Typhus in the Day of Jane Austen (1775-1817)

Typhus is an infectious disease caused by rickettsiae that can be transmitted by lice, ticks, mites, or rat fleas and is caused by certain types of bacterial infection. It usually causes flu-like symptoms that result in headache and fever, sometimes accompanied by delirium. The characteristics of the disease were further explained in a health column written in the nineteenth century by F.A.J. de Conde:

“The appearance of typhus is very characteristic, and to a practised eye is unmistakable. The sufferer lies prostrate on his back, very much like on recovering from the effects of extreme intoxication. When the attack is a severe one the sufferer lies quite helpless, moaning, with eyes closed, and too prostrate to answer a question or even to move without assistance. Thirst is a constant symptom of typhus … the rash of typhus fever, which is quite different from that of measles or scarlet fever, usually makes it appearance about the fourth or fifth day. It comes out first on the back of the wrists, and about the arm-pits and navel, but it soon covers the whole body. The rash has two distinctive appearances. One is a faint, irregular, dusky-red mottling, which appears to be some distance below the surface; the other is formed of separate spots of small size and purplish colour scatter over the mottle surface … the temperature rises rapidly in this disease often reaching on the evening of the first day 103°, rising till about the third day, when it reaches 106° or more. … A fall of the temperature on the fifth or sixth days is a favourable symptom … Often, however, an uncomplicated case of typhus ends in 12 or 14 days. The death rate in typhus fever is about 10 percent of those attacked, and among children it is as low as 5 per cent.”[1]

Typhus was often called by other names. For instance, in the sixteenth, seventeenth, and eighteenth centuries it was often referred to by its symptoms and therefore known as “brain fever,” “fever of the spirits,” or “miliary fever.” By the seventeenth and eighteenth centuries when it became common in jails and prisons it was referred to as “gaol fever” or “jail fever” and when soldiers and sailors experienced it, they called it “ship’s fever,” “camp fever,” or “war fever.”

During Jane Austen’s time there were many people who died from typhus. For instance, in 1781, an outbreak occurred in the cathedral city of Carlisle in North West England. A Dr. John Heysham then wrote a 58-page pamphlet describing the outbreak there and stated that the population of Carlisle in 1780 was 6299 inhabitants. Over the course of 8 months (May through December) he reported that 52 people died from typhus.

He also noted that of those who died in Carlisle, “three were boys; three were bachelors; fifteen where husbands; three were girls; two were maids, twenty-one were wives; and five were widows; so that above two thirds of those who died were married people.”[2] In addition, Heysham maintained:

“This Fever chiefly, I may almost say entirely, raged amongst the common and lower ranks of people; and more especially amongst those who live in narrow, close, confined lanes, and in small crowded apartments. It affected adults more frequently than children, the infirm, than the robust, women than men, and the married were more subject to it than the single.”[3]

As to how the disease progressed among Carlisle victims, Heysham reported:

“[T]he patient is confined entirely to his bed, on the second, third, or sometimes on the beginning of the fourth day … [there is] the first accession of the cold shivering fit. Almost all the symptoms now increase. The pain of the head because acute; … the appetite is totally gone; the thirst increases; a tremor of the hand supervenes; the tongue become gradually dry, and brown, and when thrust out of the mouth for examination is unsteady and tremulous; the skin continues dry; the urine pale and without sediment; the pulse becomes more frequent and feeble … The patient talks some what incoherently, yet knows his friends, and will answer questions with tolerable distinctness. In this situation he continues six, seven, eight, nine, ten, and or eleven days, and from which, if the symptoms do not increase, he gradually recovers. The acute pain of the head abates; the thirst is more moderate; the urine becomes higher coloured … the pulse gets down gradually …the patient, tho’ he has no great desire for food, yet is able to take a little when presented to him; and lastly, his strength is restored by slow degrees.”[4]

Carlisle wasn’t the only spot where typhus broke out. It also became a problem in Southampton in 1783. Mrs. Cooper, a relative to Jane Austen’s mother,* decided to send her daughter, 11-year-old Jane Cooper to boarding school. The school was run by her husband’s widowed sister, Mrs. Ann Crawley, a stiff mannered but well-respected person who had been married to the principal of Brasenose College. While attending Mrs. Crawley’s boarding school, Mrs. Cooper wanted to ensure that her daughter Jane had companionship. She therefore encouraged Mrs. Austen to send 10-year-old Cassandra. However, 7-year-old Jane also wanted to go and although Mrs. Austen initially hesitated, she became convinced to send her younger daughter too.

