In September 1795 Paine fell ill with a fever so severe that James Monroe was convinced his lodger was at death's door. A German friend who visited him in November reported that he was afflicted ‘incurably from the torture of an open wound in the side, which came from a decaying rib’. William Cobbett attributed his recovery to the care he received from Monroe's wife: ‘Mrs Monroe showed him all possible kindness. She provided him with an excellent nurse who had for him all the anxiety and assiduity of a sister. She neglected nothing to afford him ease and comfort, when he was totally unable to help himself. He was in the state of a helpless child who has its face and hands washed by it mother’. Cobbett even claimed that a famous surgeon, Dessault, ‘cured him of an abscess which he had in his side’, though Paine continued to complain of this long after he had recovered from his ‘violent fever’.

While he was convalescing he wrote two tracts, The Decline and Fall of the English System of Finance and Agrarian Justice. The first was published in April 1796. In a covering note to copies of it which he sent to the French Directory, he claimed that the British government was being ‘pressed by two internal and formidable opponents that never appeared during any former war.