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
(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.
Lambeth, August, 1832
J.W.PEEL, Printer, 9, New Cut, Lambeth
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
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
see also A.R.Bennett in London and Londoners - click here