«Air, Climate, Season, … Situation, Food, Poisons, and a few other Things»: the lexis of fevers and epidemics in British medical writing, 1770–1800
From Firenze University Press Journal: Diciottesimo Secolo
Elisabetta Lonati, Università degli Studi del Piemonte Orientale
The general term fever represents one of the most widespread, interesting, and controversial events in the medical history of humanity, whether endemic or epidemic. It was used for a variety of febrile phenomena and epidemic outbreaks (e.g. epidemic fever/s), and was associated with more or less severe, persistent, and recurring illnesses, disorders, distempers, or affections. The very use of these alternative lexemes highlight the vagueness — or the complexity — of the linguistic and extra-linguistic reality called fever/s.
Fevers were a very frequent experience, an endemic companion in eighteenth-century everyday life, in the expanding towns, in the country, in confined places, or in unhealthy environments in general. Fevers could be scaring and violent, or mild and more easily curable, «a very frequent Disorder, inseparably attended with an Inflammation, the Cause not only of many Diseases and Death, but, also, frequently of an happy and successful Cure».
On the one hand, they were associated with the most malignant and dangerous events, and with degenerating processes, usually deadly (e.g. malignant, pestilential, putrid, bilious, etc.). On the other hand, they were perceived as ordinary affections whose development and outcome could be either completely positive, or suddenly worsen (e.g. fever and sore-throat). Fevers could be considered as diseases in themselves, or as symptomatic manifestations of other dis eases (e.g. symptomatic fever), they could affect many people at once as epidemic outbreaks by either contagion or infection, or be confined to a more limited number of patients, and due to localised inflammation, or other causes.
The lexicographic treatment of fever makes the manifold interpretations and disciplinary perspectives, and the many traditional or contemporary medi-cal approaches to this phenomenon, emerge. S. Johnson defines it as a «disease in which the body is violently heated»; B. Martin as a «distemper accompanied with great heat»; whereas the Encyclopaedia Britannica, tracing back to Dr. Hoffman and encompassing Dr. W. Cullen’s approach, defines it to be «a spasmodic affection of the whole nervous and vascular system, annoying all the functions of the body», and A. Rees refers to fever as «a disease, or rather a class of diseases, whose characteristic is a preternatural heat felt through the whole body».
A disease, a distemper, a spasmodic affection, a class of dis-eases not only emphasise the difficulty to distinctly or unambiguously denote reality at the time, since many new approaches and observations were put forward, but also the fluid and encompassing experience eighteenth-century physicians and practitioners, and the lay people as well, had to face. Fevers, and epidemic fevers especially, became the focus of attention of local administrators and the nation al government: ever new plans were envisaged to prevent epidemics (and their frequent transition to endemicity), but also to deal with them when occurring, to sanitise the urban environment, to provide recovery buildings and ‘fever beds’ for the most indigent people, and to establish strict behaviour rules in public places (e.g. hos-pitals, recovery buildings, prisons) or in private dwellings (e.g. basic hygienic conditions, ventilation, window light).
The expanding pre-industrial towns, in particular, were often ravaged by epidemic emergencies. Narrow streets, lack of sewers, waste and filth, created the con-texts in which fevers and disease easily spread:
old houses with very small rooms, into each of which four or more people were crowded to eat, sleep, and frequently to work. They commonly bore marks of a long accumulation of filth, and some of them had been scarcely free from infection for many years past. As soon as one poor creature dies or is driven out of his cell he is replaced by another, generally from the country, who soon feels in his turn the consequences of breathing infected air. There was hardly any ventilation possible, many of these old houses being in dark narrow courts or blind alleys.
Prevention, cure, and healthcare were a key issue in hospitals, infirmaries, and dispensaries, for the lowest ranks first, and, as a consequence, for society as a whole. The welfare and the comfort of the poor, their good health, and their living conditions, were perceived as a primary goal. Philanthropic and charity institutions were established to alleviate wretchedness and suffering for the poor (e.g. industrious people, working poor, labouring people), and to provide those health services which will constitute the basics of the forthcoming pub-lic healthcare system.
This attention to poverty and the practical issues promoted at the time also represent-ed the effort of the higher ranks (i.e. the wealthy or the rich) to preserve themselves. On the one hand, the urban environment physically marked the separation between the elite and the rest of the population, the «quarters of the rich had gradually become detached from those of the poor»16; on the other hand, the marginalised poor were those labourers that guaranteed wealth and rich-ness to the higher ranks, and the nation.The following sections investigate the two key terms fever/s and epidemic/s, their occurrence and contemporary usage in a set of writings, and their strict connections with related terms and fields of wider socio-historical interest.
Read Full Text: https://oajournals.fupress.net/index.php/ds/article/view/12593