The Cholera of 1865-66.

Asiatic cholera reached Europe by a new route in 1865—by the way of Egypt with the pilgrims returning from the Hâj at Mecca. In the course of the autumn it appeared at Southampton and caused 35 deaths from 24 September to 4 November. A strange extension from Southampton (or from Weymouth) took place to the village of Theydon Bois in Epping Forest, where nine deaths were traced to one house from 28 September to 31 October, unhappily including the death of a most estimable medical gentleman who tasted the water of a well into which the evacuations of the sick had probably percolated.

The cholera having become established on the continent of Europe in the end of 1865, was brought into England by emigrants passing from Hull and Grimsby to Liverpool on their way to America. On board one of the emigrant steamships, the ‘England,’ a very severe epidemic arose in mid-Atlantic in April. Liverpool had once more a severe epidemic (2122 deaths); but the only other important centres in England, besides London, were Swansea, Neath, Llanelly and Merthyr Tydvil, Chester and Northwich, a group of towns on the Exe in Devonshire, and Portsmouth with other places in Hampshire. Still, the deaths in all England made the large total of 14,378, no county excepting Rutland being absolutely free. That means that the infection, although widely diffused, now wanted the conditions favourable to its development and effectiveness; and that, again, seems to mean that a vast improvement had been made in the sewering of towns, in scavenging, and in all other matters of municipal police by which the soil of inhabited spots is preserved from saturation with excremental and other filth.

The interest of the cholera of 1866 centres in London, and chiefly in the fact that three-fourths of the deaths, to the number of 3696, took place in the eastern parishes, Whitechapel, Bethnal Green, Poplar, Stepney, Mile End, St George’s in the East, and Greenwich. These had in former epidemics a fair share; but hitherto they had been surpassed by the Southwark parishes and others on the south of the Thames from Battersea to Rotherhithe, and nearly equalled by Shoreditch and the Liberties of the City. The comparative table of the four great choleras of London shows how remarkably the infection in 1866 had left its old principal seats, remaining, as if a residue, only in the East End, with death-rates comparable to those of 1849.

Comparative view of the Four Epidemics of Cholera in the several parishes of London[1576].

		1832		1849		1854 (17 wks. end. 4 Nov.)		1866
		Rate per 10,000	Deaths	Rate per 10,000	Deaths	Rate per 10,000	Deaths	Rate per 10,000	Deaths
Kensington		10	52	24	260	35	490	3·7	85
Chelsea		80	272	46	247	47	300	3·3	22
St George, Hanover Sq.		10	74	18	131	38	295	1·7	18
Westminster		50	450	68	437	60	423	6·2	43
St Martin in the Fields		—	—	37	91	24	58	4·2	10
St James, Westminster		—	—	16	57	152	485	3·5	13
Marylebone		30	355	17	261	16	347	3·0	54
Hampstead		—	—	8	9	11	14	·8	2
Pancras		20	230	22	360	13	248	6·0	138
Islington		10	39	22	187	8	97	4·3	120
Hackney		2	8	25	139	11	73	10·6	103
St Giles		50	280	53	285	21	115	9·2	49
Strand		1	26	35	156	24	111	6·6	29
Holborn		10	46	35	161	5	25	5·2	22
Clerkenwell		10	65	19	121	9	59	7·0	45
St Luke		30	118	34	183	9	52	8·1	46
East City	} }	50	605	45	182	23	85	15·7	59
West City				96	429	10	126	18·8	60
City				38	207	14	71	5·0	20
Shoreditch		10	57	76	789	20	237	10·7	139
Bethnal Green		50	345	90	789	20	192	60·4	611
Whitechapel		110	736	64	506	40	330	84·2	909
St George in the East		30	123	42	199	30	154	87·9	385
Stepney		50	358	47	501	32	388	107·6	559
Mile End Old Town		—	—	—	—	—	—	67·7	501
Poplar		40	101	71	313	38	208	90·8	837
St Saviour	}	120	1128	153	539	134	495	7·4	32
St Olave	}	120	1128	181	349	162	315	8·5	21
Bermondsey		70	210	161	734	158	845	5·3	35
St George, Southwark		—	—	164	836	101	546	6·6	38
Newington		40	200	144	907	101	696	2·8	26
Lambeth		40	337	120	1618	63	941	6·5	114
Wandsworth		10	46	100	484	77	422	4·8	40
Camberwell		30	107	97	504	91	553	5·6	46
Rotherhithe		10	19	205	352	147	285	8·7	25
Greenwich		20	149	75	718	53	576	19·5	284
Lewisham		—	—	30	96	20	81	6·1	56
Stratford		—	—	—	—	—	—	77·6	—
West Ham		—	—	—	—	—	—	49·3	—
Leyton		—	—	—	—	—	—	13·1	—

There was one significant thing associated with the peculiar incidence of the cholera of 1866 upon the East End. The main drainage of London, consisting of a high level and a low level sewer on each side of the Thames, was commenced in 1859, and was formally opened on 4 April, 1865. The two levels on each side of the river made together a length of eighty-two miles; the cost, with pumping station, was £4,200,000. When the cholera of 1866 broke out, only one part of the system was incomplete and not yet in working, namely, the low level main drainage on the northern side, which served the whole of the cholera-stricken parishes from Aldgate to Bow. However, the official mind in this country has somehow become prejudiced against the well-known and usually accepted generalities of von Pettenkofer, which make more of a foul soil in the causation of miasmatic infections, than of contaminated surface water or contaminated water from reservoirs. Accordingly, the somewhat remarkable fact that the East End of London alone retained its old proclivity for choleraic infection was not joined to the fact of its being the only great division of the capital still unsewered, but to the fact that it was supplied by water taken in from the river Lea in Hertfordshire and (it was alleged) insufficiently filtered or otherwise purified at the Old Ford waterworks[1577].

The extension to Scotland in 1866 was late in the season and insignificant compared with former epidemics. It was heard of about the end of summer in Fraserburgh and one or two other ports or fishing places on the East Coast, but it was not until October and November that it attracted notice in the eight principal towns, the whole mortality from it in Glasgow being 53, in Edinburgh 154, in Dundee 105, in Aberdeen 62, in Paisley 2, in Greenock 14, in Leith 95, and in Perth 15. Besides these deaths there were 435 more in smaller towns or villages. The year was a very healthy one, the death-rates of Glasgow, Greenock and Perth having been below the mean of the previous ten years.

In Ireland the cholera of 1866 was even slighter than in Scotland, the only considerable epidemic having been at Belfast.

Cholera has never obtained a footing in London since the epidemic of 1866. In 1873, while the disease was unusually active in some parts of Europe, a few cases occurred in Wapping among Scandinavian emigrants on their way to America, who had been landed for a few days. But the infection did not spread. In 1884, when cholera came from Cochin China to Toulon and Marseilles, two or three cases occurred on board steamships arriving at Cardiff and Liverpool. In 1893, when the disease raged in Hamburg, a number of choleraic cases occurred at Grimsby in August, which were considered certainly Asiatic owing to their high degree of fatality. In August-October, the deaths from cholera, whether cholera nostras or the Asiatic type, or both together, were about thirty in Grimsby, eighteen in Hull, and about fifty more in various other places, chiefly in the south of Yorkshire. The autumn of that year was favourable to bowel-complaints and to enteric fever.