Cholera 1832

The Social Response to an Epidemic

R. J. Morris

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000566598
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

Originally published in 1976, this is the account of British society's response to the threat of disease. It is the story of an administrative fight to exclude the disease by quarantine and to persuade commerce and working-class people to observe carefully thought-out regulations. The story of one of failure – of men hampered by lack of information, lack of resources and lack of a convincing scientific explanation. Medical science failed to see that infected water supplies were the major carriers of the epidemic and failed to acknowledge saline infusion (the basis of successful modern treatment) when it was presented to them by an obscure local surgeon in Leith. The social structure of the medical profession was as much a barrier to scientific advance as the technical limitations of statistical method and microscope. These reactions are explained in terms of the expectations and the understanding of those involved as well as in terms of modern medical knowledge and sociological theory.

1 Prologue

William Sproat, a keelman, of Sunderland, County Durham, began his short but disastrous contribution to British medical history on Sunday, 23 October 1831. On the Saturday, thinking he was recovering from a bad bout of summer diarrhoea, he had a mutton chop for dinner (much against his doctor’s advice), and walked from his house near the Long Bank in Sunderland to his keel on the river. On his return, ‘He became very ill, had a severe shivering fit and giddiness, cramps of the stomach, and violent vomiting and purging.’ When Mr Holmes, his surgeon, was called on Sunday morning he found him:

Evidently sinking; pulse almost imperceptible, and extremities cold, skin dry, eyes sunk, lips blue, features shrunk, he spoke in whispers, violent vomiting and purging, cramps of the calves and legs, and complete prostration of strength.

By mid-afternoon Sproat had been visited by two other doctors; Dr Clanny, one of the leaders of the local medical profession, and J.B. Kell, surgeon to the reserve units of the 82nd Regiment then stationed in Sunderland barracks. Kell was of little account in terms of local or professional status but he had seen and treated Asiatic cholera whilst stationed in Mauritius. He examined Sproat, confirmed that this was a case of Asiatic cholera, and Clanny agreed with his verdict. Holmes continued to visit Sproat regularly, but could do little more than attempt to restore his shattered circulation with a little brandy and hot bricks applied to the feet, and try to settle his stomach and pain with opium and calomel. On Wednesday, Holmes found his patient worse, ‘Pulse scarcely beating under the fingers, countenance quite shrunken, lips dark blue. . .at twelve o’clock at noon he died.’

William Sproat was the first confirmed case of Asiatic cholera in the British Isles. It was certain that others had died in Sunderland during the late summer of 1831. But Kell and Clanny only gained hearsay knowledge of such cases, sometimes months afterwards. The doctors who saw them could not recognise the disease, and those who suspected something was wrong were reluctant to admit that cholera had arrived in Sunderland. Within a few days of Sproat’s death, his son was dead and his grand-daughter was slowly recovering from the fever which followed in patients fortunate enough to survive the initial attack.¹

These histories of collapse, pain and death were to be repeated many times throughout Britain over the next eighteen months. Britain was seriously affected by four of the pandemics of cholera which have spread from Bengal since the early nineteenth century; namely in 1831-2, in 1848-9, in 1853-4 and in 1866. After that cholera made no more than a few incursions in port and coastal areas. Figures of varying quality are available for each epidemic (Table 1). The Registrar-General’s figures (England and Wales, 1848-9, 1853-4 and 1866, and Scotland 1866) are comparable and as accurate as possible; a few cases missed because doctors failed to recognise the disease, and other cases of English cholera included in the total. The other figures are all likely to be underestimated, especially in 1831-2, when failure to recognise the disease was a more serious problem and many places were reluctant to admit the presence of the disease for fear of disrupting trade or deterring visitors. Several places, like Yarmouth and Salisbury, failed to make any return at all. Only a small portion of these omissions was compensated for by doctors who attributed deaths from other bowel disorders to the Asiatic totals. These tables show deaths only. Recording of cases was even more haphazard. Modern experience shows that without treatment, cholera kills 40-60 per cent of its victims. As nineteenth-century Britain was without any effective treatment, this ratio may be used to infer the number of cases from the number of deaths and to detect exaggerated case figures in local accounts.

