, he finds _häutige Brandbräune_, or membranous angina maligna; while he finds in an account by Chalmers for Charleston, S. Carolina, in 1770, a third variety, _Friesel-Scharlachbräune_, or miliary scarlet angina. Again, Jaffe finds in the account by Bard “many analogies with the diphtheria of our own day.” Hirsch identifies the throat-distemper of Douglass and Colden as “exquisite scarlet fever” and the disease described by Bard as diphtheria. Häser identifies the epidemic described by Douglass as diphtheria. Bard himself did not doubt that the disease which he saw in New York previous to 1771 was the same that Douglass saw at Boston in 1735-36. Hecker, _Geschichte der neueren Heilkunde_. Bk. I. chap. 8. Max Jaffe, “Die Diphtherie in epidemiol. u. nosol. Beziehung, &c.” Original paper in _Schmidt’s Jahrbücher_, CXIII. (1862), p. 97. Hirsch, 1st ed. of _Handb. der histor. geogr. Pathol._ I. 237, note 6; II. 125, note 4; and 2nd ed. III. 80. Eng. transl. Häser, _Geschichte, &c._ III. 471. [1266] _Gent. Magaz._ IX. Nov. 1739, p. 606:--Died, “Nov. 27, the eldest and youngest son of Henry Pelham, Esq. of sore throats.” [1267] John Chandler, F.R.S., _A Treatise of the Disease called a Cold. Also a Short Description of the Genuine nature and seat of the Putrid Sore-Throat._ London, 1761, p. 55. [1268] Munk, _Roll of the College of Physicians_. Fothergill cites Spanish and other foreign writers on garrotillo in the historical introduction to his essay on the Sore-Throat (1748), without mentioning the fact that Letherland had been before him in that field. [1269] John Rutty, M.D., _Chronological History of the Weather and Seasons, and prevailing Diseases in Dublin, during forty years_. London, 1770, p. 108. [1270] John Starr, M.D., “Account of the Morbus Strangulatorius.” _Phil. Trans._ XLVI. 435, dated Liskeard, Jan. 10, 1749/50. [1271] John Fothergill, M.D., _An Account of the Sore Throat attended with Ulcers; a Disease which hath of late years appeared in this City and the parts adjacent_. London, 1748. [1272] Sir Thomas Watson (_Lectures_, II. 817), who mentions excoriations of the anus, carried Fothergill’s idea of an absorption of the acrid matter to an extreme length in explaining the irritation of the alimentary canal in scarlet fever. [1273] Letter to Rutty, _Chronol. Hist._ 1770, p. 117. [1274] _Gent. Magaz._ Oct. 1751, and July, 1755, p. 343. [1275] Nathaniel Cotton, M.D. _Observations on a particular kind of Scarlet Fever that lately prevailed in and about St Albans._ In a Letter to Dr Mead. London, 1749 (12th February). The copy in the British Museum library has a written note signed R. W. (Robert Willan, M.D.): “The only just and correct account; but was not noticed during the author’s lifetime, and it has since been consigned to oblivion.” In his work _On Cutaneous Diseases_ (1808), Willan sarcastically contrasts the means by which Fothergill gained fame while Cotton escaped notice; of the latter he says: “But, as he gave an old appellation to a disease certainly not new, his work attracted little attention, and procured him no emolument.” [1276] John Huxham, M.D., _A Dissertation on the Malignant Ulcerous Sore-Throat_. London, 1757. [1277] _Supra_, p. 125. [1278] John Wall, M.D. “Bark in the Ulcerated Sore Throat.” _Gent. Magaz._ 1751, Nov. p. 497. Dated Worcester, 15 Oct. 1751. [1279] Nash, _History of Worcestershire_, II. 39. [1280] James Johnstone, M.D., _Malignant Epidemic Fever of 1756_. London, 1758. [1281] To those who explicitly distinguished the sore-throat or angina maligna from scarlatina may be added Dr Richard Russell: “In hoc quidem morbi statu mitissimo, si ad quartum vel quintum usque diem eruptiones in cute superstites sint, paulatim recedant, et desquamationes furfuraceae, perinde ut in febre scarlatina, post se reliquant, ibi crisis integra et perfectissima est.” _Œconomia Naturae in Morbis Acutis et Chronicis Glandularum._ Lond. 1755, p. 105 seq. [1282] _Letters of Horace Walpole_, ed. Cunningham, III. 280, letter to Mann, 20 Jan. 1760. [1283] Charles Bisset, _Essay on the Medical Constitution of Great Britain, with obs. on the weather and diseases in 1758-60_. London, 1762. [1284] Hecker (u. s.) identified Bisset’s epidemic disease in Cleveland with Douglass’s in New England. Merely because they used the term “miliary,” he erects their epidemics into an imaginary class of _angina miliaris_ which was not scarlatina. [1285] Short to Rutty, Rotherham, 26 March, 1760, in Rutty’s _Chronol. Hist. of Weather, &c. and Diseases in Dublin_. London, 1770, p. 117. [1286] Sir David Hamilton, _Tractatus Duplex, &c._ London, 1710 (Engl. transl. 1737, p. 84), says that, in 1704, several in the “miliary fever” had “a pain in the jaws resembling that of the squinsy,” which killed many suddenly. At the other end of the century, Willan (_Cutaneous Diseases_, 1808, p. 333), said of fever in 1786: “The title ‘angina maligna’ would have applied with equal, if not with more propriety, to the sore-throat connected with a different species of contagion, namely, that of the typhus or malignant fever originating in the habitations of the poor where no attention is paid to cleanliness or ventilation.” [1287] Francis Penrose, _A Dissertation on the Inflammatory, Gangrenous and Putrid Sore-Throat. Also on the Putrid Fever._ Oxford, 1766. [1288] _Some Thoughts on the Anomalous Malignant Measles lately peculiarly prevalent in the Western Parts of England._ London, 1760. And to be sold at Bath and Exeter. [1289] William Watson, M.D. “An Account of the Putrid Measles as they were observed at London in the years 1763 and 1768.” _Med. Obs. and Inquiries_, IV. (1771), p. 132. [1290] James Clarke, M.D. “Medical Report for Nottingham from March, 1807, to March, 1808.” _Edin. Med. Surg. Journ._ IV. 425. [1291] These changes of the name from week to week represent probably the independent judgment of the apothecary more than the modified opinions of Watson the physician. The views which the latter expressed in his paper of 1771, are clearly reechoed in the following anonymous paragraph in the _Gent. Magaz._ XLII. (1772), Nov. p. 541: “The measles have lately been very rife and fatal in this metropolis. They are of a very different kind from those described by the great Doctor Sydenham, being of a malignant putrid nature, such as visited London in 1763 and 1768, where bleeding seemed of so little service, but small doses of emetic tartar, cordial medicines and blisters, were very efficacious. The above disorder was epidemic at Plymouth and parts adjacent in the years 1745 and 1750, and so long since as the year 1762 [1672] was described by Dr Morton, who says it raged so severely during the autumn of that year that it appeared like a gentle kind of plague, sparing neither sex nor age, and that 300 died weekly of it.” [1292] W. Grant, M.D., _Account of a Fever and Sore Throat in London, September, 1776_. London, 1777. [1293] W. Fordyce, M.D., _A new Inquiry into the Causes, Symptoms and Cure of Putrid and Inflammatory Fevers; with an Appendix on the Hectic Fever, and on the Ulcerated and Malignant Sore Throat_. London, 1773. The appendix on Sore-throat is pp. 209-222. [1294] _Gent. Magaz._ XLII. (1772), June, p. 258. [1295] G. Levison, M.D., _An Account of the Epidemical Sore-Throat_. 2nd ed. corrected. London, 1778 (1st ed. 1778). [1296] It might have been the third, as Grant (u. s.) says there was fever with sore-throat in London in September, 1776. [1297] “Angina and Scarlet Fever of 1778.” _Mem. Med. Soc._ III. 355. [1298] James Johnstone, junr. M.D., _A Treatise on the Malignant Angina or Putrid and Ulcerous Sore-Throat, &c._ Worcester, 1779. [1299] Robert Saunders, _Observations on the Sore-Throat and Fever in the North of Scotland in 1777_. London, 1778. [1300] William Withering, M.D., _Account of the Scarlet Fever and Sore-Throat, particularly as it appeared at Birmingham in 1778_. London, 1779; preface dated 1st January. [1301] Withering was perhaps too desirous to be thought the first in England to have described scarlatina anginosa. “The scarlet fever in its simple state,” he says, “is not a very uncommon disease in England, but its combination with a sore-throat, as described above, the violence of its attack, and the train of fatal symptoms that follow, are circumstances hitherto unnoticed by English writers.” It is probable from this that he had not seen Levison’s essay, with preface dated 11 May, 1778, his own being dated 1 January, 1779; but Cotton’s essay of 1749 actually bore the name of scarlet fever on its title-page, and described the throat-affection, glandular swellings, and the like quite correctly. The name of the elder Heberden is frequently brought into the history of the identification of scarlatina, with a reference to his _Commentaries on Diseases_, which were not published until 1802, some time after his death at a very advanced age. The following are among his remarks: “In the fever which has just been described there is always some degree of redness in the skin, and the throat is not without an uneasy sensation. Where it happens that the throat is full of little ulcers attended with considerable pain, there the disease, though the skin be ever so red, is not denominated from the colour, but from the soreness of the throat, and obtains the name of _malignant sore-throat_; and many suppose that the two disorders differ in nature as well as in name,” p. 23. “The enfeebled and disordered state of all the functions of the body evidently points out such a malignity of the fever as cannot be owing to the affection of the uvula or tonsils, which in other distempers we often see ulcerated and eaten away, without any danger of the patient’s life. These sores, therefore, like pestilential buboes, point out the nature of the disorder; but the danger arises, not from them, but from the fever,” p. 25. In 1790 an elaborate attempt was made by William Lee Perkins, M.D. (dating from Hampton Court, 1 March) to distinguish between cynanche maligna and scarlatina anginosa, in _An Essay for a Nosological and Comparative View of the Cynanche Maligna or Putrid Sore-Throat, and the Scarlatina Anginosa_. London, 1790. He proceeds by the nosological method of Sauvages and Cullen, erecting genera, species and varieties. The result is not clear after all; for on p. 43 (note) we read that _scarlatina_ is frequently accompanied with inflammatory and ulcerous appearances in the fauces or throat, and that _angina maligna_ or ulcerated sore-throat is often attended with red efflorescence on the skin; this had led to their being regarded as one and the same, and treated by the same method of cure. [1302] J. Parker, _A Treatise on the Putrid Constitution of 1777 and the preceding years, and the Pestilential one of 1778_. London, 1779 (of inferior value beside Withering’s). [1303] Heysham, in Hutchinson’s _Hist. of Cumberland_, u. s. [1304] John Clark, M.D., _Obs. on Fevers, and on the Scarlet Fever with Ulcerated Sore-Throat at Newcastle in 1778_. Lond. 1780; _Account of the Newcastle Dispensary from its commencement in 1777 to Michaelmas, 1789_. Newcastle, 1789 (also by Clark). [1305] James Sims, M.D. “Scarlatina Anginosa as it appeared in London in 1786.” _Mem. Med. Soc. Lond._ I. 388. Willan, however, says that measles was the epidemic in the winter and spring of 1785-86; while the epidemic at the Foundling Hospital was “measles” in March and April, 1786, “fever” in June and July, and “scarlet fever” in 1787. [1306] _On Cutaneous Diseases._ Vol. I. London, 1808, pp. 262, 277, 345. [1307] I Have Not Succeeded in Finding the Apothecary’s Book for the Years 1776-82, Within Which the Great London Epidemic of 1777-78 Fell; But Willan, Who May Have Had the Complete Set of Books Before Him, Says (_op. cit._ 1808, P. 245) “the Denomination ‘scarlet Fever and Sore-throat’ First Occurs in the Weekly Report, 1st September, 1787.” I am Indebted To the Courtesy of Mr Swift, M.R.C.S. for A Sight of the Books. [1308] J. Barker, _Epidemicks, Or General Observations on the Air and Diseases From The Year 1740 To 1777 Inclusive, and Particular Ones From That Time To the Beginning Of 1795_. Birmingham (no Date). [1309] _Lond. Med. Journ._ XI. 374. [1310] H. Rumsey, “Epidemic Sore-Throat at Chesham in 1788.” _Lond. Med. Journal_, X. 7, dated 14 Dec. 1788. [1311] H. Rumsey, “An Account of the Croup as it appeared in the Town and Neighbourhood of Chesham, in Buckinghamshire, in the years 1793 and 1794.” _Trans. of a Soc. for Improving Med. and Chirurg. Knowledge_, II. (1800),