Workshop Proceedings: Fever. Histories of (a) Disease, 1750-1840

While ‘fever’ is considered to be a universal aspect of human sickness, this medical concept’s meaning, experience, and implications varied significantly across different historical contexts. This was the central inquiry that guided the workshop “Fever: Histories of (a) Disease, 1750–1840”, hosted by the ERC Consolidator Grant Project FEVER based at Heidelberg University. Held at the Heidelberg Academy of Sciences and organised by Stefanie Gänger, Yijie Huang, Teresa Göltl, Jenny Sure, and Lea-Marie Trigilia, the conference brought together a group of historians of science and medicine to discuss and examine the history of fever — or rather fevers, plural. 

We speak of fevers in plural because it is important to consider the immense number of types and variations of this ailment that coexisted during this period. By most physicians, fever used to be regarded as a disease in its own right, by others, it was considered as an “order” of disease in the era’s taxonomies, with a plethora of varieties and species. The time period covered in the conference comprised the eighteenth and the first half of the nineteenth centuries – an epoch the Spanish historians José Luis and Mariano Peset have suggested ought to be called ‘the Age of Fevers’ due to their protagonism in the diagnostic landscape of the time.¹ Indeed, fever  was among the most common diagnoses from the mid- and late 1700s all through the first half of the 1800s – not only in (Western) Europe but also in its colonial dominions. Although fever was incredibly widespread as a diagnosis, it was an elusive concept. While it could be recognised in practice through principal symptoms—heat, altered pulse, weakness—its theoretical definition proved far more difficult.

Despite the fact that fevers are an important presence in the historical record, there is comparatively little research, discussion, or dispute over this historical concept, at least in recent decades. As Christopher Hamlin, who honoured us with his presence at our workshop, put it: “fever has been the invisible elephant in the china-shop of the medical past”.² The fact that this diagnostic prevalence presented itself in such a wide geographical area necessitates a global perspective, which is why we sought to cover as many territories across the globe as possible in order to examine how the specific, Western concept of fever was understood and employed within societies around the world.

Along these lines, the subject of our first panel was “Fever and Difference” and concerned itself with conceptualisations of fever in relation to concepts of identity. KEVIN SIENA (Trent University) opened the proceedings with a paper on how medical theories of fever contributed to formulations of identity-categories such as race and class in eighteenth-century Britain. He demonstrated how depictions of class in  medical plague and fever discourses – plague being a form of fever – grounded claims in pathological and physiological difference. These diseases might be considered hereditary and thus hence lend themselves to formulations of class and race. Such theories were deployed for class before they were later applied to racial theories. Continuing on the theme of racial difference, our very own TERESA GÖLTL (Heidelberg University) shifted the focus to medical practices in the French Caribbean colonies. She explored how plantation managers recorded and diagnosed febrile illnesses among the enslaved, and how, as laypersons, they applied medical knowledge on site to treat these ailments. The extensive study of the Reiset plantation records allowed her to demonstrate the extent to which healing practices were shaped not only by racial assumptions but also by economic considerations. In these sources, fever retains its elusiveness, shifting in character depending on the type of record in which it appears.

Our second panel explored the wider subject of fever causation. MARGARET DELACY’s  (NW New York) paper dealt with concurring beliefs regarding the origin and nature of the spread of fevers with a special focus on public health strategies. Dr. John Clark’s documentation on such disputes at the to-be-founded Newcastle Fever Hospital in the early nineteenth century exhibit the variety of arguments that surrounded debates on how to treat and isolate patients with febrile ailments. Notions on whether and when fevers were contagious influenced disputes with respect to epidemiological measures - such as the siting, design, and regimen of medical institutions. RICARDO CABRAL DE FREITAS (Federal University of Rio de Janeiro) took us across the pond to discuss the understanding of fevers in Brazil during the period of the Portuguese Royal Court’s relocation to Rio de Janeiro in 1807. This event signified not only political change, but also a challenge for medical practitioners hailing from Western Europe. In his paper, Ricardo examined how (European) physicians’ set of knowledge on fever(s) was subverted by the new capital’s tropical climate. Rio’s environmental particularities led to an understanding that the city possessed a nosological specificity, which came to be the medical community’s main concern and led to significant alterations in the city’s infrastructure and topography. On the other end of the spectrum of causation theories we encounter approaches that relate to matters that regard the individual. Such was the case in JENNY SURE’s (Heidelberg University) paper concerning emotions, passions, and affects as causes, symptoms, and remedies of fever(s), which closed the first day of the conference. Drawing upon health advise literature from the eighteenth-century German-speaking lands, she illuminated the contemporary understanding of the connection between the body and the mind. Passions such as melancholy, fear, disgust, and anger loomed large in the literature on febrile ailments of the epoch, playing a particularly significant role in explanations relating to their causes. In her talk, it also became apparent how identity matters played out in such theories, not only regarding susceptibility depending on class belonging but also on gender. 

