Supplementary Appendix: Catarrhal Fever

Catarrhal Fever

According to Wilhelm Schlegel’s letter to Johann Diederich Gries on 16 March 1800 (letter 258r), Caroline’s illness in March 1800 was preceded by catarrhal fever, which then transitioned into nervous fever.

Concerning the understanding of catarrhal fever at the time, variations of which in German were also called “river fever” (Flussfieber; see Adelung s.v., “a catarrhal Fever”; also letter 195), see Robert John Thornton, The Philosophy of Medicine: or, Medical Extracts on the nature of health and disease etc. etc., 4th ed. (London 1799), 2:356–58 (under the heading “Sthenic Diseases”):

Febris catarrhalis; Or, a catarrhal fever.

This disease commonly comes on with the same symptoms as other febrile diseases, that is,

1. With alternate chills and heats, often there is no pyrexia [abnormal elevation of body temperature].
2. The cough comes on almost at first.
3. Accompanied with some expectoration, generally of a thick ropy mucus.
4. The face is swelled and flushed.
5. Some giddiness and drowsiness accompanies the disease.
6. There is a sense of lassitude over the whole body.
7. There is a difficulty of breathing.
8. A sense of oppression, and straitness of the chest.
9. With some obscure pain there.
10. The cough is frequent and violent.
11. Sometimes it excites even vomiting.
12. Frequently a rending head-ach accompanies this disease.
13. The blood drawn shews a buffy surface.

This disease has often the appearance only of a more violent catarrh, and after the employment of some remedies is entirely relieved by a free and copious expectoration. In other cases, however, the feverish and catarrhal symptoms are at first very moderate, and even slight; but after a few days, these symptoms suddenly become considerable, and put an end to the patient’s life when the indications of danger were before very little evident.

From the different circumstances in which this disease appears, the pathology of it is difficult. It is certainly often no other at first than a catarrhal affection, which, in elderly persons, is frequently attended with a large afflux of mucus to the lungs; and it was on this footing that Sydenham considered it as only differing in degree from his Febris Hyemalis. A catarrh, however, is strictly an affection of the mucous membrane and follicles of the bronchiae alone: but it may readily have, and frequently has, a degree of pneumonic inflammation joined to it; and in that case may prove more properly the peculiar disease we treat of here. But, further, as pneumonic inflammation very often produces an effusion of serum into the bronchiae, so this, in elderly persons, may occur in consequence of a slight degree of inflammation; and when it does happen, will give the exquisite and fatal cases of the peripneumonia notha, or bastard pleurisy, called such when there is a suffusion of sputa, or lymph, thrown put into the cellular texture of the lungs.

The next entry under “sthenic diseases” is “Contageous catarrh, or influenza,” though the two were often viewed as essentially identical, or at least with rather fluid transitions. Cf., from essentially the period during which Caroline was ill, the Kaiserlich privilegirter Reichs-Anzeiger (1800) 97 (Tuesday, 29 April 1800), 1253–54:

Health News

The useful content of the following instruction makes it worthy of universal dissemination.

Influenza or, in French, la Gripe, an epidemic disease from Russia, is currently afflicting Prussia. We consider it necessary to acquaint the public with this disease in general so that people might be warned ahead of time not to endanger themselves by the use of excessively vehement remedies. According to official reports from Königsberg, this present influenza resembles that which prevailed in 1782. It consists in a sometimes slight, sometimes more powerful catarrhal fever. The ill person alternates between chills and overheating, the latter always accompanied by headaches commensurate with the degree of overheating. The catarrhal attacks, such as a cramping in one’s limbs, sniffles, coughing, and a sore throat, appear either individually or several simultaneously. The ill person also occasionally notices chest pain, chest tightness, and side stitches. And finally, it also happens that such ill persons often suffer slimy, bilious diarrhea or vomiting. In general, the illness affects the person’s strength and energy, and the ill person recovers only very slowly. All the stronger evacuation agents, such as: bloodletting, emetics, and powerful laxatives, are usually harmful, whereas gentler sweating agents are always quite tolerable at the beginning of the illness, and toward its end fortifying medications are required. Let us here recommend several general dietetic prescriptions and several generally available domestic remedies. At the beginning of the illness, it is advisable immediately to drink a decoction of barley, oats, or black bread, to which has been added vinegar and honey (to a Berlin quart of the decoction add an eighth part vinegar and half as much honey as vinegar); towards evening the ill person should drink several cups of elderberry tea or ordinary tea with two heaping tablespoons of syrup of elder. Although the ill person must remain moderately warm, he should avoid any hot food or passionate emotions. During the period of most severe weakness, which generally comes on the third or fourth day, it is recommended that the person drink a soup of beer or wine with sour wine. In extremely rare and severe cases, only a knowledgeable attending physician can determine the use of helpful evacuative agents and, at the end of the illness, the necessary fortifying medications. All authorities and clergy are herewith requested to bring this announcement to every citizen’s attention.

Berlin, 12 April 1800

Royal Prussian High Council
Medicum et Sanitatis.

Translation © 2013 Doug Stott