The Cholera of 1854 in England.

The great epidemic at Newcastle and Gateshead was over by November, 1853, those towns having no share in the general epidemic in England in 1854, although it visited their near neighbour Tynemouth. The interest of the cholera of 1854 centres chiefly in London[1565]. Few of the great foci of infection in 1849 were visited severely. Liverpool, which never escaped, had a moderate epidemic, Merthyr Tydvil also had about a fourth part of its 1849 mortality, Dudley had the disease somewhat severely, while some towns, such as Norwich, Wisbech and Sheffield, had more than usual. But Plymouth, Hull, Bristol, Manchester, Leeds, the towns of the Black Country and nearly all the populous places that had suffered heavily either in 1832 or in 1849, or on both occasions, escaped in 1854 with little cholera or none[1566]. The table shows the incidence of the epidemic (as well as that of 1866) according to counties.

Cholera Mortality in England and Wales in 1854 and 1866.

1854 1866
Rate
per
1000
Rate
per
1000
Principal centres in each county
DeathsDeaths1854 1866
England and Wales 20097 14378
London 10738 4·3 5596 1·9 South of Thames,
Eastern parishes
Eastern parishes 3691
Surrey, part of 252 1·2 82
Kent, part of 1056 2·1 284
Sussex 94 ·3 79
Hampshire 130 ·3 417 ·9 Portsea Island 20,
Southampton 48
Portsea Island 129,
Southampton 41
Berkshire 49 ·2 3
Middlesex, part of 380 2·4 51 Brentford 196
Hertfordshire 97 ·5 9
Buckinghamshire 68 ·5 10
Oxfordshire 183 1·0 4
Northamptonshire 152 ·7 7 Towcester 86
Huntingdonshire 18 ·3 1
Bedfordshire 61 ·4 22
Cambridgeshire 270 1·3 7 Wisbech 176,
Ely 46
Essex 513 1·4 471 1·0 West Ham 124,
Romford 113,
Maldon 102
West Ham 389
Suffolk 67 ·2 15
Norfolk 381 ·8 15 Norwich 193,
Yarmouth 41
Wiltshire 60 ·2 11
Dorset 45 ·2 6
Devon 188 ·3 525 ·9 Plymouth 59,
Stonehouse 15,
Devonport 2,
Bideford 46
Exeter and St Thomas
247, Newton Abbot
57, Totnes 146
Cornwall 24 ·06 21
Somerset 21 ·04 68
Gloucestershire 260 ·6 39 Bristol 76,
Clifton 92,
Gloucester 48
Herefordshire 1 ·01 2
Shropshire 13 ·05 17
Staffordshire 426 ·6 30 Dudley 256,
Wolverhampton 80
Worcestershire 103 ·4 36 Worcester 45
Warwickshire 89 ·2 15
Leicestershire 14 ·06 3
Rutlandshire 9 ·08
Lincolnshire 134 ·3 48 Great Grimsby 68
Nottinghamshire 80 ·3 12 Worksop 27,
Nottingham 16
Derbyshire 17 ·06 20
Cheshire 141 ·3 391 Chester
Lancashire 1775 ·8 2600 1·0 Liverpool 1084,
W. Derby 206,
Wigan 158
Liverpool and W. Derby
2122, Wigan 137
West Riding 470 ·3 283 Sheffield 126,
Dewsbury 66,
Leeds 48
East Riding 70 ·3 54 Hull 27
North Riding 84 ·4 21 Whitby 33,
Guisboro’ 30
Durham[1567] 2·9 352 ·6 Stockton, Auckland,
Durham
Northumberland[1568] 5·7 224 Newcastle 1431,
Gateshead 525,
Tynemouth 203
Cumberland 35 ·2 32
Westmoreland 1 ·02 1
Monmouth 18 ·1 204
South Wales 887 1·4 2033 2·9 Merthyr Tydvil
455, Cardiff 255,
Neath 54,
Brecon 54
Swansea 521, Neath
520, Llanelly 232,
Merthyr Tydvil 229
North Wales 34 ·08 256

The London cholera of 1854, like that of 1832 and of 1849, fell most upon the southern (Southwark etc.), eastern and southeastern parishes (Table, p. 858). But it fell somewhat unequally upon these; and for Southwark and Lambeth the water supply was seized upon as the thing that made the difference. There were two water companies in South London, the Lambeth company and the Southwark and Vauxhall company. The parish of Christ Church, Lambeth, chiefly supplied by the Lambeth company, had a death-rate from cholera in 1854 of only 0·43 per 1000 inhabitants; whereas the parish of St Saviour, supplied by the Southwark and Vauxhall company, had a death-rate of 2·27 per 1000. In 1849 there had been no such disparity between them, the death-rate of Christ Church being if anything the higher of the two. Now it happened that in the interval of the two epidemics of cholera the Lambeth company had removed their intake works from opposite Hungerford Market to Thames Ditton, whilst the Southwark and Vauxhall company still continued to draw their supply from the Thames near Vauxhall. Here was a fine instance of the logical method of difference. Farther, within the parish of Christ Church itself, it was sought to show that the cholera followed the lines of old water supplies, and did not follow the mains from Thames Ditton. After 1854 the Southwark and Vauxhall company also made their intake at Thames Ditton. According to the water-hypothesis of cholera, it is not surprising, as we shall duly find, that the whole of the South London parishes, which had been the chief seats of the cholera in 1832, 1849, and 1854, escaped in 1866 with a very slight visitation. Newcastle was another chosen instance of cholera distributed by the water mains; but, as we have seen, that was improbable. Another instance was Exeter: its water supply in 1832, when part of it had a disastrous epidemic of cholera, was taken from the Exe, and was impure; in 1849, when it had only a tenth part of its last cholera mortality, its water supply had been greatly improved; in 1854 it had 10 deaths; but in 1866, Exeter with the registration district of St Thomas had 247 deaths, and Totnes had 146,—for their size about the most severely visited towns in England.

In the London cholera of 1854 a very sudden and simultaneous explosion in the district of Soho attracted much notice[1569]. The district stands high, which did not save it from being the scene of the first outbreak in the great plague of 1665. In the subdistricts of St Anne, Golden Square and Berwick Street, with a population of 42,000, many of them well-to-do families, there were 537 deaths from cholera, a rate of 12·8 per 1000, contrasting with the rate of 6 per 1000 for all London. The attacks and fatalities were remarkably numerous for one or two days, falling at once thereafter to about a half. There was a pump in Broad Street, in the centre of this district, which was supposed to have dispersed cholera broadcast in its contaminated water; a death had occurred in Swain’s Lane, at the foot of Highgate Hill, of a person who had drank the water of the Broad Street pump. The whole incident was seized upon and worked up by Dr Snow, who had written a speculative essay in 1849 upon the probability of cholera being conveyed by water, according to the similar theory of Parkin in 1832[1570]. The Board of Health, having very full data before them of the Soho outbreak in all its aspects (including a whole biological treatise upon the organisms found in water), did not adopt Snow’s conclusion, although he had enthusiastic followers at the time, and has probably more now[1571]:

“In explanation of the remarkable intensity of this outbreak within very definite limits, it has been suggested by Dr Snow that the real cause of whatever was peculiar in the case lay in the general use of one particular well, situate at Broad Street in the middle of the district, and having (it was imagined) its waters contaminated by the rice-water evacuations of cholera patients. After careful inquiry we see no reason to adopt this belief. We do not find it established that the water was contaminated in the manner alleged; nor is there before us any sufficient evidence to show whether inhabitants of the district, drinking from that well, suffered in proportion more than other inhabitants of the district who drank from other sources.”