Huxham says that it was in Cornwall and the west of Devon in February, 1733, and that at Plymouth, on the 10th of that month, some were suddenly seized: “the day after they fell down in multitudes, and on the 18th or 20th of March, scarce anyone had escaped it.”

Huxham is unusually full on the coughs and anginas of horses for several months before the influenza of men. In August, 1732, coughs were troubling some horses; in September, a coughing angina (called “the strangles”) everywhere among horses which almost suffocates most of them; in October the disease of horses is raging at its worst; and in December it is still among them.

The Influenza of 1737.

After several years, unhealthy in other ways, the influenza came again in the autumn of 1737. In Devonshire, according to Huxham, the horses began to suffer from cough and angina, and some of them to die, as early as January, 1737, the epizootic being mentioned again in February, but not subsequently. The same observer says the influenza began at Plymouth in November and lasted to the end of December, 1737, seizing almost everyone, and proving much more severe than the epidemic catarrhal febricula of 1733[627]. In London it must have begun in the end of August, to judge by the characteristic rise in the weekly bills, and in the item of “fevers” more especially; and although the deaths kept high for a longer period than in 1733, yet no single week of 1737 had much more than half the highest weekly mortality of the preceding influenza season.

London Weekly Mortalities.

1733

1737

In Dublin the worst week’s mortality in 1737, in the month of October, was 144, whereas in the influenza of 1733 the highest weekly bill had been only 98[628]. Hardly any particulars of the influenza of 1737 remain, although it appears to have been widely diffused, being recorded for Barbados and New England. The only source of English information is Huxham of Plymouth, who mentions some symptoms which should serve to characterize this outbreak, namely: violent swelling of the face, the parotids and maxillary glands, followed by an immense discharge of an exceedingly acrid pituita from the mouth and nose; toothache and, in some, hemicrania; “in multitudes,” wandering rheumatic pains; in others violent sciatics; in some griping of the bowels. Huxham makes one interesting statement: “This catarrhal fever has prevailed more or less for several winters past;” or, in other words, the interval between the severe influenza of 1733 and the milder influenza of 1737 was not altogether clear of the disease. He adds that it put on various forms, according to the different constitutions of those it attacked.

The Influenza of 1743.

Six years after, in 1743, came another influenza, which presents some interesting points. A writer in the Gentleman’s Magazine for May, 1743, says that the epidemic began in September last in Saxony, that it progressed to Milan, Genoa, and Venice, and to Florence and Rome, where it was called the Influenza; in February last (1743) no fewer than 80,000 were sick of it [? in Rome] and 500 buried in one day. At Messina it was suspected to be the forerunner of a plague—which did, indeed, ensue. It is now (May) in Spain, depopulating whole villages. The outbreak in Italy is authenticated by many notices collected by Corradi, Brescia having had the epidemic in October, 1742, Milan and Venice in November, Bologna in December, Rome, Pisa, Leghorn, Florence and Genoa in January, 1743, Naples and the Sicilian towns in February. The English troops, in cantonments near Brussels, were little touched by it when it reached that capital about the end of February, but, strangely enough, “many who in the preceding autumn had been seized with intermittents then relapsed[629].”

In London the epidemic appears to have begun in the end of March, and had trebled the deaths in the week ending 12th April; by the beginning of May it was practically over.

London Weekly Mortalities.

1743

The familiar view of the influenza in London is given in a letter by Horace Walpole from Arlington Street, 25 March, 1743[630]:

The account in the Gentleman’s Magazine confirms the vast shedding of blood: “In the last two months it visited almost every family in the city; so that the surgeons and all the phlebotomists had full employment. Bleeding, sweating and blistering were the remedies usually prescribed. All over the island it cut off old people. At Greenwich upwards of twenty hospital men and boys were buried in a night[631].” In Edinburgh, as in London, the weekly burials were trebled. On Sunday, May 6th, fifty sick persons were prayed for in the Edinburgh churches, and in the preceding week there had been seventy burials in the Greyfriars, being three times the usual number[632]. It reached Dublin in May, proving milder and less fatal than in London (perhaps that is why the writer in the Gentleman’s Magazine says it did not visit Ireland at all); it visited, also, the remote parts of Ulster and Munster, scarce sparing a family[633].

