Fear and humour in the art of cholera
Authors: MP Park, RHR Park
Journal: Journal of the Royal Society of Medicine (2010)

Although the recent swine flu pandemic posed an international health threat, the disease was the subject of many humorous cartoons and posters. Such a response is not new. It has long been recognized that in times of such adversity humour can play a significant role in aiding communities to cope with the fear of disease and death.1 In the art associated with the cholera pandemics of the 19th century, for example, humour and fear combined with particular resonance.

The cholera pandemic of 1831–1832 and its associated high mortality (31,000 deaths in Britain alone)2 may appear an inappropriate topic for cartoons but its arrival in Sunderland in October 1831 provided an opportunity for satirists to excel. The cholera cartoons highlighted the disagreement between doctors on the diagnosis and treatment of cholera, public mistrust of the medical profession and their ineffective treatment, and political attacks on government policies. Several of these themes were included in Robert Cruikshank's Random Shots (No 1) A Cholera Doctor ( Figure 1) and Robert Cruikshank's Random Shots (No 2) A Cholera Patient ( Figure 2). These humorous prints illustrate contrasting experiences during the pandemic – the affluent medical profession thrives while the destitute public withers. Robert Cruikshank (1789–1856) was born in London and after a brief commission in the East India Company he returned to the capital where he became a book illustrator and cartoonist. Although not as successful an artist as his father Isaac or his brother George, with whom he often collaborated, he was equally adept at ridiculing topical events.



Figure 1

Robert Cruikshank's Random Shots (No 1) A Cholera Doctor, c1832 (coloured etching). Reproduced with permission from Yale University, Harvey Cushing/John Hay Whitney Medical Library (in colour online)





Figure 2

Robert Cruikshank's Random Shots (No 2) A Cholera Doctor, c1832 (coloured etching). Reproduced with permission from Yale University, Harvey Cushing/John Hay Whitney Medical Library (in colour online)



In Robert Cruikshank's Random Shots (No 1) A Cholera Doctor the artist exaggerates the public's mistrust in doctors and in particular the belief that they had a pecuniary interest in prolonging the epidemic. On 14 February 1832, as cholera was making its first appearance in London, an anonymous letter writer (‘Theta’) to The Times accused the Central Board of Health, which had been established in June 1831 to investigate the causes of cholera and organize preventive measures, of paying its medical officers a fee of 20 guineas a day while the epidemic lasted and criticized ‘the profit derived from cholera-phobia by the profession at large’.3 Following a week of heated debate on the subject, an editorial in The Times on 21 February 1832 supported the criticism of the medical profession and even commented that ‘it is doubtful whether any really contagious disease exists’.4 In Cruikshank's print the wealthy doctor helping himself to a rather generous portion of pie etched with the words ‘£20 per day’ (perhaps an added insult to doctors since professionals were paid in guineas) is also fixated by the cascade of coins. ‘Lancet’ is engraved on the sabre-shaped knife, alluding to the journal's defence of the Central Board of Health following The Times' letter. In a leading article, The Lancet criticized The Times for its ‘slanderous attacks’ on the Board of Health, and the ‘atrocious falsehoods regarding the pay and emoluments of those engaged in the execution in the sanitary duties’ and revealed that six medical inspectors received payment of ‘the full sum of seven shillings and six pence per day, with 10s. 6d. a week for lodging expenses!!’5 The name of Dr Robert Daun, a Government Inspector who had been sent to the initial outbreak in Sunderland in 1831, appears on the label of the brandy bottle (‘cholera brandy’ was one of the many unproven cures or preventive measures against the disease). The Times letter had singled out Dr Daun as a beneficiary of the Board of Health's plans.

In Robert Cruikshank's Random Shots (No 2) A Cholera Patient the artist turns his attention to the impoverished public and extends his ridicule of the medical management of cholera. The terrified and emaciated patient is perched next to a table propped up with human bones and laden with the standard treatment. His elbow showing through his threadbare clothes rests on a box of Blue pills (a purgative containing mercury), one of which he is holding in his hand, next to an anthropomorphic-shaped emetic bottle from which claw-like hands extend. As starvation was not a recommended treatment the ‘starvation stool’ may refer to the hardship endured by most patients and to the Day of Fasting and Humiliation held on 21 March 1832, arranged as an act of penance and resented by the poor.6 The bald-headed ‘Fee Fo Fum’ creature under the table alludes to the impending doom of the patient – ‘I smell the blood of an Englishman’.

