It is probable that the mortalities in Scotland on this occasion, besides those in Glasgow, Edinburgh and Dundee, were neither so general nor so great as in 1832. One remarkable outbreak happened at the village of Symington, in Ayrshire: in a population of 240 there were 110 attacks and 30 deaths; nearly all the cases were in houses on one side of the village street, which got their water from a public well; the houses on the other side, having private wells (and differing, doubtless, in other respects), were notably free from the infection[1574].

The cholera of 1854 was unimportant in Ireland. Cases appeared among emigrants on board ships in Belfast Lough and at Queenstown in the end of 1853, but no diffusion took place until 1854, and then only to a moderate extent. It is supposed that some 1706 persons died of it in Ireland in that year, according to the retrospective figures of the census of 1861; but a good many deaths from “cholera” were returned for every year of the decennium, so that it is improbable that the whole 1706 in 1854 were of the true Asiatic type. Ulster had 895 of these, Leinster 453, Munster 324, and the whole of Connaught only 34[1575].

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 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].