Cholera in Historical Perspective

Using what you learned in the last 2 classes, search the historical London Times database for the 4 most important or interesting articles you can find on the history of cholera and industrialization in the UK in the 18th and 19th c.

In a short essay (600-800 words) explain the historical significance of the articles you chose, focusing on telling us how your chosen articles show change over time and what new insight they help lead us to, particularly with regard to how the understanding of waterborne illness and the need for infrastructure changed over time. Essay is due February 7 by 11pm, passed in electronically–uploaded to the comments of this post. Please leave an extra space between paragraphs because indents are stripped out by the comment upload process.


  1. The development of cholera in London brought death, debate, and innovation in the 19th century. One perspective to consider was the development of medical professional’s opinions on both the origin of the disease, and the nature of its progression. During the early 1830’s, medical professionals focused their attention on cholera as a foreign disease from India, and engaged in a public debate over its transmission. This focus lead to an initial structural preventative strategy of quarantine. However as the disease continued to plague the city, this focus shifted to a disease that was born out of domestic filth, and discussion narrowed toward the notion of contaminated water.

    Medical professionals in the early 1830’s were aware of cholera’s danger, but their primary efforts were discovering the method of transmission, and tracking the progression of the disease. In multiple 1831 letters to the editor of the Times, doctors openly debated the transmission of Indian cholera. Prior to this time the common medical opinion was that the disease was not contagious, but born out of specific atmospheric conditions (1). But this common notion was disputed by many, including surgeon James Kennedy, whose case studies showed “Europeans in India were not exactly unanimous upon the question of non-contagion” (2). Additionally, in a report of the physicians response, a committee of physicians concluded the disease was indeed contagious, and could not rule out the idea of infection from exchanging of goods (3). In multiple medical circles the belief of a contagious nature was gaining momentum, which, combined with the focus on the disease’s foreign origin, lead to an interesting combative strategy.

    In an 1832 Times news publication, an aging physician provided a history of the disease’s progression from the Ganges river in India, through Asia, eastern Europe, to the Atlantic coast (4). Interestingly, the physician notes the differences between this Indian cholera, and the English cholera, portraying the Indian version as more violent, and deadlier (5). Herein lies a significant argument presented to the British public; this disease is from another place, and worse than our own version. Instead of an introspective look at the conditions that foster the disease, the physician blames foreign lands and people. The combination of a belief that cholera was foreign, and contagious, lead to the preventative measure of quarantine. The College of Physicians in 1831 advocated for a “strict quarantine being enforced both on persons and merchandise” (6). This fear of contagion via contact, and fear of foreign disease invasion, in effect took the medical communities eyes off the primary issues of excess filth and improper waste management.

    In 1853, decades after the previous publications in the Times, a doctor named John Hall wrote a letter to the Times showing a distinct shift in the narrative of cholera. In his letter, Hall asserts “cholera can no longer be regarded as a disease peculiar to the East…the disease must now be most certainly regarded as European…it must also be looked upon as one of the regular diseases of England” (7). Hall throws out the importance of tracing cholera’s origin and path, instead emphasizing England’s role in the creation and prevention of the disease. Hall also narrows the discussion of cholera’s causes, focusing on the filth of London, and advocating for “a better system of sewerage, drainage, ventilation of houses” (8). While he does blame many vague aspects of London filth, Hall also mentions the need for proper supply of water, but in the same breath notes the favorable atmospheric influences that bring cholera (9). We can see that the understanding of cholera’s waterborne transmission is not yet widespread in the medical community, however the shift in focus to a disease that is grown out of domestic filth is important. Hall’s letter is a public plea to change the narrative of cholera, that only comprehensive waste management will really combat the disease.