It had reached Plymouth in the end of April. Huxham, who is again the chief witness to its symptoms, says that it was much less severe there than in the south of Europe or even than in London.

Some Localized Influenzas and Horse-colds.

For the space of nineteen years, from 1743 to 1762, there occurred no universal cold common to all the countries of Europe; the convergence of positive testimony, which is so remarkable on many occasions from the 16th century onwards, is found on no occasion during that interval. And yet the period is not wanting in instructive notices of epidemic catarrh, which I shall take from English writings only. British troops occupied Minorca during some of those years, and the epidemics of the island were carefully noted by Cleghorn. Under the year 1748 he writes:

Another English epidemiographist, Hillary, who had begun his records at Ripon, was in those years resident in Barbados; and in that island, as in Minorca, we hear of unmistakeable universal colds, although none of them at the same time as the one recorded by Cleghorn. The Barbados annalist records a general catarrhous fever in September, 1752[637], and a recurrence of the same in the end of December, lasting until February 1753 (catarrh and coryza, cough, hoarseness, a great defluxion of rheum, some having fever with it). As it ceased in February, 1753, a slow nervous fever began, and continued epidemic for eighteen months, until September, 1784, when it totally disappeared, and was not seen again so long as Hillary remained in the island (1758). In 1755 there was another epidemic catarrhal fever, first in February and again in the end of the year. In the earlier outbreak, few escaped having more or less of it, the symptoms being cold ague for a few hours, followed by a hot fever with great pain in the head, or pains in the back and all over the body, which lasted two or three days, or longer, and then went off in some by a critical sweat. In the October outbreak it affected children mostly. Once more, in 1757, the same catarrhous fever returned, with almost the same circumstances[638]. That year there was a universal catarrh in North America.

Not less remarkable than the epidemic catarrhal fever in Minorca in 1748, or those in Barbados in 1752-3, 1755 and 1757, was the epidemic of 1758 in Scotland[639]. It was first noticed with east winds from the 16th to 20th September, several children having taken fever like a cold. In the last week of September thirty out of sixty boys at the Grammar School of Dalkeith were seized with it in two or three days. In October it became more general, among old and young, and increased till about the 24th, when it began to abate. In Edinburgh not one in six or seven escaped. It was in most parts of Scotland in October—Kirkaldy, St Andrews, Perthshire (where many died of it), Ayrshire, Glasgow, Aberdeenshire, Rossshire (end of October). A gentleman told Dr Whytt that in the Carse of Gowrie, in September, “before this disease was perceived, the horses were observed to be more than usually affected with a cold and a cough.”

The symptoms in Scotland were of the Protean kind of “influenza”: there might be fever with no cold; or a coryzal attack with little or no fever; or some had bleeding at the nose for several days, which might be profuse; or the soreness and pains in the bones might be in all parts of the body, or confined to the cheekbones, teeth and sides of the head. Others had a fever without any distinctive concomitant, but a cough when the fever subsided[640]. One of Whytt’s patients, a lady aged thirty, had been feverish for four days, when a scarlet rash appeared, but did not come fully out; the fall of the pulse and fever coincided with the beginning of a troublesome tickling cough, “so that the cough might be said to have been truly critical.” Those who exposed themselves too soon frequently relapsed. Few died of the disease, except some old people. “In some parts of the country, when the disease was not taken care of in the beginning, as being attended with no alarming symptoms, it assumed the form of a slow fever, which sometimes proved mortal.”

The year after the localised influenza of Scotland there was an epidemic of the same kind in Peru and Bolivia, that year, 1759, being one in which no universal fever or catarrh is reported from any other country. It extended from south to north, along the coast as well as over the high table-lands of Bolivia and the sierra region of Peru, invading, among others, the populous towns of Chuquisaca, Potosi, La Paz, Cuzco and Lima. In five or six days hardly one inhabitant of a place had escaped it, although some had it very slightly. As it was swift in its attack, so it was soon over, lasting about a month in each place. Its symptoms were great dizziness and heaviness of the head (vertigo and gravedo), feebleness of all the senses, deafness, strong pains over all the body, moderate fever, weariness, great prostration, complete loss of appetite, bleeding from the mouth and nostrils (this had been noted in Scotland the year before), and a long convalescence. Dogs shared the disorder, and might have been seen lying stretched out in the streets, unable to stand. It will be observed that the symptoms given do not include catarrh[641].

