Fen Ague

“Arrested by the Bailey of marshland”, was a common term used to describe the fen ague. Whilst recognized for centuries and a reason for many travelers to avoid the area the “fen ague” was a much misunderstood disease that created many arguments.

In 1858 an argument typical of its age ensued in the Field with a popular perception that the fen ague was the result of a damp situation. The correspondent “C.A.” responded thus in answer to the columnist titled “Mechanic”:

“…..ague is occasioned by the liver being out of order. I have lived in Lincolnshire, in the heart of the Fens and never knew it particularly unhealthy. It is a singular fact that strangers are not generally speaking, attacked with ague until they have resided in Lincolnshire two or three years. Ague has been more prevalent lately in consequence of the dryness of the season.”

Another correspondent “J.H.” added the following: “ Mechanic is informed, in the event of his residing in Lincolnshire that he should first ascertain whether the place has ever been reclaimed from the Fens. Those parts subject to ague are chiefly in the neighbourhood of Boston and Spalding, where the fens once existed. He need be in no fear of the ague in the elevated parts of the county. Let him ‘look before he leaps’. If he catches the ague he will soon know what it is, and will find it an awkward customer to get rid of. It is known by shivering fits, attended with fever, and the parts most likely to be disordered are liver, spleen and stomach. The former is frequently tumefied to such a degree that bark cannot be given. The ague  is attended with great debility, and totally incapacitates a man from work.”

The fen ague was much feared and by some was a reason not to travel anywhere near the fen,. This was despite the fact that the fen ague was to be found in the growing towns and cities of the East Midlands. As drainage of towns improved you see reduction in the levels of fen ague in those areas observed as early as 1777 in both Leicester and Lincoln.

The fen ague saw a whole range of quack cures develop in the late eighteenth and early nineteenth century involving pills and medicines of unknown, unregulated ingredients and even “electrical” cures found as early as 1782 being in the form of static electricity. Fenmen learned that the best treatment for fen ague was either opium, sometimes consumed in the form of laudanum, or the “bark”, that is, quinine. The fen ague was malaria, but it has to be understood that mosquitoes were not understood to be the vector of malaria until 1897 when Sir Ronald Ross identified the malaria parasite in the stomach of a mosquito in India. These parasites had first been understood in 1877 by Patrick Manson. The prevalent theory prior to this time, although subject to argument, was that miasma or 2bad air” was responsible for malaria or the fen ague.

Around 1901 a greater understanding of the fen ague was achieved with extensive observations of the distribution of certain mosquitos in England were made, with a result that it was found that there was a striking similarity between the range of the mosquitoes (anopheles) and the area in which the ague was formerly very prevalent. The investigators expressed the opinion that the disappearance of the ague was probably due to certain causes acting together, viz: a reduction in the number of anopheles consequent upon the drainage of the land, this being in accord with earlier authors , who attributed the disappearance of ague largely to this cause; a reduction of the population  in infected districts as a result of emigration about the time when ague disappeared from England. This would naturally reduce the number of infected individuals, and thus lessen the chance of the anopheles becoming infected; it is possible that the use of quinine had reduced the chance of infecting the anopheles through checking the development of the parasites in the blood of subjects affected with ague.

In 1931 Sir Malcolm Watson, Principal of the Department of Malaria Control at the Rose Institute and Hospital for Tropical Diseases in London visited the marshes of Holbeach, Gedney and Sutton and he felt that better conditions of living and improved housing accommodation, especially drainage and sewage were a significant factor.

There was a benefit of the subsidence of the fen ague in that laudanum drinking experienced by the previous generations at the turn of the century and opiate dependance had reduced, although when prevalent it was hardly recognized as an addiction. In 1936 the Poison Act restricted the sale of laudanum, but looking back forty years before then the observation was that laudanum addiction was possibly as much a problem as malaria or ague:

“It is generally conceded, I believe, that the ordinary human being half-an-ounce of laudanum would constitute a fatal dose. Yet people in this locality drank many ounces a week and although they undoubted suffered ill effect the apparent result was merely tonic. I was chatting with two chemists of the older school only this week  and one told me that whereas it was common for people to ask for an ounce or more in a measure – and drank it in his shop – he had once experienced an aged hawker who drank four ounces at a draught. She would arrive at the shop, he tells me, trembling all over, scarcely able to crawl into the shop, but after the draught she would walk out, as he put it, as straight as a soldier.

Another pharmacist tells me that many years ago, in a town you all know well, a well-known personality would walk into his shop three times a day probably and  drink an ounce-and-a-half of laudanum at a time.

More than once in my own experience I have heard people ask for laudanum with the remark, ‘You need not put it in a bottle mister, the measure will do.’ And they forthwith drank it to a drain.

In my opinion, habit , far more than fen fever, was root cause of this wholesale laudanum drinking, and it is a blessing that the law precludes the habit continuing to this generation.

It was not always the liquid that was sold, but within recent years chemists in this part of the country invariably had made up small doses of gum-opium for sale on market days. Despite pessimists times have improved.” – The Watcher editorial in Spalding Guardian 30^th May 1938.

It therefore appears addiction was as much a problem as the fen ague, with the later providing an excuse.