    More than a decade later, a news report titled “The Cholera Epidemic of 1866” was published. The publication discusses a 400 page report by Dr. R.S. Farr, that places blame for the 1866 outbreak on unfiltered water distributed by the East London Water Company (10). In this report Farr notes that experience has conclusively proved the influence of water as a medium for the diffusion of fatal cholera, and uses statistical mortality rates of previous cholera epidemics to counter his critics (11). This is a profound report, using evidence of past cholera outbreaks, and the theory of waterborne transmission, to discover a source of contamination. Additionally, Farr goes on to discuss current practices in water distribution, and proposals for new systems of fresh water delivery to the city (12). This article shows the development of a more in depth understanding of both the causes of cholera, and the possibilities of structural prevention.

    Over the course of more than 30 years, medical professional’s understanding of cholera in London shifted tremendously. Through debate about the origin and cause of cholera outbreaks, a deeper understanding of the role of contaminated water was founded. From this knowledge, prevention strategies shifted too from quarantine, to water purification and waste management.

    1. James Kennedy., et al. “Indian Cholera.” Times [London, England] 18 June 1831: 5. The Times Digital Archive. Web. 7 Feb. 2018.

    2. James Kennedy., et al. “Indian Cholera.” Times [London, England] 18 June 1831: 5. The Times Digital Archive. Web. 7 Feb. 2018.

    3. James Kennedy., et al. “Indian Cholera.” Times [London, England] 18 June 1831: 5. The Times Digital Archive. Web. 7 Feb. 2018.

    4. ”Warning to the British Public Against the Alarming Approach of the Indian Cholera.” Times [London, England] 10 Nov. 1831: 3+. The Times Digital Archive. Web. 7 Feb. 2018.

    5. ”Warning to the British Public Against the Alarming Approach of the Indian Cholera.” Times [London, England] 10 Nov. 1831: 3+. The Times Digital Archive. Web. 7 Feb. 2018.

    6. James Kennedy., et al. “Indian Cholera.” Times [London, England] 18 June 1831: 5. The Times Digital Archive. Web. 7 Feb. 2018.

    7. John Charles Hall, M.D. “The Health Of Towns.-Prevention Of Cholera.” Times [London, England] 17 Sept. 1853: 11. The Times Digital Archive. Web. 7 Feb. 2018.

    8. John Charles Hall, M.D. “The Health Of Towns.-Prevention Of Cholera.” Times [London, England] 17 Sept. 1853: 11. The Times Digital Archive. Web. 7 Feb. 2018.

    9. John Charles Hall, M.D. “The Health Of Towns.-Prevention Of Cholera.” Times [London, England] 17 Sept. 1853: 11. The Times Digital Archive. Web. 7 Feb. 2018.

    10. “The Cholera Epidemic Of 1866.” Times [London, England] 15 Aug. 1868: 6. The Times Digital Archive. Web. 7 Feb. 2018.

    11. “The Cholera Epidemic Of 1866.” Times [London, England] 15 Aug. 1868: 6. The Times Digital Archive. Web. 7 Feb. 2018.

    12. “The Cholera Epidemic Of 1866.” Times [London, England] 15 Aug. 1868: 6. The Times Digital Archive. Web. 7 Feb. 2018.

  2. With little initial consensus on the transmission of cholera, preventive measures in 19th century London were based firmly in what could be perceived. Cholera wracked local neighborhoods, sickening hundreds in the span of days. Little could be explained as children and adults fell ill, vomiting and expelling their bowels until they were emaciated, hanging on the edge of death. Countless folk remedies emerged in this period, ranging from strange to utterly bizarre. Many of the treatments for cholera in the 1830’s arose from the perception that the disease was a poor man’s affliction, stemming from insufficient nutrition. This was supported by the “emaciated” state in which many cholera victims passed in. Despite the later emergence of contaminated water as a theory of explaining cholera transmission, doctors still struggled to explain why “nourishing” meals resulted in higher survival rates. By treating those affected by cholera with boiled liquids such as soups or alcohol, however, it is entirely possible that doctors and folk practitioners inadvertently rehydrated victims, leading to the temporary establishment of “nutritious food” as an effective treatment.