Before we come to the next general influenza in Britain, that of 1762, there are some facts to be mentioned as to agues and horse-colds in the interval since 1743. In Rutty’s Dublin chronology, agues are entered as prevalent in 1745. In 1750, about the middle or end of December, the most epidemic and universally spreading disease among horses that anyone living remembered made its appearance in Dublin, and in Ulster and Munster almost as soon. It had been in England in November, and was like that which preceded the universal catarrhs of mankind in 1737 and 1743. In 1751, irregular agues were frequent in March, as were also tumours of the face, jaws and throat. Agues also continued to be frequent in April, both in Dublin and in several parts of the country. In December, 1751, and January, 1752, there was another horse-cold, the same as a twelvemonth before. In 1754 the spring agues were frequent in Kilkenny and Carlow, though rare in Dublin. In 1757, “intermittent fevers, which had not appeared since April, 1746,” came in the end of February. In 1760, a great catarrh among horses became general in Dublin in April. Coughs and tumours about the fauces and throat, with a slight fever, often occurred in March; and regular intermittents, tertians or quotidians, were more frequent than for some years past. These, according to Sims, of Tyrone, abated after 1762, so that he had not seen an intermittent since 1764 until the date of his writing, 1773.

The horse-cold of 1760 was observed in London in January. The Annual Register says under date 27 Jan.: “A distemper which rages amongst horses makes great havock in and about town. Near a hundred died in one week.” In a letter a day later (28 Jan.) Horace Walpole writes: “All the horses in town are laid up with sore throats and colds, and are so hoarse you cannot hear them speak.... I have had a nervous fever these six or seven weeks every night, and have taken bark enough to have made a rind for Daphne[642].” This same horse-cold is reported from the Cleveland district of Yorkshire: “In February, [1760] horses were invaded by the most epidemic cold or catarrh that has ever happened in the remembrance of the oldest men living[643].” The same authority for Cleveland says that intermittents were frequent and obstinate in the spring of 1760.

Among these miscellanies of the history may be mentioned an outbreak of “violent pleuritic fever or peripneumene” in the spring of 1747, which was fatal to a comparatively large number in the parish of George Ham, North Devon. Thirteen died of it from the 20th to the 31st March, four in April, four in May, and one in June, “most of them in four or five days after the first seizure.” The same family names recur in the list[644].

The Influenza of 1762.

The universal slight fever or catarrhal fever of 1762 was, in London, much less mortal than those of 1733 and 1743.

London Weekly Mortalities.

1762

It began in London about the 4th of April, and by the 24th of that month “pervaded the whole city far and wide, scarcely sparing anyone.” It was in Edinburgh by the beginning of May, and in Dublin about the same time, but did not reach some parts of Cumberland until the end of June. Short, who was then living at Rotherham, says that it “continued most of the summer[645].” It had the usual variety of symptoms in the individual cases, of which only a few need be again particularized. Where the fever was sharp, it usually remitted during the day, having its exacerbation in the night. Sometimes it proved periodical, and of the tertian type: “it usually returned every night with an aggravation of the feverish symptoms” (Rutty). Perspiration was a constant symptom; the tongue was as if covered with cream (Baker repeats this figure of Huxham’s in 1743). “Depression of mind and failure of strength were in all cases much greater than was proportionate to the amount of disease. A great number of those affected were very slowly restored to health, languishing for months, and some even for a whole year with cough and feverishness—relics of the disease which it was difficult to shake off. Some, after struggling long with impaired health, fell victims to pulmonary consumption. In some there were pains in all the joints and in the head, with lassitude and vehement fever, but with little signs of catarrh.” Rutty, of Dublin, says that in some a measly efflorescence or a red rash was seen, attended by violent itching[646]. Among labourers in the country, the pestilence was so violent as to destroy many within four days, from complications of pneumonia, pleurisy and angina. Sometimes it took the form of a slow fever, “and approximated to that form of malady which the ancients denominated ‘cardiac’[647].”

