I have refrained for a long time from writing down anything about the cholera, because the subject is intolerably disgusting to me, and I have been bored past endurance by the perpetual questions of every fool about it. It is not, however, devoid of interest. In the first place, what has happened here proves that ‘the people’ of this enlightened, reading, thinking, reforming nation are not a whit less barbarous than the serfs in Russia, for precisely the same prejudices have been shown here that were found at St. Petersburg and at Berlin. The disposition of the public was (and is) to believe that the whole thing was a humbug, and accordingly plenty of people were found to write in that sense, and the press lent itself to propagate the same idea. The disease, however, kept creeping on, the Boards of Health which were everywhere established immediately became odious, and the vestries and parishes stoutly resisted all pecuniary demands for the purpose of carrying into effect the recommendations of the Central Board or the orders of the Privy Council. In this town the mob has taken the part of the anti-cholerites, and the most disgraceful scenes have occurred. The other day a Mr. Pope, head of the hospital in Marylebone (Cholera Hospital), came to the Council Office to complain that a patient who was being removed with his own consent had been taken out of his chair by the mob and carried back, the chair broken, and the bearers and surgeon hardly escaping with their lives. Furious contests have taken place about the burials, it having been recommended that bodies should be burned directly after death, and the most violent prejudice opposing itself to this recommendation; in short, there is no end to the scenes of uproar, violence, and brutal ignorance that have gone on, and this on the part of the lower orders, for whose especial benefit all the precautions are taken, and for whose relief large sums have been raised and all the resources of charity called into activity in every part of the town.
Charles Greville, Diary, April 1st 1832
Has
DEATH
(in a rage)
Been invited by the Commissioners of Common Sewers
to take up his abode in Lambeth?
Or, from what other villainous cause proceeds this frightful
Mortality by which we are surrounded?
In this Pest-House of the Metropolis, and disgrace to the Nation,
the main thoroughfares are still without Common Sewers,
although the Inhabitants have paid exorbitant Rates
from time immemorial!!!
'O Heaven! that such companions thoudst unfold,
And put in every honest hand, a whip,
To lash the rascals naked through the world.'
Unless something be speedily done to allay the
growing discontent of the people, retributive justice in her salutary
Vengeance will commence her operations with the Lamp-Iron and the Halter.
SALUS POPULI
Lambeth, August, 1832
J.W.PEEL, Printer, 9, New Cut, Lambeth
poster, 1832
It seems clear that there is every probability that we shall
before long be subject to a visit from the cholera, and it is as clear that
whilst we have a considerable stock of food, i.e. dirt, for its
maintenance and propagation, we are nearly without any rules for its proper,
successful medical treatment, we are in a condition to show the utmost
hospitality to the dreaded guest; we can house and feed it after its own heart,
and if it was a welcome guest right merry should we be to see it at our
Christmas festivities; but it so happens that this visitor brings death and
terror in its train - death which defies the doctor, and terror predisposing for
that death. I know of but one way in which you can get rid of a visitor who
seeks a lodging you are not disposed to offer him - find out what he requires
for his comfort and take care that he has it not. . . .
Now, the Metropolitan health commission seem disposed to act
on this common sense view of the case; they have ascertained the exact nature of
those things which are most inviting to the cholera, the particular localities
in which it most loves to take up its abode, the particular class of persons it
chiefly loves to embrace. As with typhus, so with cholera, the first attraction
is a vitiated atmosphere. Both these devourers of human existence flourish best
in a climate thoroughly impregnated with the odours of decayed vegetable and
animal matter; a pure air is their destruction; they wing their flight over the
localities which are blessed with the cleanliness which removes to a distance
from the abodes of man those decaying matters which are as offensive to every
well-regulated sense as they are deleterious; they stop in their course to
alight and settle where they find man in close contact with dirt of the worst
quality, in quantity sufficient to depress those physical energies on which his
health depends. What carrion is to the vulture and the raven, bad drainage and
overcrowded dwellings are to typhus and cholera. If, then, we would greet these
destroyers of our kind, if we would court their presence, we have only to take
care that they find multitudes living in lanes and alleys in which there is no
drainage, or in which the drainage is inefficient, where open cesspools and
accumulated heaps of a filth unnamable abound; pack these multitudes together in
close unventilated rooms, let the habits of their lives be, as they almost ever
will be, in keeping with the atmosphere around them, and you have spread the
banquet and prepared the lodging which will insure the advent of typhus at all
times; at this particular time - will in all probability also insure the visit
of cholera.