    In 1830, the sweeping advance of cholera across Russia prompted alarm around the globe. Ambassadors from St. Petersburg began warning officials in London to prepare quarantine protocols. The fatal advance of the cholera morbus seemed unavoidable; the only precaution was to prevent entrance of the disease into the country entirely. A call was put out to medical professionals for the “discovery of any effectual mode of treatment.” This article demonstrated the genuine fear and confusion cholera inspired in governments and doctors alike. The need for a cure–and the lethality of the impending outbreaks–pushed society to test and develop new treatments for cholera.

    For many seeking a cure, the steps to treatment began in identifying why the disease afflicted certain people, and not others. One of the most historically significant articles from this period is a letter to the editor in 1832, where a researcher ponders the prevalence of cholera in the poorer neighborhoods. He identifies the squalid conditions many people live in, describing cold apartments filled with filth and little food. One house he visited sold fruit and fish for a living, subsisting on the spoiled remains because of their poverty. He asks, “Can we wonder at the prevalence of the disease? Do we require a “contagion” (a thing which nobody understands) to explain phenomena…[?]” He ends by labelling cholera a “poor man’s disease.” What is most significant about this article is the idea that cholera was a “contagion” or passed along through some sort of contact was beginning to be considered. However, strong arguments were also being made for the relationship between food and cholera, leading to the emergence of folk treatments targeting the stomach.

    As early as 1826, as evidenced by an article describing cholera outbreaks in Ireland, “nourishing food” was given to victims as a treatment. Defying discoveries surrounding water and miasma theory, families and doctors gave patients soups, boiled liquids, and alcohol. One letter to the editor in 1849 suggested the public avoid all fruits and vegetables that cause “indigestion.” Others suggested meals heavy with meat be given to victims. These two articles demonstrate the peculiar continuation of the nourishment-cholera theory from the 1820’s into the 1850’s.

    This treatment–and its prevalence, despite its conflict with other theories–gives valuable insight into how many in London perceived cholera. For poor workers, desperate doctors, and others, the mechanism of transmission was not as important as treating patients. What encouraged the usage of “nourishing meals” was, in essence, its occasional effectiveness. In the face of an inevitable death sentence, the success in one instance was enough to keep the treatment viable. Additionally, though not easy to confirm, the usage of boiled liquids (soup, alcohol, oils) may have even kept patients away from infected water sources, while simultaneously rehydrating them. Inadvertently, some cholera patients may have been saved by folk treatments that did not understand the mechanism of transmission.

    The miasma theory of disease would eventually give way to germ theory in the 1850’s, changing the fundamental understanding of cholera. However, up until that point, cholera was often viewed solely through the lense of treatment. Miasma theory relied on the presence of smells; “nourishment” theory was often based in the visible symptoms of the disease itself. Because patients became emaciated and dehydrated quickly, treatments centered around the patient’s access to food. By re-nourishing patients with “rich” soups and alcohols, however, this practice led to the confirmation of the “nourishment” theory despite competing evidence indicating the contagion-like properties of cholera. This demonstrates the resistance to change many folk practitioners had when treating cholera; it was much easier to rely on treatments that could be explained by the physical symptoms of the disease than by something invisible and unfamiliar.


    A.B.G., et al. “The Cholera.” The Times, 8 Aug. 1849. The Times Digital Archive, February 7, 2018. Web.

    W. Holtyates. “To The Editor Of The Times.” The Times, 24 Feb. 1832. The Times Digital Archive, February 7, 2018. Web.

    “Cholera Morbus.” The Times, 7 Oct. 1830. The Times Digital Archive, February 7, 2018. Web.

    “Distress In Ireland.” The Times, 16 Aug. 1826. The Times Digital Archive, February 7, 2018. Web.

