The History of Cholera in Great Britain

ALTHOUGH Asiatic cholera did not visit the shores of this island until 1831, it had quite a respectable history long before that date. Macnamara [1 ]-an authority on the history of cholera in the East-thought that the disease may have existed in India in 400 B.C., and there are records of outbreaks in the fifteenth century. The devastating epidemic which prevailed in Lower Bengal in 1817 was the occasion of a number of short treatises on the subject by Europeans. Several of these were in the form of Latin theses presented to the Universities of Glasgow and Edinburgh [2]. Cholera reached Europe in 1829, and during 1830 and 1831 it was widespread in the countries of Central Europe. In Great Britain generally much interest was caused, and many fears aroused, by the continued existence in Europe of a disease which had until then been regarded as purely Asiatic. Preventive measures included the formation of a Central Board of Health with Sir Henry Halford as President, and also of many local Boards of Health in different parts of the country. About this time nearly all observers were much concerned about the indigenous "cholera" of Britain. It was known as "cholera nostras" and by various other names, and in certain features it did resemble Asiatic cholera. How were medical men to decide whether the true cholera had arrived, or whether they were still dealing with severe cases of cholera nostras? In order to settle this point the Central Board arranged for consultations to be given by medical men who had had experience of Asiatic cholera in the East. But the Eastern disease had a way of its own of settling the question, and when it did arrive the issue was never long in doubt. The epidemic of1831-32. -The first death from true Asiatic cholera in this country occurred in Sunderland on October 20, 1831. After a slight lull the disease took a heavy toll during the next few months, so that by January 9, 1832, 215 deaths from cholera alone had occurred in Sunderland. Cholera next appeared at Newcastle on December 7, 1831, and there it ran most of its course during the next few months. It did not finally exhaust itself until the summer, by which time there had been over 1,330 cases and 801 deaths. Gateshead and other Tyneside towns were attacked about Christmas or the New Year. Almost contemporaneously cholera appeared in Haddington. The first case occurred on December 17, and the next on the 25th. By February 23 there had been 125 cases with 54 deaths [3]. A little later the Tranent area was affected. The town of Tranent itself, with a population of 1,631 persons, had 204 cases and 64 deaths; and the villages of Cockenzie and Port Seton, and the town of Prestonpans, with a total population of 2,717 persons, had 195 cases and 36 deaths [4]. The small town of Musselburgh suffered a devastating attack, and between January 18 and February 22 there were over 400 cases and 202 deaths. The next areas to suffer the dire effects of the new disease were the large cities and the industrial centresEdinburgh at the end of January, and Glasgow during the second week of February. In each the disease seemed to be exhausting itself about the beginning of the summer, but in July and August it sprang to life again in an even more violent form. In Glasgow alone there were 3,166 deaths-the highest mortality figures in the country, apart from London. The epidemic in England fell much later than in Scotland, and really occurred in the summer and autumn. London was an exception, since the disease started there about February 14, and dragged on until the end of the year. The first important provincial city to be attacked was Hull. This was during the first week of April. The disease had broken out at Liverpool by the end of that month, and between then and the middle of July severe outbreaks had commenced in Manchester, Salford, Leeds, Plymouth, Sheffield, Nottingham, Bristol and Exeter. In a previous communication [5] 1 gave a full account, with a statistical discussion, of the epidemic as it affected the centres of population in Yorkshire. Hull and Goole were considered by the Central Board of Health as infected from April 6, but the first authentic cholera death in this area probably occurred on April 13. Alderson [6] described this outbreak well, and from his account it would appear that the disease did not really make itself felt until June, by which time it was epidemic throughout Yorkshire. Most deaths occurred at Leeds (702), Sheffield (402), Hull (300), and York (185). The writings dealing with the Sheffield outbreak were collected in 1921 by Stokes [7]. In Lancashire the