The mortality is said to have varied much. White, of Manchester, declared that fewer died there than in ordinary while the epidemic lasted. On the other hand Offley, of Norwich, said there were more victims there than by the epidemic of 1733 “or by the more severe visitation called influenza in 1743”—the two visitations which were incomparably the worst in the whole history, according to the London bills. Baker says that it infested cities and the larger towns crowded with inhabitants earlier than the surrounding villages, and is inclined to think that it was mostly brought by persons coming from London[648].

The progress of this epidemic over Europe had been peculiar. It was seen in the end of February, 1762, at Breslau, where the deaths rose from 30 or 40 in a week to 150. It was in Vienna at the end of March, and in North Germany about the same time as in England—April and May. There were at that time British troops in Bremen, among whom the epidemic appeared shortly after the 10th April[649].

It is said to have been nowhere in France except in Strasburg and the rest of Alsace, in June. Baker says, “Whilst it raged everywhere else, it did not reach Paris or its vicinity, a fact which I learned from trustworthy persons.” On board British ships of war in the Mediterranean it occurred in July. Its severity appears to have varied greatly in different cities of the same country. Rutty, for Ireland, agrees with Baker, for England, that it was more fatal in the country than in the towns.

The Influenza of 1767.

The next influenza, that of 1767, was so unimportant that its existence in England would hardly have been known but for Dr Heberden’s paper, “The Epidemical Cold in June and July 1767[650].” Those few who were affected by a cold in London early in June observed that it differed from a common cold, and resembled the epidemical cold of the year 1762, on account of the great languor, feverishness, and loss of appetite. It became more common, was at its height in the last week of June or beginning of July, and before the end of July had entirely ceased. It was less epidemical and far less dangerous than the cold of 1762, so much so that the London bills of mortality hardly witness at all to its existence. The attack began with several chills; then came a troublesome and almost unceasing cough, very acute pains in the head, back, and abdomen under the left ribs, occasioning want of sleep. Many of the symptoms hung upon several for at least a week, and sometimes lasted a month. The fever might be great enough to bring on deliriousness, yet had plain remissions and intermissions. The same disorder was reported to be common about the same time in many other parts of England, and more fatal than it was in London. Heberden did not anticipate from it the lingering effects in the individual, for months or years, which marked so many of the cases in 1762[651].

The Influenza of 1775.

Heberden invited physicians in the provinces to send in accounts of the epidemic of June and July, 1767, but no one seems to have responded. However, the next epidemic catarrh, of November and December, 1775, was made the subject of many communications from all parts of Britain, in response to a circular drawn up by Dr John Fothergill. This was a distinctly catarrhal epidemic, running of the nose and eyes, cough and (or) diarrhoea, being commonly noted.

At Northampton some had “a severe pain in one side of the face, affecting the teeth and ears, and returning periodically at certain hours in the evening, or about midnight, attended with vertigo, delirium and limpid urine during the exacerbation. Some whose cases were complicated with the above symptoms had a general rash, but without its proving critical.... Many of those who escaped the catarrh have been more or less sensible of giddiness, or pains in the head or face,” with limpid urine, etc., as if they had a full attack[652]. The epidemic began in London about the 20th October, and made a slight impression upon the bills of mortality in some weeks of November and December[653]. Grant says that it lasted nearly five months in London, having been attended by the same “comatose” fever which Sydenham associated with the epidemic catarrh of 1675. The fatalities in Grant’s practice occurred late in the epidemic:

A Liverpool writer also says that the catarrh of 1782 “distinguished by the same title,” was a much slighter complaint than the “influenza” of 1775. The latter, however, was a summer epidemic, and was naturally less complicated with pneumonia and bronchitis, whatever the “comatose” fever of 1775 may have been. Grant’s statement that the influenza of 1775 lasted five months in London is borne out by the Foundling Hospital records: on 11 November, there were 16 in the Infirmary with “epidemic fever and cough,” next week 22 with “fevers, coughs and colds,” and so on week by week under the same names until the 9th of March, 1776[655]. At Dorchester it was general after 10th November; about the same time it was in Exeter, where within a week it seized all the inmates, but two children, in the Devon and Exeter Hospital, to the number of 173 persons. The middle of November is also the date of its decided outbreak at Birmingham, at Worcester, and at Chester, where Howard found the prisoners suffering from it. At York in the north, as at Blandford in the south, it is claimed to have begun earlier than in London. At Lancaster it was not seen until three weeks after the accounts of its prevalence in London began to come in, but only three days after it was first heard of in Liverpool. At Aberdeen it was fully a month later than in London. It did not visit Fraserburgh, though there was a putrid fever there very fatal at that time[656].

In many cases the disease assumed the type of an intermittent towards its decline, but bark was not useful (Fothergill, Ash, while Baker says that bark did good when the fever was spent). All the observers agree both as to its slight fatality and its universality. At Chester it attacked 73 out of 97 affluent persons, neighbours in the Abbey Square; at the Cross, inhabited by people in trade, 109 had the disease out of 144; in the House of Industry, not one escaped out of 175; it attacked people in the country rather later than in the town, and less generally, but it was in villages and even in solitary houses.

The unusual prevalence of catarrh among horses (and dogs) is asserted by John Fothergill (“during this time”), Cuming (“after the middle of August very generally in Yorkshire”), Glass (in September), Haygarth (in North Wales, about August and September), Pulteney (“before we heard of it among the human race”). The fullest statement is by Dr Anthony Fothergill, of Northampton:

The progress of influenza from other countries towards Britain was so much a matter of rumour or vague statement in the earlier periods that it has not seemed worth while to make a point of it under each epidemic. It happens, however, that there is good evidence of the line of progress of the epidemic of 1775. The afterwards celebrated Professor Gregory, of Edinburgh, encountered it in Italy in the autumn, and followed it all the way home to Scotland. He saw it successively in Genoa, in the south of France, in the north of France, in London, and last of all in Edinburgh, where he himself at length fell ill with it, several of his travelling companions having taken it in Italy two or three months before. In his lectures long after (as reported by Christison, who heard them about 1817) he traced the influenza of 1775 from south to north: “It appears to have broken out somewhere on the north and west coast of Africa, whence it spread not only north into Europe, but likewise eastward to Arabia, Egypt, Syria, Palestine, Asia Minor, Hindostan, China, and was ascertained to have spread over the whole immense empire of the Chinese. From China it returned westward by a northern route through the extensive dominions of Russia and from that country it was sent again over Europe in 1782[658].”

The Influenza of 1782.

Seven years after, in the early summer of 1782, there came another swift and brief wave of catarrhal fevers over England, Scotland and Ireland, in the midst of a great “constitution” of epidemic agues which continued for several years. This was the occasion when the Italian name of “influenza” was formally adopted by the College of Physicians. Perhaps the first appearance of the name in English was in an account of the epidemic in Italy in 1729, given by a London periodical devoted to political news from foreign countries, and called, “The Political State of Great Britain[659].” In 1743 the news of the Italian epidemic under its native name reached London before the infection itself, the Italian name being frequently given to it while it lasted that season in England. When the next epidemic came, in 1762, it was not called the influenza as a matter of course, but was compared to the disease in 1743 “called the influenza.” In the epidemic of 1775, “influenza” came more into use, and in 1782 it was the name usually given to the epidemic malady. The adoption of this name put an end at length to the ambiguity between epidemic agues and influenzas, leaving the curious correspondences between them in time and place, or the nosological affinities between them, as interesting as ever.