  3. In the mid-1800s, cholera was ravaging through London. Although there were many outbreaks, the 1854 London cholera epidemic grabbed the attention of many Londoners because it began affecting middle-class citizens rather than almost exclusively the poor (Hicks, 2018). Quack medicine remedies surfaced but were unsuccessful. During the cholera epidemic, with the realization that individual quack medicine remedies were ineffective, public opinion shifted in favor of the creation of a sewage system. This transition in opinion was not immediate, however. In order to better understand how the public opinion changed, one must look at the quack medicine remedies that existed before sewage management was ever much of a concern.

    When cholera transitioned from nearly exclusively affecting the lower class to afflicting the middle and even upper classes, the disease began to attract significantly more attention. One manifestation of this newfound attention was with classified advertisements, which began popping up in newspapers. These ads, usually through unfounded medicine, claimed the ability to prevent or cure cholera-if the reader was willing to buy the product. One preposterous example was a galvanic battery which would supposedly afford the wearer a continuous and unnoticeable current “as a preventive against cholera” (Rheumatism, 1853). Quack medicine remedies such as this one emerged carrying hefty claims of cholera preventions, cures, or treatments. However, perhaps unsurprisingly, these quack medicine remedies failed to effectively prevent or treat cholera. Instead, a different solution was needed. As Londoners began to search for more reliable methods of cholera control, attention began to turn towards the water supply.

    Society in 19th century London was not always concerned with its water supply. The simple fact that the Thames river and other water sources were permitted to exist in a sludgy, semi-liquid state exemplifies the public’s and government’s lack of concern for their water quality (Hicks, 2018). However, with the onset of worsening cholera outbreaks, public attention began to take the quality of water sources more seriously. Cholera and the London Water Supply, published in 1853, began to question the city’s water supply, providing lists of water supply companies and the quality of each company’s water (Cholera, 1853). The appearance of an informational report such as this indicates that the newspaper’s readers, for whom we can assume represent the general population of London, are beginning to question the cleanliness of the water they’re drinking. Yet despite the topic of water quality garnering public concern, there was no concerted effort to make a change. For that, it would take the 1854 cholera outbreak.

    In response to the 1854 cholera outbreak, a report by Mr. Simon to the Board of Health was released. Its influence can be seen in newspaper editorials as it swayed the opinions of many individuals. The report, which draws a connection between filthy water and increased cholera mortality, is heavily referenced in the newspaper editorial Whether to drink or breathe poison? (Whether we shall drink, 1856). The observation changed many opinions, and the public appeared to be convinced that water quality was important enough to necessitate a large public health effort. Thus, the creation of a system to transport sewage out of the city began to be discussed and the idea, although not universally accepted, gained traction. The matter was placed alongside other matters of high importance such as managing heavy pollution from the Industrial Revolution and providing affordable, quality housing for the lower class (Whether we shall drink, 1856). In a society where water quality and sewage management were once not topics of major concern, they had found their way to the forefront of public discussion by 1856 when the Whether to drink or breathe poison? was published, exhibiting a change in public opinion over time.

    The public’s opinion did not change without some initiating factor, however. The report by Mr. Simon correlating filthy water and increased cholera mortality was certainly a player in changing opinions. However, had it not been for John Snow, the man who linked water and cholera, it is doubtful that this change in opinion would have been observed. Without Snow’s epidemiological efforts, water quality and sewage management would have most likely not been linked to the cholera outbreaks and the topic of sewage management would not have arisen. Instead, public awareness about the dangers of unclean drinking waters emerged and a shift in public opinion about sewage management was initiated. Public opinion transitioned from unconcerned, even oblivious, towards sewage management to pushing for the creation of a sewage system. Thankfully, it turned out to be enough to curb the cholera epidemic and lives were saved.


    (1853, November 25). Cholera and the London Water Supply. The London Times, pp5 (Issue 21595). Retrieved from

    (1853, December 21). Rheumatism, Brochitis, General Debility, Toothach, and all Nervous and Neuralgic Diseases. The London Times, pp12 (Issue 21617). Retrieved from

    (1856, June 25). Whether we shall drink or breathe poison? The London Times, pp 8 (Issue 22403). Retrieved from

    Hicks, A. (2018, January 29). Cholera [lecture].

