The great scourge of the first half of the 19th century was cholera, a deeply unpleasant disease causing the victim to suffer excessively from diarrhoea and vomiting leading to dehydration and in many cases death. It is thought to have originated in the Indian sub-continent where the many pools of still water were ideal breeding grounds for the bacteria responsible for its spread.
Globally there have been seven cholera pandemics in the last two centuries, the first occurring between 1817 and 1824, originating in Bengal and spreading through Southeast Asia, China, Japan, the Middle East and Russia. Improvements in transportation and the increasing globalisation of trade meant that the second pandemic spread to Western Europe and the United States. The seventh pandemic occurred as recently as 1961 and centred on Indonesia. Cholera is thought to have killed tens of millions of people, a million alone in Russia during the outbreak between 1847 and 1851.
For those responsible for public health, cholera posed a major problem. At first the strategies they adopted were identical to those used to combat other epidemics such as the plague. Lazarettos were planned for the major western Mediterranean ports and a major one was built in Bordeaux. Ships were barred from entry into ports if they were arriving from regions where cholera was present. Travellers were quarantined, sick people forced to stay in lazarettos and beggars and prostitutes were forced by health officials away from conurbations.
During the cholera pandemic that swept the Mediterranean area and Italy in particular in 1835-6, the only Italian region to escape the disease was Sardinia which had instituted a regime whereby armed personnel had explicit orders to prevent by force, if necessary, any ships attempting to land persons or cargo on the coast. For Italian monarchies, fighting an ultimately losing battle against republicans and revolutionaries, the presence of or the threat of plague or cholera gave them the welcome opportunity to suppress civic rights and liberties. Conversely, people’s developing understanding and attachment to personal liberties coupled with scientific questioning of the theory of miasma as the route by which disease spread meant that the days of draconian (and wrong) public health policies were numbered. After all, the principal issue was accessing contaminated water, not communicating germs from one person to another.
For those unfortunates in the grips of cholera there were a range of remedies offered to ease their sufferings. In Naples during the epidemic in the mid 1830s the odiferous camphor was used. In northern America the praises of tomato syrup as a remedy were sung while in England you could do worse than elecampane or horse-heal. Placebos at best, I suspect.
The pioneering work of John Snow, as we have seen elsewhere, demonstrated conclusively that a contaminated water pump was the locus of a cholera outbreak in London’s Soho. The greater understanding of the causes of epidemics such as cholera coupled with the introduction of (more effective) sanitation systems in major conurbations, improved treatment regimes for those who contracted the disease and more effective inoculation programmes meant that outbreaks of cholera started to reduce in both frequency and severity and for it to pretty much disappear in what are euphemistically known as developed countries.
But in its heyday cholera was a major killer and a much feared disease.