Table 1: Cholera Deaths in Britain, 1831-1866

England and Wales			Scotland
Year	Cholera Deaths	Deaths per 1,000,000	Cholera Deaths	Deaths per 1,000,000
1831	21,882^a	–	9,592^a	–
1832
1848	1,908^b	110^b	6,000 to 7,000^c	–
1849	53,293^b	3,034^b
1853	4,419^b	244^b	6,848^d	–
1854	20,097^b	1,094^b
1866	14,378^b	685^b	1,270^e	420^e

Sources:

a. Derived from figures collected by Charles Creighton, A History of Epidemics, vol.2, p.816, 2nd edition, D.E.C. Eversley, E.A. Underwood and L. Overnall (eds.), London, 1965. Creighton’s figures seem more complete than those published by the Statistical Society or the 1849 Board of Health.

b. Report on the cholera epidemic of 1866 in England, supplement to the 29th Annual Report of the Registrar-General for Births, Deaths and Marriages for England and Wales, P.P., 1867-8, vol.37.

c. Estimate from Board of Health returns in Report of the General Board of Health on the epidemic of cholera in 1848 and 1849, P.P., 1850, vol.21.

d. 16th Annual Report of the Registrar-General in England and Wales, Abstracts for 1854. The total for Scotland was derived from the Board of Health returns, 31 August 1853 to 17 November 1854.

e. 12th detailed Annual Report of the Registrar-General of Births, Deaths and Marriages in Scotland, P.P., 1868-9, vol.16.

The demographic impact of cholera was small but significant. In the period 1838-68 in England and Wales the Registrar-General’s figures show the cholera years as peaks in the mortality figures (Table 2). These figures must be put in perspective. The impact of cholera in 1849 only just exceeds that of the typhus which was brought to Britain in 1847 by refugees from the Irish famine, and, over a five-year period around 1849, deaths from common diarrhoea exceed deaths from cholera. In 1854, the two totals are nearly equal.

Table 2: Crude Death Rate in England and Wales, 1846-56 and 1865-67

Year	Total Deaths	per 1,000	Year	Total Deaths	per 1,000
1846	390,315	23.06	1854	437,905	23.52*
1847	423,304	24.71	1855	425,703	22.61
1848	399,833	23.06	1856	390,506	20.51
1849	440,839	25.12*	. . . .	. . . .	. . . .
1850	368,995	20.77	. . . .	. . . .	. . . .
1851	395,396	21.99	1865	490,909	23.39
1852	407,135	22.38	1866	500,689	23.61*
1853	421,097	22.88	1867	471,073	21.98

*cholera years

Source: 31st Annual Report of the Registrar-General in England and Wales, London, 1870.

Although cholera was often compared to plague, the death rate was nothing like that of the medieval and seventeenth-century plagues. Historians have traditionally claimed that the ‘Black Death’ of 1349 killed between a third and a half of the population. In London the Bills of Mortality suggest that the later plagues killed between 15 and 25 per cent of the population.² The London cholera totals for 1849, 0.62 per cent, and for 1854, 0.43 per cent were minute beside the plague totals. Even the disaster villages of the cholera era did not approach the plague death rates. Newburn in County Durham lost 10 per cent of its population of 350, whilst at Bilston, where events horrified a country already suffering, 693 people died, 4.8 per cent of the total population of 14,492. None of these totals compare with the plague village of Eyam in Derbyshire where 259 died in a population of 350 during 1665-6.

Although the cholera epidemics of the nineteenth century can in no way be called demographic crises, the approach and arrival of these epidemics, especially that of 1832, created a crisis atmosphere in the country quite unlike that produced by any other threat apart from foreign invasion. The normally calm Quarterly Review viewed the approach of ‘one of the most terrible pestilences which have ever desolated the earth’ with considerable horror. It had killed fifty million people in fourteen years, the Review claimed, and threatened economic and social chaos as well as pain and death: ‘If this malady should really take root and spread in these islands, it is impossible to calculate the horror even of its probable financial results alone.’³ Cholera was a shock disease. It demanded and got attention from everyone, from all shades and all forms of opinion. This is its value for the historian. There are few other events or aspects of social life in early nineteenth-century Britain on which comments came from so many different places. There was a characteristic response from the religious periodicals and medical journals, from the radical newspapers and from magazines on household management; from the educational and temperance Press, and the literary and scientific papers. They all made some ‘survey’ of the literature and provided ‘advice’ for readers. The steady reporting of cases and deaths in the newspapers had the depressing effect of the tolling of a funeral bell. Many diseases killed more widely and killed more people than cholera, but few had such concentrated attention from so many. As the correspondent of the Edinburgh Courant commented on the border town of Jedburgh in 1849, ‘The smallpox is still raging amongst us, numbering even more victims than the cholera; being as it were indigenous to the country, the dread of it is absorbed in the all pervading thought of cholera.’

There are many distinctive qualities about cholera that make an enquiry into the death of William Sproat more than an enquiry into the first of 140,000 dead. The question who or what killed William Sproat requires not only a medical answer but a close study of the workings of B...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Table of Contents
• Acknowledgements
• 1 Prologue
• 2 Approach
• 3 Sunderland
• 4 Containment Fails
• 5 Victims
• 6 Class, Power and Cholera
• 7 Religion and Morals
• 8 Medicine and Science
• 9 Epilogue
• 10 Reflections
• Select Bibliography
• Index