The cholera pandemic of 1831–1832 and subsequent outbreaks also caused widespread devastation on mainland Europe. The Continent's response was similar to Britain's ‘cholera-phobia’ but with an additional concern – the risk of premature burial. Reports of errors in the confirmation of death arose from the death-like appearances of severe cases and were exacerbated by the requirement for an early and quick burial.7,8 One of the most melodramatic images on this theme is L'Inhumation Precipitee [The Premature Burial] ( Figure 3) by the artist Antoine-Joseph Wiertz (1806–1865). Born in Dinant, Belgium, Wiertz studied at Antwerp Academy and moved to Paris in November 1828. In 1837, after a three-year residence in Rome, he returned to Belgium, settling first in Liege and then in Brussels in 1845.



Figure 3

Antoine-Joseph Wiertz: L'Inhumation Precipitee [The Premature Burial], 1854 (oil on canvas) Musee Wiertz Museum, Brussels (in colour online)



Although a fine portraitist, Wiertz became celebrated for his bizarre and often disturbing fantasy compositions in which death is a common theme. Even at the age of 15 he exhibited eccentric behaviour living as a recluse in a miserable attic room accompanied by a skeleton and a ‘cleverly painted death’s head'.9 The Premature Burial is set in a dark stone cellar or crypt the floor of which is littered with coffins and skeletal remains. In the foreground the shrouded figure of a cholera victim cries out in fear as he prises open the lid of the coffin in which he has been laid and attempts to escape, his arm desperately stretched out towards us. And yet at the centre of this nightmarish vision lies an unexpected touch of macabre humour for Wiertz has added an inscription on the side of the coffin: ‘Mort du cholera – certifie par nous docteurs [signe] sandoutes’ (death from cholera – certified by our doctors [signed] without doubt). Blending fear and humour, the painting powerfully illustrates ‘without doubt’ that the unfortunate victim has indeed been buried alive.

Edgar Allan Poe's short story The Premature Burial (1844) has been cited as the stimulus for Wiertz's painting but a much more personal experience may have shaped the image. As his studies in Rome drew to a close in 1837, news reached him of a cholera epidemic in Naples. By promising the medical authorities of Rome that he would not return there, Wiertz was given permission to visit Naples where he discovered ‘the sick, but not yet dead, people being hastily buried, so great was the population’s (and Doctors') fear for the contagion' (personal communication, Brita Velghe, Musee Wiertz Museum). Even before his visit to Naples, Wiertz would have been aware of the concern about the risk of premature burial: it was a theme found in numerous continental folklore tales. In addition, during the late 18th and early 19th centuries there was considerable debate over the signs of confirmation of death resulting in several articles in the popular press. This led to preventive measures including extending the time between death and burial to 48 hours in Belgium and Austria.10 In 1790, Dr Christoph Wilhelm Hufeland, practising in Weimar, proposed a house for the dead which he called the Vitae Dubiae Asylum (the Asylum of Doubtful Life), subsequently known as a waiting mortuary.10 His asylum was designed to provide ‘the supervision of alleged corpses until they could safely be declared dead’.10 The first one opened in Weimar in 1792, followed by many more throughout Germany and Austria during the next 90 years. A 14 ‘corpse bedded’ waiting mortuary in Brussels was in use until the 1870s.10

Wiertz, who died from septicaemia on 18 June 1865, had arranged with the Belgian government an exchange of his paintings for the construction of a large studio (now the Musee Wiertz Museum, Brussels) built to house his art. In 1868 the museum, with its images of disease and death including The Premature Burial, became part of the Royal Museums of Fine Arts of Belgium.

Cruikshank and Wiertz are only two of the many artists whose work offers a window into the impact of such catastrophic diseases. As future pandemics appear, even in this era of multimedia, there remains an important role for art in documenting not only the physical suffering but also the use of humour as a coping mechanism to alleviate fear of disease and death.