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The S O H 0 Cholera Epidemic 1854

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The S O H 0 Cholera Epidemic 1854 THE SOH0 CHOLERA EPIDEMIC 1854 by Mr. W. R. Winterton Cholera IS an infection which has been endemic in many parts of the world for centuries. In India there is a statue of the time of Alexanderthe Great of a cholera vict~mbut the flrst appearance of the infection in the British Isles is comparatively recent, only 150 years ago. Cholera was thought to be caused by emanations from foul drains and that spread by contagion did not occur. Consequently it was not understood how it was conveyed from one major town to another which were only connected by roads. The traders who travelled these roads were not considered possible carriers. There have been four major out- hospitals refused, sheltering behind continued and there were deaths breaks of cholera in this country.' their laws. throughout the first six months of 1831 - 1833; 1848 - 1849; 1953 - The Royal Free Hospital on the 1854, but during the summer the death 1854 and 1866. There has been none other hand opened its doors for the rate rose until at the end of August and since. The first diagnosed case of first time in order to help with this beginning of September the numbers: cholera was in Sunderland in February epidemic. This hospital began in 1828 reached a dramatic peak. In October 1831. This originated from an as a dispensary on the ground floor of and November the numbers fell until epidemic in Bengal which had spread a four story building at 16 Greville in December they dropped to zero. overland through Russia to West Street, Hatton Garden, and was called Diarrhoea and cholera are referred Europe and was brought to England the London General Institution for the to as separate diagnoses, with the by seamen from Hamburg. From Gratuitous Cure of Malignant former sometimes progressing to the Sunderland it eventually spread to Diseases. In 1832 the tenants of the latter. Without bacteriological assist- London in 1832. It died down during upper floors at Greville Street were ance an exact differentiationis imposs- the winter of that year to reappear in given notice to quit and the cholera iible. The definitions used at the time the summer of 1833. Naturally it sufferers became the first in-patients.2 and in the Board of Health report are caused great distress and panic and A point of particular interest is that as follows. there was an interesting number of William Stevens treated these cases Diarrhoea theories as to how it arose. Since there by the administration orally and intra- Simple: Stools faecal. No was more overcrowding in the poorer venously of up to four pints of ~aline.~ vomiting, no cramps. parts of towns the incidence of infec- The Royal Free Hospital claims to Choleraeic: Watery stools, but tion was greater there and this lead to have treated in this 1832 epidemic tinged with bile. Vomiting, no the suggestion that the rich were 566 patients with only 135 deaths. cramps. deliberately poisoning the poor. The Stevens' treatment was much in cholera Christian Observer put the epidemic advance of the accepted treatment Rice water stools, colourless. down to the prevalence of infidelity even in the 1854 outbreak. Cramps. No urine passed. and profaneness, while The Presby- By some miracle cholera did not Temperature lowered. Poor terian Coventor felt th% it was a appear again until 1848 - 1849 and by pulse. visitation of God upon England for this time London was to some extent . ', In London generally the 1849 having granted Catholic Emancipation prepared. Treatment mainly consisted outbreak was more severe than that of in 1829! of purging and emetics, in order to 1854 apart from the Golden Square - This was some years before the eliminate the poisons, astringents and Berwick Street area of Soho. The study of bacteriology and nearly fifty alteratives (calomel). Records of this total deaths in 1849 being 14,600, or years before Koch discovered the outbreak are more complete. It was 6.2 per 1,000 living, whereas in 1854 vibrio-cholerae in 1883. Records at the most widespread of the four, partly the death rate was 11,000 or 4.5 per this time were poor; the official due to the freer movement of people 1,000. registration of deaths did not begin as a result of improved transport. The report of the Committee for until 1837. During the summer of 1853 there Scientific Eaquiries set up by the In London the infection spread had been some diarrhoea and in July General Board of Health4 investigated along the banks of the Thames which the reports state that the diarrhoea as the epidemic in relation to density of included the lower parts of well as the common form of cholera population, Elevation, Atmospheric Westminster. The Department of became serious and some deaths were Influences and Water Supply, both Health took some steps to deal with recorded, and beside the river a few the chemical content and microspic the outbreak and asked the hospitals, deaths from cholera of the Asiatic form content.- including The Middlesex Hospital, to were registered. In the autumn the There had been a lower incidence admit cases of cholera but most of the number of cases fell but the diarrhoea ofcholera in the St. James' area in the CHOLERA 183 1 and 1848 epidemics than in was considerably older. Untrapped to this the corridors and stairs of some many areas of London, 1.3 and 1.6 gullies drained into all the sewers and houses were occupied at night by per 1,000, and it was regarded as a there were open ventilating grills. those of no fixed abode, with healthy place, probably because it was Most of the houses had privies in the insanitary consequences. The inhab about 60 feet above Trinity High basement yard, some were in the front itants of the attics emptied everything Water, although other conditions were area and a few were in the house. on to the roof so that the gutters not so good. When therefore the exple Many of these were untrapped and became secondary cesspools. sion of cases of cholera occurred there opened straight into cesspools. Every The district was also considered on the night of 3 1st August and I st house had a cesspool which was rarely bad from the point of view of ventila- , September, greater than anywhere emptied and it was only the overflow tion because the streets were shon else in London, some explanation had from them which drained into the and shut in so there was poor to be found. sewers. These cesspools should have aeration. Apart from the smells from The Golden Square and Berwick been filled in when the sewers were the drains, there were also outside ' Street Subdistricts of St. James' connected but that had not been done. nuisances. There were eight butchers, Westminster with which this paper is Many of the cesspool walls were of every one of which had his own mainly concerned had been fashion- rotten bricks and leaked. The rarity of abbatoir and his own cattle shed. As I able in the early 18th century but had water closets and the small small well as these individual butchers there I become much decayed by the mid- volume of water meant that there was was one very large wholesale abbatoir. I 19th century. The houses were still very little flow to flush the sewers Much of the blood of the animals went considered of a good standard and while in addition the fall was only 1 in into the cesspools where it went bad were highly rated, but the over- 250: as a result the sewers became while the intestines were left outside i crowding was great. In Broad Street silted up. and supposed to be collected each ' the average number of inhabitants per Following a doctor's complaint evening by contract. There was also a 1 house was 18. The St. James' district of the smell outside his surgery the tripe house, a bone boiling house and covered 164 acres with a population sewer was opened up. A six inch brewery, all very smelly affairs. At ! of 36,000. This was divided into three channel carrying a trickle was found 38 Broad Street was a percussion cap subdistricts, St. James' Square, running through the silt of which 200 factory owned by Mr. Eley. Berwick Street and Golden Square. loads were taken away from a length The two last covered an area of 80 of a few yards. The sewers emptied Water Supply acres with a population of 25,000, a untreated into the Thames at the end The mains water was from two rate of 300 persons to the acre, one of of Northumberland Avenue and a sources, the New River Water Co, the highest in London at that time.= high tide would wash the sewage back and the Grand Junction Water Co. again. Many of the yards of the houses The New River brought its water from Sewer Systems were unpaved and most were filthy. Hertfordshire while the Grand There were three sewer systems Children frequently used the yards Junction took its water from the to serve the area, the last twoof which rather than the privies, which were Thames at Kew where it is tidal and were put in during the three years often without seats, only having a rail therefore polluted with sewage, before the 1854 outbreak. The third which was too high for them. Added although this water was by no means as heavily infected as some other supplies in London. The only attempt at purification consisted of no more than straining with wire mesh.
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