Disease in 18th, 19th and early 20th centuries in Highland Perthshire

With few doctors and no registration of death before 1855 it is difficult to get an accurate assessment of the health of the population during this period. Some of the parish ministers that wrote for the old and new statistical accounts gave us a layman’s view of disease in the 1790s and 1830s.

Statistical accounts:

The parish ministers of Kenmore wrote much on the moral delinquency of the population and nothing of their health but Duncan McAra of Fortingall commented;

'It may be added that fewer children die in the Highlands than almost anywhere particularly since inoculation has been so universally practised, which it has been for a good many years back, to the saving of many lives'.

Robert Campbell, also of Fortingall, writing  for the New Statistical account seemed to feel that his flock was immune to disease;

'When easterly winds prevail in the end of spring or beginning of summer catarrhal complaints are common.  We have no other epidemical distempers and often in wet weather and unhealthy seasons, when neighbouring districts are affected with influenza and other pulmonary complaints, our glens, owing to their hard and gravelly bottoms, are quite healthy.'

James McDiarmed from the parish of Weem in 1791 gave a very good and detailed account;

'Epidemical diseases seldom make their appearance excepting measles, smallpox and chin cough.  Before the practice of inoculation was introduced, the smallpox generally carried off 1in 7; but since inoculation has become pretty general, not 1in 200.  Even those who are seized without being inoculated escape much better than formerly as the cool regimen is universally observed.  The most common diseases are rheumatism both acute and chronic, pleurisy, quinfires and other inflammatory disorders.  The jaundice, before the year of 1789, was a very uncommon disorder in this country; but since that period, hundreds have been seized with it of all ages and sexes.  It is indeed but a slight disorder when taken in time and properly treated especially when the patient is young or in the vigour of life; but where it attacks old people or women with child or when it is neglected or improperly treated it often proves a tedious and in some cases a dangerous disorder.  No change in the way of living can account for this disorder being so frequent. 
In the cure of pleurisy, an uncommon method of cupping was anciently used in this country as well as in many other parts of the Highlands.  The part affected was slightly scarified with a razor, in the form of a circle, and the broad end of a large cow horn was applied over it, and a piece being cut off the top, it was strongly sucked by a person’s mouth, by which means a considerable quantity of blood was taken away, and often almost immediate relief was procured.  Since the use of blisters and proper cupping apparatus have been introduced; this awkward method is, in most places discontinued.  A few tertian and many putrid and nervous fevers are frequently brought from the Low Country.  The tertians are easily cured; but the other kinds of fever prove often infectious, spread over considerable districts, and sometimes cut off a great many lives.'

(Chin cough was whooping cough, an infectious disease with a high mortality before the 20th century. Quinfires probably referred to quinsy and diphtheria. Tertian in modern parlance describes a type of malaria - it is not clear what he meant in this context. The 'other kinds of fever' must have included TB.)

About the parish of Logierait Thomas Bissett in the 1790s wrote:

Twice or thrice within these 30 years, numbers have been swept away by a putrid fever.  A fever accompanied with a sore throat has at times been very mortal.  The common epidemical diseases prove occasionally fatal among the children but, since the practice of inoculation has been introduced among us, we suffer much less than formerly from smallpox.

He was almost certainly writing about diphtheria

Black Death (1340 - 1771) killed an estimated 75 million people worldwide with 20 million deaths in Europe

See also Cholera in the 19th century

After 1855 when statutory registration of deaths was instituted

It is very striking how many died of tuberculosis and, in 1918, influenza.

Cancer was a fairly frequent cause of death with prevalence seeming much as today. Operative mortality was however high with many dying from septic complications and even one from tetanus.

Strokes were common with a high mortality probably because adequate treatment of high blood pressure has only become possible in recent years.

Valvular heart disease was fairly common, probably because rheumatic fever was common, but coronary atery seemed to be very rare with only one of my family being recorded as dying of it. Tobaccco and dietary excess has since unleashed coronary artery disease as a major killer.

Improved public health, antibiotics and immunisation account for much of the variation from current disease patterns.

See also

Page last updated - 27/9/16