Having ascertained thus much of the habits of these plagues,
the Commission has pointed out on clear evidence, that, like my unwelcome guest,
typhus or cholera, in possession, can only be ejected by depriving them of those
essentials to their abiding. Loving dirt, we must offer cleanliness; an air that
stinks being the air they love to breathe, we must banish stink - (I wish I
could find a more civilized work, but it is a libel on the word smell to
apply it to these matters); seeking a dwelling in room whose walls are painted
with a thick coating of smoke and animal exhalation, laid on in combination, we
must disturb their rest, by scraping off this inviting paint, and laying on that
which is the object of the worst hate of typhus - a coat of quick lime; hating
ventilation, we must boldly ventilate. Let me add to this stock of commission
found experience, that which I have again and again remarked - that typhus has
peculiar notions as to the bed on which it loves to lie and mutter its wild
deleriumit; hates clean sheets - it cannot have too many companions in bed with
it - it likes to have its bed-fellows sleep unwashed - it loves to see the floor
beneath its bed, one mass of accumulated woollen and other rags - a head or two
of old herrings and a few rabit-skins add much to its sense of domestic comfort;
I have again and again seen it sulk, rebel, and quit when I have offered to
those with whom it has taken up its abode, clean bed-linen; when I have forced
their own bed-linen and furniture into a washing-tub, the water of which has
been impregnated with chloride of lime; I have seen a fair fight between typhus
and a clever M.D., in which the latter was getting the worst, put to an end, and
typhus forced to yield to chlorine preparations of bark, simply by the removal
of about half a barrow load of rags from under the bed. I have again and again
seen it driven from a locality, by a little pains taken to either lessen the
number sleeping in one room, or, where that was not possible, the taking steps
to ventilate the room . . .
letter from "S.G.O." to The Times, December 27, 1847
see also Henry Mayhew on Jacob's Island and cholera
see also Thomas Beames in The Rookeries of London - click here
A COURT FOR KING CHOLERA
Punch, Jul.-Dec. 1852
see also George Godwin in London Shadows - click here
John Snow Archive and Research Companion
On the Mode of Communication of Cholera, by John Snow M.D. 2nd ed. 1854
(home page:- Delta Omega Health, http://www.deltaomega.org/)
The connection between disease and defective structural and
economic arrangements continues to demand the most serious attention. The relationship of cholera, and fever, and crime, to cesspools,
imperfect drainage, impure water, overcharged graveyards, and want
of ventilation, is a great sanitary question, with which we feel ourselves all the more urgently called upon to deal, to the best of our
ability and experience, since it is one on which the medical faculty
themselves, strange to say, differ materially.
This is an unfortunate state of things, and shows the necessity for
renewed and continued inquiries.
One thing appears beyond all doubt,-and it is on this we work
resolutely, however feebly, - that where human beings are crowded
together in ill-arranged dwellings; where the drainage is bad and the
cesspool lurks; where refuse rots, the air is vitiated, or the water impure and
scanty, - there cholera and fever, when evoked, reign and
slay. Those still speak correctly who make King Cholera sing,-.
"What is my court? These cellars piled
With filth of many a year
These rooms with rotting damps defiled;
These alleys where the sun ne'er smiled,
Darkling and drear!These streets along the river's bank,
Below the rise of tide;
These hovels, set in stifling rank,
Sapp'd by the earth-damps green and dank;
These cesspools wide.These yards, whose heaps of dust and bone
Breathe poison all around;
These sties, whose swinish tenants, grown
Half human, with their masters own
A common ground.What are my perfumes? Stink and stench
From slaughter-house and sewer;
The oozing gas from open'd trench,
The effluvia of the pools that drench
Courtyards impure.
Two points have been often dwelt upon by the Registrar-General
in his reports, as increasing the risk of cholera, namely, lowness of
level and impure water. Thus, after pointing out in one of his
reports, that the district in which the poorer classes abound suffered
generally most from the epidemic, he said: "From an attentive consideration of all the facts, the rich, living on low ground, in houses
supplied with impure water, are in great danger during a cholera
epidemic; while the industrious, hardworking population, living on
simple food, in clean houses not much crowded, supplied with pure
water, on high ground, or on well-drained ground that has not been a
marsh, have little to fear from cholera in England."
Contrasting some of the districts, the Registrar has said: "Rotherhithe and Chelsea differ little in rental; but. the Chelsea district,
supplied by the Chelsea Water Company, is on an elevation of 12 feet,
and lost 47 inhabitants in 10,000 by cholera; while Rotherhithe,
on lower ground (0 feet), supplied with impure water, lost 176 by
cholera in 10,000 inhabitants. In Hackney, again, the people are
apparently not in better circumstances than the people of Camberwell, yet in the two epidemics cholera was fivefold more fatal in
Camberwell than it was in Hackney; Camberwell lying low, and receiving the impure water;
Hackney lying high, and receiving, in
1854, a water of better quality.