Originally the boarding school was in Oxford but when measles broke out Mrs. Crawley relocated her school to Southampton. The girls moved with her and everything seemed okay until August of 1783. At that time returning troops from Gibraltar arrived in Southampton and brought typhus with them “as a result of their sea voyage in cramped and insanitary conditions; within a few weeks the town’s death-rate showed an alarming rise.”[5]

All three girls caught the disease. Mrs. Crawley did not seem to think it was serious enough to inform the girl’s mothers. Fortunately, Jane Cooper wrote to her mother telling her about the outbreak. Mrs. Cooper then wrote to Mrs. Austen and both mothers went and picked up their daughters. The older girls suffered less than 7-year-old Jane, who became seriously ill. In fact, Jane nearly died, and it took a year for her to recover. Mrs. Cooper also caught the fever, but in her case, she was not as lucky as Jane as she did not survive. She passed away in Bath on 25 October 1783, and her heart-broken husband buried her at the Whaddon church a few days later.

As noted, soldiers and sailors of these times were particularly susceptible to typhus because of the close quarters they shared with one another. This susceptibility was mentioned by authors Kenneth F. Kiple and Kriemhild Conèe Ornelas in their 1997 article titled, “Typhus, Ships and Soldiers.” According to them:

“Body lice depend on humans to shelter them and their eggs in their clothing, warm them with their bodies, and feed them with their blood – all reasons why heaven for the little creatures historically has consisted of soldiers, or sailors, crowded together in cold weather, wearing a considerable amount of clothing but with little opportunity for changing. Such conditions are also ideal for the spread of typhus pathogens.”[6]  

Of those soldiers who experienced problems with typhus Napoleon Bonaparte’s troops were some of the worse affected (you can read more here). Difficulties with typhus began in 1812 during Napoleon’s Russian campaign and the disease altered history.

“Napoleon’s close to half a million soldiers marched into Russia to collide with typhus as well as the Russians. The French bad luck against the disease held, and, after the battle of Ostrowo, typhus had taken such a heavy toll as to force a retreat from Moscow. When this got underway in October 1812, only 80,000 men (less than 20 percent of those who had entered Russia) were fit for duty. Only 6,000 made it back and Napoleon’s career of conquest was at an end.”[7]

Typhus also caused a great problem for the Irish. It all began in the year of 1816, which was also called “the year without a summer” because of the massive volcanic eruption of Mount Tambora in April 1815 in the Dutch East Indies. The eruption caused severe climate abnormalities resulting in average global temperatures decreasing by 0.4–0.7 C (0.72–1.26 F), which thereby created major food shortages across the Northern Hemisphere.

The year without a summer was also the same year when Ireland suffered a major typhus epidemic. There typhus was known as the “Irish ague” and mortality during the crises was estimated “at 44,000 by Harty [author in 1820 of An Historic Sketch of the Progress, Extent and Mortality of the Contagious Fever Epidemic During the Years 1817, 1818 and 1819] and at 65,000 by Barker and Cheyne, two Dublin medical men charged with public health at the time.”[8] Moreover, the outbreak primarily affected Ireland’s poor and happened during miserable weather. The disease also “remained endemic until 1819, peaking in the summer of 1818.”[9]

A Treatiste on the Continued Fevers of Great Britain by Charles Murchison, a British physician and a noted authority on fevers and diseases of the liver, was published in 1873. He gave more details about the effect of weather in Ireland and the surrounding areas during 1816 to 1819, when typhus raged.

“In February of 1816, the thermometer, in London, fell one day to five degrees below zero of Fahrenheit, and during four days it never rose to freezing point. In Ireland, the temperature was not so low; but even there the cold during the winter and spring of 1815-16 was unusually severe. … The winter of 1815-16 was followed by a cold and wet summer and autumn, and in Ireland there was a complete failure of the harvest and of the potato crop. In the neighbourhood of Edinburgh the crops were still quite green at the beginning of September. The harvest of the following year was no better. In September 1817, the thermometer in Ireland, fell suddenly from 75° to 30°, and the cold completely destroyed the potato crop and the late oats: in the month of December, sheaves of corn might be seen rotting upon the ground. Owing to the wet seasons also, the turf or peat, the chief fuel of the poor in Ireland, could not be cut or dried for use. … As always happens under such circumstances, many of the working classes were thrown out of employment … Extreme distress ensued.”[10]

