102 TYPHUS FEVER 



regarded as the most desirable residence city in the kingdom. Within 

 the walls, it had a population of about 3,500 and from 1764-1773 the 

 death rate was only 17.2 per 1,000, but the poor lived outside the walls 

 and Haygarth describes the condition as follows : 



The houses were small, close, crowded and dirty, ill supplied with water, 

 undrained, and built on ground that received the sewage from within the 

 walls. The people were ill-fed and they seldom changed or washed their 

 clothes; when they went abroad they were noisome and offensive to the smell. 

 ... In these poor habitations when one person was seized with the fever, 

 others of the same family are generally affected with the same fever in a 

 greater or lesser degree. 



The second half of the eighteenth century saw the great manu- 

 facturing development of England by the employment of machinery. 

 Now the poor were exploited by the manufacturer. The houses occu- 

 pied by the operatives are said by Ferrier to have been dirty, without 

 ventilation, and with the beds almost touching. "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 conse- 

 quences of breathing infected air." The only voices heard in behalf 

 of the poor were those of medical men, and in Manchester Ferrier 

 pleaded for them in strong language : 



I have seen patients in agonies of despair on finding themselves over- 

 whelmed with filth and abandoned by everyone who could do them any service. 

 . . . The situation of the poor at present is extremely dangerous, and often 

 destructive to the middle and higher ranks of society. . . . The poor are 

 indeed the first sufferers, but the mischief does not always rest with them. By 

 secret avenues it reaches the most opulent and severely revenges their neglect 

 or insensibility to the wretchedness surrounding them. 



It was the fact that typhus occasionally found its way into the 

 midst of the rich, and, when it did, killed so many and so quickly, 

 that they were compelled to recognize that the misfortunes of the poor 

 were of concern to themselves. Finally in a half-hearted way, urged 

 by physicians, growling about the wastefulness and improvidence of 

 the laboring classes, driven by the occasional deadly outbreaks in their 

 own ranks, the ruling classes began to provide special hospitals for the 

 isolation and care of cases of typhus. The London fever hospital 

 was established in 1802. 