As late as the very fatal aguish years 1727-29, there was no clear separation of the epidemic agues from the influenzas, of which latter there were two or more, the one in the end of 1729 being easy to identify. In the great aguish constitution of 1678-81, Sydenham distinguished the epidemic coughs and catarrhs in Nov. 1679; but Morley made no such distinction, describing the whole series of agues for two seasons (and he might have done so for two seasons more) as the “new fever,” “new ague,” or “new delight,” as in Derbyshire, without a suspicion that the universal coughs, catarrhs and fevers in November, 1679, were something nosologically distinct, which the future would identify as “influenza.” In like manner Whitmore, in the great aguish period immediately preceding, that of 1658-59, had described the “new disease” as one single Proteus. In the still earlier epidemic seasons of 1557-58 and 1580-82, everything was “ague,” although we now discover influenza mixed therewith. I do not say that this inclusive naming was the better scientifically; nor do I uphold Willis and Sydenham in their teaching that the intermittent constitution passed into the catarrhal, in 1658 and 1679 respectively. But it is necessary to bear in mind the matter of fact, namely, that those agues, amidst which the “great colds” occurred, were epidemic agues, and not the endemic fevers of malarious places; and I have now to show that the “influenza” of 1782 was in like manner a brief episode in the midst of several successive seasons of agues, which were as much “new” or “strange” as any of those in the earlier history. Whether the epidemic agues of 1780-85 were the last of the kind in Britain had better be left an open question until our most recent and most strange experiences in 1890-93 are read in the light of history.

The influenza of 1782 was a very definite incident of a few weeks—teres atque rotundus. It is easily discoverable in the weekly bills of mortality in London to have fallen in the month of June:

London Weekly Mortalities.

1782

The sudden rise and fall of the deaths and the height reached are much the same as in other such epidemics in the summer—the “gentle correction” of 1580, the “transient slight fever” of 1688, and the epidemic catarrh of 1762. On the other hand the epidemics of autumn, winter or spring in 1729, 1733, 1737 and 1743 were far more severe, while the winter epidemics of 1675 and 1679 had figures almost the same as the summer epidemics.

The influenza of 1782 was not remarkable, whether in its fatality or in its characters; but it received far more attention than any that had preceded it. Two collective inquiries were held upon it, one by a Society for promoting Medical Knowledge[660], the other by a committee of the College of Physicians of London[661], many physicians all over England, Scotland and Ireland contributing to one or other. There were also three or more separate essays[662].

The epidemic appeared in 1782 at Newcastle in the end of April, and raged there all May and part of June. In London it appeared between the 12th and 18th of May, in the Eastern Counties about the middle of May, in Surrey and at Portsmouth, Oxford and Edinburgh, also about the third week of May, but not in Musselburgh until the 9th or 10th of June. It was at Chester on the 26th of May, at Plymouth on the 30th, at Ipswich, Yarmouth, York, Liverpool and Glasgow in the first week of June. In Northumberland it was raging in July, and did not cease until the third week of August. In Scotland it was at a height in July, during the haymaking[663]. The most curious fact in its incidence comes from North Devon; it was prevalent in Barnstaple at the usual time, the month of June; but the neighbouring town of Torrington was not then affected by it, having previously gone through the epidemic, it is said, from a date as early as the 24th of March[664]. In all places it spread quickly, affecting from three-fourths to four-fifths of the adult inhabitants, but children not so much. At Christ’s Hospital, London, only fourteen out of seven hundred boys had it. Wherever it attacked children, it did so mildly. It lasted under six weeks in each place that it came to. There were some strange attacks of it in London in September, “two months after the late epidemical catarrh had entirely disappeared from England.” The king’s ships ‘Convert’ and ‘Lizard’ arrived in the Thames from the West Indies in September. Their crews were perfectly healthy till they reached Gravesend, where they took on board three custom-house officers; and in a very few hours after that the influenza began to make its appearance. Hardly a man in either ship escaped it; and many both of the officers and common seamen had it in a severe degree[665]. Others who came to London from the West Indies in merchantmen in the end of September were attacked by influenza in their lodgings in the beginning of October[666]. To this epidemic belong also the strange experiences of the Channel Fleet in its two divisions under Howe and Kempenfelt; but I postpone for the present the whole question of influenza at sea.

Gray thus sums up the great variety of symptoms as related by his numerous correspondents: