Source 2: Meeting about cholera, 1832
Source 1: 
Cholera hospital, 1832
Prince Albert married Queen Victoria in 1840 and they had nine children, but in December 1861 he fell ill and died. Prince Albert had caught TYPHOID, a disease that is caused by drinking either dirty water or milk, or eating dirty food. The usual cause of typhoid was allowing drinking water to be polluted by sewage. The death of her husband was a great shock to Queen Victoria. How could one of the most important people in Britain die from a disease like this? Was this common? Were rich and poor just as likely to die from diseases like this at the time of the Great Exhibition? 



Source 3: Poster on cholera, 1848
Source 4: Cholera epidemic The big killer disease of the mid-nineteenth century was CHOLERA which was caused in a similar way to the disease Prince Albert had died of. Cholera had arrived in Britain for the first time in 1831, probably arriving on ships bringing imports from China. Doctors had little idea about the causes of cholera. Most accepted the miasmatic (read on!) theory of disease. They believed that diseases were caused by the air somehow being polluted by waste. This came about because severe outbreaks of disease often happened in hot summers when there was a great deal of rubbish lying in the streets. As the rubbish rotted, it gave off a stronger and stronger smell. This, many doctors believed, caused disease. 



Source 6: Public health poster, Ormskirk Source 5: 
Health of the town of Ormskirk
 
 
Cholera was most dangerous in the new industrial towns of the north or in the centre of big cities like London. Here people lived in crowded housing. Most people got their water from a tap in the street and often the supply was pumped out of a nearby river. This river could easily be used for sewage disposal at the same time. In London, one water company drew water out of the River Thames from a point right next to the outlet of the Great Ranelagh Sewer. 



Source 8: Cholera outbreak, 1853
Source 7: Petition from Ormskirk In the new industrial towns, cholera was even more dangerous because many of the houses had been built quickly with no attempts at planning. Often there was no sanitation and no fresh water. In one street in Bolton the people used a trench at the back of the houses as a toilet, which was cleared out and the mess stacked up against the end wall of the last house. The mess was taken away every six months. There was a second big outbreak of cholera in 1848, a third in 1853 and a fourth in 1866. Each time thousands of people died swiftly and in terrible pain. They suffered violent vomiting and diarrhoea, coupled with very bad stomach pains. The actual cause of death was often dehydration (not enough water). 

Edwin Chadwick In 1842 Edwin Chadwick published his 'Report on the Sanitary Conditions of the Labouring Population of Great Britain'. He had surveyed different areas around the country and calculated the average life expectancy of people from different classes and areas. The results were startling to say the least. Chadwick claimed that people living in the countryside lived far longer than people in towns. He compared Rutland, a rural county with no large towns, with the new industrial cities of the north. 

 
 
Chadwick's report led to the setting up of a Royal Commission and then to the Public Health Act of 1848. He became one of the Commissioners.  
Unfortunately many people found Chadwick rather rude and he often provoked opposition. In 1854 he was forced to retire. This letter was sent to 'The Times' to explain why he was unpopular.  
' We prefer to take our chance with cholera than be bullied into health. There is nothing a man hates so much as being cleansed against his will or having his floor swept, his hall whitewashed, his dung heaps cleared away and his thatch forced to give way to slate. It is a fact that many people have died from a good washing.' 
John Snow (1813-1858) 
John Snow was the eldest son of a farmer and born at York on 15th March 1813. He was educated at a private school in York until the age of fourteen, when he was apprenticed to a surgeon living at Newcastle-on-Tyne. He worked as surgeon in the mines and later as unqualified assistant during the cholera epidemic of 1831-2. Snow continued his medical training in London. In October 1838 he became a licentiate of the Society of Apothecaries, having been admitted a member of the Royal College of Surgeons of England in May 1838. He graduated as an M.D. of the University of London on 20 December 1844, and in 1850 he was admitted a licentiate of the Royal College of Physicians. 

Snow's great breakthrough theory was that cholera spreads through means of an impure water supply. He outlined his ideas in an essay about the communication of cholera which was published in 1849, and awarded a prize by the Institute of France. In 1855 a second edition was published, with a much more detailed investigation into the water supply in certain districts of South London during in the epidemic of 1854.  
Snow was also interested in the properties of ether, then newly adopted in America as an anaesthetic. He made great improvements in the method of giving patients the drug. He obtained permission to demonstrate his results in the dental out-patient room at St. George's Hospital surgery which was highly successful. Nevertheless, Snow appreciated the value of other anaesthetizing drugs, notably chloroform. He gave this to Queen Victoria on 7 April 1853, during the birth of Prince Leopold, and again on 14 April 1857 at the birth of Princess Beatrice. Snow died unmarried on 16 June 1858, and was buried in the Brompton cemetery. 


 
1a Why has the letter been written?  
1b What had happened in the hospital? 1c Would the treatment received in the hospital have helped to stop cholera spreading? 
 
 
This is a letter written on 5th January 1832. It was sent from the Board of Health to the Newcastle Board. The writer is talking about conditions in Gateshead hospital. 

## (Pro Ref: Pc 1/93)


 
2a How many new cases were reported? 2b How many of the deaths were reported?  
2c How many cases of cholera were there altogether? 2d How many people had died? 2e Approximately what percentage of people who caught cholera actually died 
from the disease? 
 
These are the minutes of a meeting of the Board of Health held on 13th January 1832. It includes a report of the numbers of cases of cholera in Sunderland, Newcastle and Gateshead. 

3a What is the poster saying it can help prevent?  
3b The poster gives advice on how to avoid getting cholera. Some advice is good, some is bad. i) Write down three good pieces of advice. ii) Write down three bad pieces of advice (choose the worst!). 

3c What else is the poster offering apart from advice?  
3d The poster suggests two things that can be bought for protection against cholera. 

What were they? Would either of these have been of any use? 

 
 
This is a poster that was put up in London in 1848, during the second outbreak of cholera. 

 
(PRO ref: MH 13/245) 
 

4a Where does he say the worst outbreaks of cholera took place? 4b Where were there not many, if any, cases of cholera? 4c How does he explain the differences? 4d What does he believe were the causes of cholera?  
4e Do you think that people in 1848 had any better idea of the ways to treat cholera than they had had in 1832? (Source 1) 4f If all the suggestions made in source 3 and 4 had been followed, would this have prevented an outbreak of cholera? 

 
In October 1848 this letter was written to the General Board of Health (set up by the Public Health Act 1848). The writer is describing the cholera epidemic of 1832 which he had witnessed. 

## (Pro Ref: Mh 13/245)

5a How many people had signed the petition in Ormskirk? 5b What are the reasons for sending the letter? 5c Which of the reasons would help prevent cholera? Which would not? 
 
 
This is a letter written by the Chairman of the Sanitary Committee of Ormskirk to the General Board of Health in 1848. Towns could ask the General Board to set up a Local Board, but at least ten percent of the ratepayers had to sign a petition. The General Board would then send an inspector to town to inspect the sanitary state of the  town. 


## (Pro Ref: Mh13/138)


6a What was the inspector going to look into? 6b Would his enquiries have helped to identify possible causes of cholera outbreaks in the town?  
Look back at source 5 
6c In what ways do these sources suggest that cholera was being taken more seriously in Britain? 

This poster appeared in the town of Ormskirk in Lancashire in October 1848. It was signed by the inspector appointed for Ormskirk. 

## (Pro Ref: Mh 13/138)

 

7a. Why was this petition sent? What were the people objecting to? 7b. Why do they believe that a Local Board of Health is not needed? 
A petition sent by people in Ormskirk to the General Board of Health. 

 

## (Pro Ref: Mh 13/138)

 

8a. What is the main reason for the outbreak of cholera suggested in this source? 

8b. What conditions in Newcastle upon Tyne and Gateshead caused cholera to spread so easily? 

8c. The end of the source says that some men are against efforts to improve living conditions in the worst parts of the city. Can you explain this? 

 

 
This is part of newspaper report from October 1853; this was at the time of the third outbreak of cholera.