Touching impure water, the late Dr. Snow, who died too soon,
considered that the morbid material producing cholera must be introduced into the alimentary
canal - must, in fact, be
swallowed; and
that it has the property of reproducing its own kind. Particulars of
the way in which it is swallowed would scarcely suit these pages
suffice it to say, that the want of personal cleanliness, scarcity of
water, deficiency of light, and over-crowding, are shown to concur in
bringing this about; and his theory is made to explain why in thousands of instances a case of cholera in one member of the family was
followed in hundreds of instances by other cases, whilst medical men
and others who merely visited the patients, escaped. The chief
means of extension, however, he considered to be the contamination
of the water, used for drinking and culinary purposes, by matters,
containing the morbid material, either permeating the ground, and
getting into wells, or by running along channels and sewers into the
rivers, from which entire towns are sometimes supplied with water.
The cases where attacks of cholera were traced to the contamination of water by adjoining cesspools, are not few.
When the terrible outbreak of cholera in Broad-street,
Golden-square, and adjacent streets, of which we have had occasion to
speak, took place, Dr. Snow suspected some contamination of the
much-used pump in Broad-street, near time end of Cambridge-street;
and he brought together a number of circumstances which seemed
to show some connection. Of the eighty-nine deaths from cholera
registered during the week ending Sept. 2nd, in the sub-districts
of Golden-square, Berwick-street, and St. Ann's, Soho, he found that
nearly all had taken place within a short distance of the pump.
There were only ten deaths in houses decidely nearer to another
street pump, and in five of these cases the families informed him that
they always sent to the pump in Broad-street. "There are certain
circumstances bearing on the subject of this outbreak of cholera
which require to be mentioned. The workhouse in Poland-street is
more than three-fourths surrounded by houses in which deaths from
cholera occurred; yet out of 535 inmates only five died of cholera,
the other deaths which took place being those of persons admitted
after they were attacked. The workhouse has a pump-well on the
premises, in addition to the supply from the Grand Junction Waterworks, and the inmates never sent to Broad-street for water. If the
mortality in the workhouse had been equal to that in the streets
immediately surrounding it on three sides, upwards of 100 persons
would have died."
At a brewery in Broad-street, where there were seventy men, none
suffered from cholera: few drank water at all, and the few who did,
never obtained water from the pump, having a deep well on the
premises.
Dr. Snow gave a map of the locality, showing the deaths by a
black line in the situation of the house where it occurred, and adduced
reasons for believing that the deaths either very much diminished, or
ceased altogether at every point where it was decidedly nearer to send
to another pump than to the one in Broad-street. Against one of
time houses, immediately adjoining the pump, there are eighteen black
lines! The total number of deaths ascertained was over 600! The
pump-well was afterwards opened, and its connection with a cesspool
was shown unmistakably.
Some extraordinary facts have been deduced from an examination
of a part of London where many of the houses are supplied by the
Southwark and Vauxhall Company, and others by the Lambeth Company, who take their supply at Thames Ditton. The
pipes of each
company go down all the streets. "Each company supplies both rich
and poor, both large houses and small: there is no difference either in
the condition or occupation of the persons receiving the water of the
different companies. Now it must be evident that, if the diminution
of cholera, in the districts partly supplied with the improved water,
depended on this supply, the houses receiving it would be the houses
enjoying the whole benefit of the diminution of the malady, whilst
the houses supplied with the water from Battersea-fields would suffer
the same mortality as they would if the improved supply did not exist
at all. As there is no difference whatever, either in the houses or in the people receiving
the supply of the two water companies, or in any
of the physical conditions with which they are surrounded, it is
obvious that no experiment could have been devised which would
more thoroughly test the effect of water-supply on the progress of
cholera than this, which circumstances placed ready-made before the
observer.
The inquiry gave striking results. In the first seven weeks of
the
epidemics, the proportion of deaths to 10,000 houses, was, in those
supplied by the Southwark and Vauxhall Company, 315; while in
those supplied by the Lambeth Company, it was but 37. In the
second seven weeks, when other means of communication came
into operation, the difference was not quite so great; but even then
the population supplied by the Southwark and Vauxhall continued
to suffer nearly five times the mortality of that supplied by the
Lambeth!
George Godwin, Town Swamps and Social Bridges, 1859
see also James Greenwood in The Wilds of London - click here