The Epidemic Century - An Evil Necessity?

A punch comic from 1858 depicting three diseases found within the Thames River -Cholera, Scrofula and Diphtheria

Labelled as the “Epidemic Century”, the 19th century in Britain has been seen as one of the most decisive shapers of History. This influential period of change rose within the landscape of the Industrial Revolution and with this came a dark cloud that threatened the new way of life of the British population. Mass urbanization and industrialization paved the way for an increase in disease as the ever-increasing population led to the easier spreading of these new infectious sicknesses. The mass impact of these diseases however sparked developments in medicine and vaccines as well as growth in the fields of microbiology and germ theory. The end of the epidemic century, with the massive fall in mortality rates appears to propose the question, was this period an evil necessity?

To begin to understand this dark period of history, one must first understand the conditions under which the diseases were able to develop. Especially within the first half of the century, both the rural and urban populations were subjected to overcrowding, unsanitary housing, and the dread of old age. Middle-class men were expected to live to around 45 years and those of the working class were deemed lucky to reach half of that. In fact, the start of the Industrial Revolution, as Benjamin Disraeli describes, only aided in depressing living standards and creating greater gaps between the “two nations” – the rich and the poor.[1] Conditions of squalor and huge amounts of poverty have been depicted as a result - London became an ever-growing cesspit of disease and illness. Historians have reasoned that disease in the epidemic period resulted in approximately 40 percent of deaths in the mid-19th Century, as a result of poor conditions and overcrowding.[2]

One of the more infectious sicknesses was Typhoid, which spread through infected water and milk. Such was the case of London; it had the prevalent ability to strike both the rich and the poor, the dirty and the clean alike. The Thames River became host to this disease; it had become swamped with sewage and created a great sense of panic with the reported death of Prince Albert from typhoid fever in 1861, which left both sides of life under constant threat and fear of infection. In contrast, Typhus resulted in greater class inequalities as the poor were prominently blamed. A constant visitor to larger cities, Typhus was persistently spread through body louse, leaving the victim with large rashes and skin issues, and resulted in the deaths of over 30,000 in England and over 130,000 within Ireland. It spread especially quickly in places with unsanitary conditions such as areas of economic downturn, yet the inescapable nature of the louse meant all classes of life were at risk. Furthermore, Ronald Hare commented that this disease led to a greater view of “Anglophobia” from the United States as a result of Irish immigration.[3]

Although Typhoid and Typhus were prevalent, the epidemic century is most commonly attributed to Cholera. A letter from John Snow depicts the August 1854 Cholera outbreak in London, which killed over 600 people within the space of a month.[4] Though initially feeling nauseous, victims would have cramps, comas and death, as 40-60 percent of those who contracted Cholera died. Stemming from the contamination of water, this case study served to provide evidence to suggest that sanitation was vital within the water system, due to the massive mortality rates between both Cholera and Typhoid. This sparked a change to an increase in personal hygiene and water standards. Snow noted the “improved water” led to 10 times fewer deaths than the “impure water”, as the prominence of these diseases led to a quicker change in health within the population.

A letter from John Snow depicting a Cholera Outbreak in London

Further change in health and medicine came with new bacteriological studies from Louis Pasteur and Robert Koch, the latter identifying the bacteria and establishing its relation towards the disease Cholera. Reported from Calcutta in 1884, Koch theorised the bacteria came from the vibrio in the intestines, which was later named vibrio cholera.[5] These developments sparked a huge increase in vaccinations, as causes of many diseases were discovered by new microbiological methods. As early as 1885, a vaccine for Cholera was created in Spain. Despite the high mortality rates in the earlier period, the Epidemic Century waned due to rising standards of public health and water standards combined with an increase in vaccines and medicine. By the late 1800s, a transition had begun from epidemic to chronic diseases, such as cancer. Despite the mass of death and illness, the Epidemic Century sparked an epidemiological transition, that in which life expectancy rose and mortality rates plummeted. In any case, the historical weight of this century should not be undervalued in its contribution to the development of human life as we have it today.

Bibliography

De Pennington, J, Beneath the Surface: A country of two nations, (2011), http://www.bbc.co.uk/history/british/victorians/bsurface_01.shtml - accessed 10/08/21

Disraeli, B, Sybil, Project Gutenburg, (1845)

Hare, R. Pomp and Pestilence, (New York, N.Y., Philosophical Library, 1855)

Howard-Jones, N, Robert Koch and the cholera vibrio: a centenary, British Medical Journal v.228, (1984)

Mooney G. ‘Infectious Diseases and Epidemiologic Transition in Victorian Britain? Definitely’, Social History of Medicine, 20, (2007)

Picard, L, Health and Hygeine in the 19th Century, (2009), https://www.bl.uk/victorian-britain/articles/health-and-hygiene-in-the-19th-century - accessed 10/08/21

Punch, Figure 1, 'Father Thames Introducing his Offspring to the Fair City of London', Punch Ltd, (British Library, 1858)

Snow, J, Figure 2, 1854, The source of cholera – a letter from John Snow, M.D. to the Medical Times and Gazette, https://www.bl.uk/victorian-britain/articles/health-and-hygiene-in-the-19th-century - accessed 10/08/21

Sowards, Will, 2017, History of the Cholera Vaccine, https://www.passporthealthusa.com/2017/11/history-of-the-cholera-vaccine/ - accessed 10/08/21

[1] Benjamin Disraeli, Sybil, Project Gutenburg, (1845) [2] Graham Mooney ‘Infectious Diseases and Epidemiologic Transition in Victorian Britain? Definitely’, Social History of Medicine, 20, (2006) 595–606. [3] Ronald Hare, Pomp and Pestilence, (New York, N.Y., Philosophical Library, 1855) 95-152. [4] John Snow, Figure 2, The source of cholera – a letter from John Snow, M.D. to the Medical Times and Gazette, 1854 [5] Howard-Jones, N, Robert Koch and the cholera vibrio: a centenary, British Medical Journal v.228, (1984), 379-382