Tuesday, February 16, 2016

Flu Season in Jane Austen's Time

By Lauren Gilbert

Recovery from Sickness, An Allegory by Sir Joshua Reynolds

Here we are in the depths of winter.  We all know someone who has it, has recovered from it, or is trying hard not to get it.  What might “it” be?  That miserable cold, the awful flu, whatever it is that is going around.  Interestingly enough, it was all going around in Jane Austen’s time, too.  However, the seriousness of the winter ailments and their effects in the late 18th and early 19th century is frequently forgotten or overlooked today.

In the early part of the 19th century, medicine had improved dramatically.  Superstition was waning - people no longer believed that the ruler’s touch could heal a form of tubercular infection called scrofula (or “King’s Evil”).  Bathing was becoming more common.  Vaccination with the cowpox vaccine was making inroads on that dreaded scourge, smallpox.  However, bleeding, laudanum and bathing in or drinking spa waters were still standby treatments for many illnesses.

Two of the winter ailments in Jane Austen’s time were the “epidemic cold” and the “putrid sore throat.”  The epidemic cold appears to be basically the same as it is today; a virus resulting in sneezing, sore throat, coughing, slight fever, and so forth.  It would appear that the standard treatment was staying in, keeping warm, and getting plenty of rest, as it is today.  (It must be noted that, in Miss Austen's time, the stricture to get plenty of rest would have been reinforced with a few drops of laudanum, if necessary!) 

The second ailment, the “putrid sore throat,” was much more serious, indeed life threatening.  This term appears to cover a variety of ailments, all manifesting in the throat.  At its most basic, a putrid sore throat seems to be a sore throat complicated by serious infection resulting in any or all of these: accumulation of pus, ulceration and sloughing of soft tissue at the back of the throat, and even gangrene.  In trying to identify this illness with modern diseases, it has been linked to tonsillitis, diphtheria, bronchitis, and even a form of streptococcal throat infection, as well as scarlatina or scarlet fever, and possibly measles.  Obviously, this would be a very painful condition.  

Scarlet fever, measles, diphtheria, and strep are also quite contagious.  It is also worth noting that all of these conditions frequently resulted in death or disability, such as damage to the heart.   While most are considered childhood diseases, adults can also contract these illnesses.  Lacking knowledge of germs, bacteria and other microorganisms, as well as the issues of sepsis, these conditions could sweep through a household (or a neighborhood), creating havoc if not outright death. 

Diphtheria produces fever and weakness, and causes the formation of a thick gray membrane in the throat, causing difficulty breathing and swallowing.  Scarlet fever and scarlatina result from infection with type A strep bacteria, and are characterized by a fever, sore throat, and a bright red rash; there is also flushing from high fever.  Tonsillitis is the inflammation of tonsils resulting from infection by a virus or bacteria, with symptoms including fever and sore throat; if the result of a bacterial infection, this can be contagious.  Measles also manifest with fever, sore throat, a rash. 

Treatment of illness and high fevers included blisters (which literally raised blisters on the head or other part of the body where applied), broths made of various materials (some harmless, some not), poultices, patent medicines of questionable value and homemade remedies.  Mercury and other toxic substances were considered medicinal and may have been included in many concoctions. CULPEPER'S COMPLETE HERBAL AND ENGLISH PHYSICIAN included many herbs with medicinal properties.  

Willow was considered cooling and a tea made of willow bark was used for fever.  Sorrel was also cooling, useful for skin conditions (including itching) and good for sores or ulcers in the mouth when used as a rinse or gargle.  Pennyroyal  was recommended for phlegm, headache and cough.  While these and similar herbal tonics might have ameliorated some symptoms, they were unlikely to effect a cure.  They also depended on availability-not everyone had access to an apothecary or the means to buy herbs, if they did not have their own gardens or stillrooms.

The similarities of the symptoms of these diseases, as well as the fact that they were all common in Jane Austen’s time, make the question of pinning down an exact definition of what disease constituted a putrid sore throat very difficult.  The real issue is that the lack of modern medical treatment, some of which evolved later in the 19th century, made treatment very difficult, infection hard to contain, and recovery as much a matter of luck and a good constitution as anything else.  The discovery of how disease spreads, improved vaccination for more diseases, and antibiotics have drastically reduced, if not eliminated, these conditions today, and the resulting damage that these conditions can cause, which include heart damage, blindness, deafness, and even brain damage from an uncontrolled high fever.  
Thanks to modern medicine, our concept of “flu season” is much more an uncomfortable inconvenience; in Jane Austen’s time, it was truly a major threat.
Sources include:
CULPEPER'S COMPLETE HERBAL, AND ENGLISH PHYSICIAN.  Manchester: J Gleave and Son, Deansgate, 1826.  Facsimile edition reproduced by Harvey Sales, 1981.  (Nicholas Culpeper published THE ENGLISH PHYSICIAN in 1652, and the COMPLETE HERBAL in 1653.  Numerous editions were published.)
Olsen, Kirstin.  DAILY LIFE IN 18th CENTURY ENGLAND. Westport, CT: Greenwood Press, 1999.
“18th Century Medicine.” by Tim Lambert.  LIFE IN THE 18th CENTURY. HERE
19th Century Diseases. HERE 
Bader, Ted, “Mr. Woodhouse is not a Hypochondriac!” PERSUASIONS On-Line, V. 21 , No. 2 (Summer 2000). HERE 
“Health and Medicine in the 19th Century,” by Tim Lambert.  LIFE IN THE 19th CENTURY.   HERE
Landers, John.  DEATH AND THE METROPOLIS Studies in the Demographic History of London, 1670-1830.  Cambridge Books On-Line.  The Autumn Diseases and the ‘putrid sore throat’ pp. 363-364.  HERE
MedicineNet.com.  HERE
English Glossary Causes of Death and other Archaic Medical Terms. HERE 
Image is in the Public Domain via Wikimedia Commons.

Lauren Gilbert published her first book, HEYERWOOD: A Novel, in 2011 and her second, A RATIONAL ATTACHMENT, is in process.  She lives in Florida with her husband.  Visit her website at www.lauren-gilbert.com


  1. Reminds me of the Victorian era too where everybody had the "cough." Of course, I have kids in preschool, so it feels like we have plenty of 19th century flus and colds going around here;)

  2. Makes me grateful for modern medicine!


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