Various methods to cure typhus were used when the disease broke out. For instance, typhus was sometimes treated with “stimulants,” meaning that alcohol was administered “indiscriminately,” and, of course, “injudiciously.” Heysham chose the alcohol method for his Carlisle patients reporting that he treated “all his patients with bark and plenty of port wine.”[11]

In Edinburgh and in Ireland, they chose a different approach. Rather than relying on alcohol they relied on bloodletting and leeches. The believed these methods were a much more effective way to care for typhus patients. In fact, bloodletting was embraced so much a Dr. Stoke of Ireland recalled:

“I remember when I was a student of the old Meath Hospital, there was hardly a morning that some twenty or thirty unfortunate creatures were not phlebotomized largely. The floor was running with blood; it was difficult to cross the prescribing hall for fear of slipping. Patients were seen wallowing in their own blood like leeches after a salt emetic. ‘Bleeding,’ wrote Dr. Sandwich, of Bridlington, ‘was by far the most efficacious agent in the treatment [of typhus]; in all cases in which recovery took place without bleeding, it was to be regarded as an escape rather than a cure.’”[12]

Another method that was often embraced to fight typhus was fumigation. The Kentish Weekly Post or Canterbury Journal reported in 1817:

“A pennyworth of salt and a pennyworth of vitriol [a poison used by the Widow Gras] would always operate as a preventive, by being applied as a fumigation, a little nitre and a little sulphur would answer the same purpose.”[13]  

Although Jane Austen and many others survived typhus, not everyone did. In fact, there were several well-known people who died from the disease. Among them were Jean-Antoine Marbot, a French general and politician. He died during the Austrian siege of Genoa on 19 April 1800 because of his wounds and typhus. In addition, the English artist John Russell died on 20 April 1806 from the disease. He was renowned for his oil and pastel portraits of the 1700 and 1800s. Another victim of typhus was 68-year-old Benjamin Rush, a signer of the United States Declaration of Independence and a civic leader in Philadelphia, where he worked as a physician, politician, social reformer, humanitarian, and educator. He died on 19 April 1813 and was buried next to his wife in the Christ Church Burial Ground in Philadelphia, not far from where Benjamin Franklin was buried.

After Jane Austen’s time, typhus continued to kill. For instance, in America, during the American Civil War although typhoid fever might have killed more people, typhus was a prevalent cause of U.S. Civil War “camp fever.” The disease also struck during World I, killing three million in Russia and even more in Poland and Romania. It struck again in World II, resulting in thousands of soldiers dying. Moreover, despite a vaccine being developed during World War II, typhus epidemics still break out day and they are still a major focus of research and a continuing worry for today’s homeless populations.

—
*Mrs. Cooper’s brother was married to Mrs. Austen’s sister.

References:

• [1] Otaga Witness, “Health Column,” July 28, 1883, p. 28.
• [2] J. Heysham, An Account of the Jail Fever: Or Typhus Carcerum: as it Appeared at Carlisle in the Year 1781. By John Heysham, An Account of the Jail Fever: Or Typhus Carcerum: as it Appeared at Carlisle in the Year 1781. By John Heysham (London: T. Cadell, J. Murray, R. Faulder, and J. Milliken, 1782), p. 3.
• [3] Ibid., p. 5.
• [4] Ibid., p. 9–11.
• [5] D. Le Faye, W. Austen-Leigh and R. A. Austen-Leigh, Jane Austen: A Family Record (Cambridge: Cambridge University Press, 2004), p. 48–49.
• [6] K. F. Kiple, ed., Plauge, Pox & Pestilence (London: Weidenfeld & Nicholson, 1997), p. 104.
• [7] Ibid., p. 107.
• [8] C. Ó’Gráda, The Great Irish Famine, New Studies in Economic and Social History (Dublin: Cambridge University Press, 1995), p. 13.
• [9] Ibid., p. 13.
• [10] C. Murchison, A Treatise on the Continued Fevers of Great Britain (London: Longmans, Green, 1873), p. 39.
• [11] Ibid., p. 36.
• [12] Ibid., p. 42.
• [13] Kentish Weekly Post or Canterbury Journal, “Contagious Fever,” November 25, 1817, p. 4.