The workshop participants reconvened in the following morning to discuss the subject of temporality and fever(s), which was the theme of the third panel. ALEXANDER WRAGGE-MORLEY (University of Lancaster) presented a paper on the intersection of periodicity – the tendency of certain symptoms to reoccur at regular intervals – and habit in regard to febrile illnesses. In the eighteenth century, European physicians saw the acquisition and loss of habits as one of the main ways by which environmental and social conditions came to gradually alter the workings of mind and body, eventually producing biologically distinct groups of humans. Habits, in turn, formed by the nervous system, were employed to explain why fevers manifested differently across different cultures and environments – a subject that resonated especially with the speakers of our first panel. STEFANIE GÄNGER’s (Heidelberg University) talk examined cases in which sufferers failed to fully recover from ‘fevers’, that is, with fever as a harbinger of chronic, longer-term illnesses, or _sequelae_. The paper exposed the wide range of ailments contemporaries attributed to ‘fevers’ after their apparent resolution – from ‘gouty pain’, ‘dimness of vision’, or ‘a long State of Weakness’, to an ‘Offensive Smell in the Nose’, loss of one’s emotional poise, or the use of a limb –, gauged the usual duration of these complaints. Furthermore, she sought to explain the conspicuous credibility of sequelae in the period – the fact that contemporaries never dismissed or questioned the veracity of those who reported them.

The final panel considered fever in social and political contexts. CHRISTOPHER HAMLIN (University of Notre Dame) contributed to the conference with a talk on the political implications of fever(s) in a period of profound political change in Ireland that culminated in the famine-fever of 1845-52. Hamlin drew on the writings of Irish physician-philosophers – for whom he coined the term “fever radicals” due to their deep concern with febrile outbreaks - to explore the theme of “social/political medicine” in relation to endemic and epidemic fevers. Hamlin was able to show that an “afebrile life” was beginning to be perceived as a political right in Ireland in the first half of the nineteenth century, but that establishing afebrility as a fundamental right had very diverse political motivations. Moving, again, away from Europe, YIJIE HUANG (Heidelberg University) closed the proceedings with an insightful talk on the role of fever(s) in the context of political and commercial relations, or, rather, tensions between the British Empire and China in the early nineteenth century. Contextualising the two failed British diplomatic missions to the Qing Court within a longue-durée framework, her paper traced the period’s varying views of China’s medical landscape through European/British eyes. She showed how fever(s) offer a prism to observe the interplay of British-Chinese relations and how such experiences were later translated into an extensive system of global etiological knowledge and disease management, which in turn relegated China to the part of the diseased world which Europe distinguished itself from.

The workshop proved to be an incredibly productive event that inspired us to discuss the wide variety of the history of fever(s) in depth and in a colloquial spirit. Approaching the subject of febrile diseases from a global perspective proved to be highly fruitful, exhibiting the geographical ubiquity and breadth of this phenomenon as well as its relevance across the globe, whilst revealing historical local and regional specificities and contingencies. We are delighted that this first joint workshop on the history of fever has laid the groundwork for future collaborations, and we look forward to publishing the insights shared in Heidelberg. The complexity, intricacy, and convolution of the historical disease category of fever makes it a subject impossible for one individual to master; we are ever grateful to the participants of this workshop for having joined us in Heidelberg to undertake this together.

 

[1] Peset, José Luís and Peset, Mariano: ‘Epidemias y sociedad en la España del Antiguo Régimen’ , in: Estudios de la Historia Social 4 (1978), pp. 7-28.
[2] Hamlin, Christopher: More than Hot. A Short History of Fever, Baltimore 2016, p. 12.