  4. In the mid-nineteenth century, British commenters viewed endemic cholera as a condition prevalent among the poor. One correspondent to The Times in 1831, for example, noted that cholera inflicted disparately egregious damage to impoverished communities across Great Britain.[1] Notably, this reporter asserted that only during tragedies such as epidemics of cholera did the English upper class take note of their indigent compatriots.[2] “It is only during the existence,” he wrote, “of some extraordinary visitation like the present that the hovels of the poor come to be thoroughly submitted to the scrutiny of the rich.”[3] However, concerned Englishmen did not approach the disparity of cholera cases complacently. Rather, they moved beyond mere consciousness of the inequality to aspire to make systematic changes that would alleviate the disproportionate effect of cholera upon the poor.

    By the eighteen forties, boards of guardians administering the 1834 Poor Law employed surgeons to attend to impoverished cholera sufferers.[4] One surgeon, who took the nom de plume “Quid Pro Quo” wrote in The Times that the board gave him standing orders to treat all cases of cholera as they arose.[5] This surgeon “laboured and toiled incessantly” and found little time to sleep during the epidemic.[6] With services rendered, the physician sought a modest recompense of 25£ from the board of guardians, but he received less than 4£.[7] He found that the board of guardians regularly undercompensated their doctors, and, in doing so, undermined the Poor Law that they administered, as they found insufficient surgeons to employ.[8] The de facto system of cholera treatment for the poor continued to rely on the charity of physicians, then, even after the passage of the Poor Law.[9] “Quid Pro Quo” decried this misadministration and pleaded that the ills of the poor be treated with better compensation for medical officers: “Are the poor, then, to be committed to fortuitous medical aid? I think not; for they must perish unless a proper system of attendance is enforced.”[10]

    While the Poor Law’s medical officer offered the solution to the poor of cholera treatment, other reformers sought to prevent cases of cholera by extending water infrastructure to the poor.[11] A board that sought to improve the water supply and sewerage of London met in 1849 and noted that “thousands of the city poor were in want of water.”[12] The board understood that clean water could prevent cholera and so resolved to remove the barrier of high prices that kept the poor from enjoying the life-saving “ordinary precaution of water supply.”[13]

    Another writer in the London Times, who used the pen name “Philo,” thought that the mere administration of medical care by boards of guardians under the Poor Law remained insufficient.[14] This aid, he noted, ended with the recovery of the patient, even though cholera would continue to inflict suffering.[15] He offered a more progressive proposal to alleviate the particular suffering of the poor who contracted cholera, wherein the afflicted would receive monetary support from an endowment after treatment for cholera.[16] Philo appealed to the “liberality of Englishmen” and advocated that “those who are suffering from the effects of the present awful visitation … need no aggravation in the form of poverty.”[17]

    Not only, then, did cholera epidemics inspire a class-consciousness among Englishmen, but the inequality of the disease’s incidence inspired proposals to allay the suffering of the cholera-inflicted poor. Epidemic cholera demonstrated the need to reform Poor Law healthcare, improve the poor’s access to water infrastructure, and even alleviate poverty per se.

    [1] “Cholera Morbus,” The Times (London), December 16, 1831.
    [2] Ibid.
    [3] Ibid.
    [4] QUID PRO QUO, “The Cholera And Poor Law Medical Officers,” The Times (London), September 3, 1850.
    [5] Ibid.
    [6] Ibid.
    [7] Ibid.
    [8] Ibid.
    [9] Ibid.
    [10] Ibid.
    [11] “Supply of Water to the Metropolis,” The Times (London), October 23, 1849.
    [12] Ibid.
    [13] Ibid.
    [14] Philo, “Cholera and Poverty,” The Times (London), September 10, 1849.
    [15] Ibid.
    [16] Ibid.
    [17] Ibid.

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