It is the 1830’s. Early Victorian London is seeing a population explosion, doubling in size in 20-years and now fast approaching 1.5-million residents.
But as the largest city in the world its ever-growing population is spilling into overcrowded, decaying, stinking slums and the poorest are literally surrounded by their own filth. Piled in courtyards or overflowing from basement cesspits, raw sewage is everywhere.
Disease is inevitable. Typhoid, Influenza, Tuberculosis, Smallpox and Scarlet Fever are rife. But it was Victorian London’s experience of cholera in 1832 that would have the greatest social impact.
First detected in the slums of Jessore in India, cholera is spread by the bacteria-laced diarrhoea of its victims, and it’s violent and rapid assault on the human body was beyond the understanding of the physicians of the time.
It eventually arrived in England from Baltic ships docking in the Northern port of Sunderland. After the first death there on 26 October 1831, the epidemic spread to neighbouring Newcastle and then northwest to Scotland. The disease soon reached London, carried on colliers’ ships bringing coal south to the capital.
Ten years later, under pressure from London’s elite worried for their own health, leading social reformer Edwin Chadwick was commissioned to conduct an inquiry into the state of public sanitation. His 1842 report, “The Sanitary Conditions of the Labouring Population,” made a clear connection between disease and living conditions and demanded urgent action.
By 1848, Chadwick had been appointed to the first Board of Health and was Sanitary Commissioner of London. He now had the power to change things.
But his actions were firmly guided by the “miasma theory” of disease – that foul air was the route of much disease. But this did at least advocate the rapid removal of human waste through improvements to the sewage and drainage systems.
Unfortunately, this led to a greater flow of raw sewage into the River Thames – the main source of drinking water for Londoners, further contaminating London’s water supply and dramatically increasing the risk of cholera.
It was 1854 before research by physician John Snow, a leader in the adoption of anaesthesia and medical hygiene, would inspire the fundamental changes in the water and waste systems of London required, leading to similar changes in other cities, and a significant improvement in general public health around the world.
Unlike most of his contemporaries, Snow was no “miasmatist” – he publicly stated in 1849 that cholera was transmitted through water.
He was already researching links between water supply and deaths from cholera when the disease returned to the heart of London’s Soho on 31st August 1854.
Over the next three days, 127 people on or near Broad Street died. In the next week, three quarters of the residents had fled the area. By 10 September, 500 people had died and the mortality rate was 12.8 percent in some parts of the city. By the end of the outbreak, 616 people had died.