Jo Innes: A Fever and a Familiar Past – Where Typhus and COVID-19 Overlap

A Fever and a Familiar Past: Where Typhus and COVID-19 Overlap

Professor Jo Innes looks back to an 1801 typhus outbreak in the small Bedfordshire village of Langford. She finds there some golden precepts of public health that remain as vital today as they did more than two hundred years ago…

Until relatively late in the eighteenth century, ‘fevers’ were accepted as a fact of life, as part of the natural cycle.

The experience of the coronavirus pandemic has, for many of us, been punctuated by the awful novelty of post-lockdown life. Social distancing, hygiene, contact tracing: these measures can seem onerous and confusing. But they have long histories – histories from which we can, perhaps, draw instructive analogies.

With this thought in mind, I recently revisited some material I had collected on a typhus epidemic in the Bedfordshire village of Langford in 1801. I was particularly interested in looking at the methods employed by a local magistrate and doctor to handle the crisis.

Until relatively late in the eighteenth century, ‘fevers’ – not then distinguished into different diseases – were accepted as a natural fact of life. Gradually, however, it came to be thought that institutions where disease flourished, such as prisons and factories, could be organised so as to reduce infections; then that the same approach could be extended into the community. A newly expanded army made a perfect testing ground for novel approaches to reducing disease such as improved hygiene and sanitation, with added impetus provided by the rising frequency of typhus epidemics that accompanied increased industrialisation.

On to Bedfordshire in 1801. That year saw yet another terrible harvest, and, predictably, a fever epidemic. The papers relating to Langford’s experience can be found in the archive of Samuel Whitbread, at the time a major local landowner, a magistrate, and an MP. Whitbread was a fiery radical, sympathetic to the French Revolution, who had even tried to get minimum-wage legislation passed

The Windmill fixed on Newgate Prison to work the ventilators that would, it was hoped, remove diseasebearing vapours

during harvest crises in 1795 and 1801. He was also a member of the Society for Bettering the Condition of the Poor, founded in 1798, whose newsletter encouraged supporters to implement new initiatives in their neighbourhoods – including new approaches to fever.

Hearing that there was fever in Langford, Whitbread stretched his authority to the limit and invoked a 1790 law passed by his

father (a Tory MP and fellow welfare activist) authorising magistrates to inspect parish workhouses. There, he found a woman (later named as Mary Sack) sick with fever and sleeping on the floor of a room full of noisy young children, lacking clothes or bedding. He ordered the parish officers not only to overhaul the workhouse, but also to establish a separate, properly equipped place to house the sick, since (he said) unless the fever was vigorously dealt with, many more would succumb – the same principle underlying selfisolation today.

And like today’s governments, he drew on expertise. He told the parish to consult an ambitious young Bedford medical man, Floridaborn Grant David Yeats. Dr Yeats paid many visits to the parish, attending on different patients and issuing general directions. ‘By examination not a little tedious’ he was able to carry out a rudimentary form of contact tracing, pinpointing the origins of the sickness to a local labourer who had been ploughing in a swampy field in August and had fallen sick. His next-door neighbour, ditching in the same field, fell sick too, as did another neighbour who came to visit the ploughman, from which it spread to her ‘numerous family crowded in one dark small room where they eat and sleep and together cook their victuals’ and then to a neighbour who came to visit her, and to his family, and thence it became general.

Dr Yeats told parish officers to clean houses where there had been fever, and to tell the inhabitants thenceforth to keep them clean and ventilated; he prescribed it as a rule that ‘no stranger … be admitted into any cottage where the fever has prevailed to any degree until the cottage be cleaned.’ Meanwhile, he directed that a barn be converted into a ‘house of recovery’, where the sick could be properly cared for. ‘It required not a little management at first to persuade the patients to come into the house, so much prejudice existed against it,’ but when it was seen that the sick were maintained in comfort and ease, this did away with prejudices and false notions, and smoothed the way for the reception of others.

The measures must have been effective. By the beginning of January, ‘the spreading of the contagion [had been] arrested.’

There is much we can relate to here. Yes, coronavirus is not typhus. Yes, understandings, resources and technologies change. And yet look at what endures: a professional commitment to managing the epidemic; a recognition of the need for communication and public trust; and the acceptance that small, simple measures upheld throughout the community can make all the difference.

These are lessons we are learning anew two centuries later. In that there is some comfort – as well as some room, perhaps, for progress.

‘By examination not a little tedious’ he was able to carry out a rudimementary form of contact tracing.

Below left:Samuel Whitbread II by John Opie

Right:A later exercise in analysing disease: Henry Acland’s map of places badly affected by ‘fever’ and cholera in Oxford 1830s-50s. The site of Somerville wasn’t badly affected, but the area around Observatory Street and Plantation Road was.