Some account of the epidemic fever which prevailed in Liverpool, in the latter months of the year 1844 / by George Churchill Watson.

Date:
1846
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Licence: Public Domain Mark

Credit: Some account of the epidemic fever which prevailed in Liverpool, in the latter months of the year 1844 / by George Churchill Watson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    description of a malignant fever prevalent at Roudout, New York, in August and September, 1843, closely resembles that of the Scottish epidemic.” {Transac- tions of the Provincial Medical and Surgical Association, New Series, vol. i., page 17.) Dr. Cowan also draws attention to an admirable description by Dr. Dielt, of the epidemic of typhus, which ravaged the Austrian capital during the years 1842 and 1843. At the time of our own epidemic I had not read Dr. Cowan’s address, and therefore whatever degree of correspondence there is between these notices of epidemics elsewhere, which he quotes, and the observa- tions detailed here, will be received as valuable evidence of coincident observations derived from unbiased records. Dr. Dielt’s remark, that a red tongue seemed the index of the most favourable condition, and that a pale tongue was associated with a painful abdomen, I have not seen verified in our experience. Dr. Dielt noted the acute tuberculization of the lungs preceding or following the epidemic ; but he does not state whether such disease yielded more readily to treatment than in ordinary, a fact which some believe, and already quoted in this paper. Both the fever and the tuberculation appear to have had their more ordinary symptoms merged, so as to mask the presence of each. He considers that the fever gave an activity to latent tubercle, <and there is no doubt that rapid phthisis is not infrequently associated with fever, suddenly presenting the latter stages of this diseases when the stage of deposition of tubercle must often be traced back through the fever to an antecedent period. Another point dwelt upon by Dr. Dielt is, “that those enfeebled by anxiety, or deficient food, were very seldom affected.” This strikingly agrees with our observations here, and which was so general a truth, that I do not suppose there is a single practitioner who will not bear testimony to the fact. Before parting with Dr. Dielt, let me trespass on the reader by a final quotation from him, as referred to by Dr. Cowan, because it may find some corroboration in the statistics I have so very imperfectly tabulated. He states that “ a decided exacerbation of the epidemic was observed every third week, but in proportion as the cases were severe was their number diminished, as if the quantity of the poison remaining the same, its diffusion was subject to periodical contraction and expansion.” A paper, recording some of the effects of the mala- rious poison, can have little to do with its origin, although from my own scanty observations, I feel inclined most to accuse vegetable decomposition. There is an opportunity about to occur in this district, which, if well observed, might perhaps tend to throw some additional light upon the development, march, and modifying agency of miasmata. The locality at present healthy, and having the types, &c., of its present diseases marked carefully, will be shortly ob- noxious to the influence of marsh miasm, which may be accurately watched in its effects upon the sanitary constitution of the district, and the hilly character of the neighbouring ground will furnish currents and foci where its effects may be tracked out. This district will again become, some two or three years hence, changed in respect of originating malaria, and probably also become densely populated in the course of time by busy hives of beings dependent on the commercial activity which large dock-space creates. The mala- rious area will be partly covered by the water of the docks, and partly by the surrounding warehouses and tenements. In referring to the map, the reader will remark, on the Cheshire side of the River Mersey, a large body of water, called “ Wallasey Pool,” up which, for a considerable distance, the tidal waters of the river at present flow. New docks are in the course of construction upon this site, and as the tidal flow will be cut off by a sea-wall run across the mouth of the pool, a large space will not only be left divested of its periodic salt-water covering, but the depth of mud, accumulated for centuries, must be removed. It is genuine mud, not river silt, but a noxious deposit from half stagnant water, the amount of which, along with the subjacent rock and sand, has been estimated, at a rough guess, and from inspection of the plans and the works, which appear to be already completed, at from 1,500,000 to 2,000,000 cubic yards of excava- tion. Here may be presumed to be a fountain of intermittent fever, which will be unsealed for the first time in our neighbourhood, and then, if I may retain the figure, resealed, but not till it has told upon the excavators and surrounding population. If along with meteorological observations the medical practitioners of the districts of Birkenhead and Wallasey would note carefully the advance and progress of the endemic threatening their quarter, valuable data might be ob- tained bearing upon the etiology of ague, the exoteric periods of Dr. Laycock, and other important subjects of research. In reference to malarious agency, I have at present a patient, a lady, who whilst on a visit to a fen district, caught ague in one of its most severe forms, insomuch that her life was apprehended to be in great danger for a long time. After removal, she gradually recovered ; but though now enjoying ordinary health, yet at every catamenial period she gets a regularly formed quoti- dian fit, and then she has no more of it until the next period comes on. It is an interesting illustration of Dr. Laycock’s esoteric periodicity, or internal series of chronal changes. The ague influence also im- presses itself upon any catarrhal or other disoider. The antagonism of typhus and ague is partly borne out by the topography of our epidemic, which the map will exhibit; the usual fever district, where the typhus always “ has a home” in Liverpool, was not touched ]jy the epidemic, which visited the best sanitai j quarter of the township. This febrile epidemic appeared amongst a class so usually exempt from fever, that it excited no little surprise and alarm in a grade of society which as lai as this town is conerned, had been in the habit of con- gratulating themselves upon their own immunity from the pestilential visitant of the humbler walks of life. Though such privilege is not the case so remarkably in large and older cities, yet that it was enjoyed for many years by this class in Liverpool, the following quotation from the honoured pen of Dr. Currie will serve to prove:—“ In Liverpool it has been supposed that this disease (typhus,) is seldom to be met with, and it is certainly true, that the upper classes of the inhabitants are not often subject to its ravages. It has never, in the last sixteen years, spread among the higher classes so as to occasion any general alarm.”