It is rare to find material on cholera that doesn’t use the word ‘explosive’. Of the more than 200 varieties of cholera now known, the two that are the most virulent human pathogens – O1 and O139 – are explosive in both the speed they spread and the physiological impact they produce. How shocking it must be to watch a person with cholera be hale and hearty at breakfast, blue by tea-time and dead by supper.
But after cholera arrived in Sunderland by ship in the autumn of 1831, the explosion was stealthy. There was communication, but private letters and reports by medical gentlemen lacked the immediacy of modern epidemiological intelligence. Even so, to watch the approach of cholera, geographically and across the pages of the Leeds Intelligencer, is chilling. It is in Moscow in September 1830, then Vienna in August 1831. By September that year, the Viennese public “has given itself up so entirely to dread, that already several persons have died with fright or become mad”.
The English knew what ‘cholera’ was; they had it every summer, just as in the winter they caught colds (although what they called cholera covered what would now be called gastroenteritis or typhus). But this new one was so frightening, they weren’t even sure what to call it: cholera morbus, cholera spasmodica, Asiatic cholera. There was quiet in October, then on 10 November, the Leeds Intelligencer ran a dark headline: THE CHOLERA MORBUS IN ENGLAND.
At least some of the initial victims in Sunderland, where cholera called first, had communicated with the crew of the nameless ship that brought it: “an old man and his son, another labouring man, a nurse…and her grand-daughter, a little girl”. The little girl was 12-year-old Isabella Hazard, the subject of the famous portrait of ‘the Blue Girl’, and she was dead within a day. Alarm spread.
Medical gentlemen experienced with Asiatic cholera (which had been raging periodically throughout India since 1817) were dispatched from London to Sunderland, where the Board of Health spent weeks denying that the cholera was not the ‘English’, mild version, to save the port’s trade.
The people of Sunderland and the writers of the Leeds Intelligencer defended themselves against the cholera with the only thing they had: their thoughts. Cholera attacked only the poor, the dirty and the indigent, women such as Eddy, the wife of a waterman, and Maria Mills, a common prostitute. The clean and temperate told themselves they were safe, even when cholera reached Newcastle and the gut of Robert Jordan, 50 years of age, “of good health and temperate habits”. Never mind; he was a labourer, so “he was frequently dirty in his person”.
The people of Leeds read about this and began to prepare. They issued reports on the general health of their town and found it good. They set up a cholera hospital. And then, they waited. A short news item in May 1832: cholera at Goole. Then Liverpool, then on 14 June, at Leeds. It had commenced in May 1832 in the Blue Bell Fold, in a “child of two years of age”, wrote Dr Robert Baker, a town surgeon, in his 1833 report for the Leeds Board of Health.
Baker had already travelled to Sunderland to see the cholera there. He was quoted as saying that Indian cholera “was a most improper name, as the disease was quite distinct from the common cholera known in England, and consequently calculated to mislead”. He was a sensible man, despite thinking that because cholera had broken out near “pigstyes”, eating pork may predispose one to it.
In this time of panic, many methods and measures were proposed, from stench traps to keeping the bowels “in regular action chiefly by rhubarb”. There were injections of oxygen into sufferers’ veins or lungs and the taking of camphor, cajeput oil and calomel. In Ireland, an unholy bishop launched a pyramid scheme in which citizens had to burn a piece of “blessed turf”, then run to deliver turf to seven more houses. This protected from disease, and exhausted a lot of Irishmen (one ran 30 miles to find an unprotected house that he could supply with his turf).
Baker was curious about poor sanitary conditions and disease, and he set off to Leeds’ yards and lanes to do some detective work when cholera arrived in the town. This was 20 years before John Snow began his cholera map of Soho, and although Baker was a convinced miasmatist [believing that some diseases were caused by ‘bad air’] his report was still groundbreaking.
He walked, wrote and talked his way around 586 streets. He attempted to collate their condition with 1,817 known cholera cases and 702 deaths. He found streets and yards that were grim and deadly. Baxter’s Yard was “most dingy, privies open”. In Micklethwaite’s Yard “stones have to be put down to walk”. Orange Street was simply “most wretchedly bad”. He walked through streets that I walk through today (some yards and ginnels still exist) and around the slums of Mabgate and Lower Briggate, near my office, which I reach by walking up a hill where hundreds of cholera victims are buried.
Baker concluded that cholera struck more severely in streets with appalling sanitation and that unsanitary environments were more to blame than the moral or hygienic character of cholera’s victims. His conclusions, and his report and cholera map, were striking.
Robert Baker was no John Snow. His understanding that cholera had something to do with water and sanitation – or, at least, with hygiene – was instinctive but not proven, and he remained a miasmatist. He thought that the sensible treatment of injecting saline into cholera victims (as proposed by doctors such as Dr W B O’Shaughnessy and reported in the Lancet) was wrong, and it was not continued. But among the fear and confusion that prevailed during this time of cholera, Baker’s report should be better saluted for making steps – trudged over the contents of privies and through filthy slum yards – into modern epidemiology.