Cholera comes from the Greek word kholē. Transmission of cholera usually occurs through the fecal-oral route because of contaminated food or water caused by poor sanitation. The first cholera pandemic began in 1816 in India and eventually spread by trade routes infecting China, Europe, North American, and the remainder of the world. It was a deadly disease that killed tens of millions of people.
Because it was so dangerous, people were concerned. This resulted in a group of British gentlemen being appointed by the Poor Law Commissioners to examine the conditions of the London Poor Houses. After their examination, they provided the following 22 tips that were published in an article titled, “Remedies Against the Cholera.” Their 22 tips are provided here almost verbatim:
- We would urge the necessity, in cases of Cholera, of an instant recourse to medical aid, and also under every form and variety of indisposition, for during the prevalence of this epidemic all disorders are found to merge in the dominant disease.
- Let immediate relief be sought under disorder of the bowels especially, however slight. The invasion of Cholera, may thus be readily and at once prevented.
- Let every impurity, animal and vegetable, be quickly removed to a distance from the habitations — such as slaughter-houses, pigsties, cess-pools, necessaries, and all other domestic nuisances.
- Let all uncovered rains be carefully and frequently cleansed.
- Let the grounds in and around the habitations be drained, so as effectually to carry off moisture of every kind.
- Let all partitions be removed from within and without habitations, which unnecessarily impeded ventilation.
- Let every room be daily thrown open for the admission of fresh air; and this should be done about noon, when the atmosphere is most likely to be dry.
- Let dry scrubbing be used in domestic cleansing, in place of water cleansing.
- Let excessive fatigue, and exposure to damp and cold, especially during the night, be avoided.
- Let the use of cold drinks, and acid liquors, especially under fatigue, or when the body is heated, be avoided.
- Let the use of cold acid fruits, and vegetables be avoided.
- Let excess in the use of ardent and fermented liquors and tobacco be avoided.
- Let a poor diet and the use of impure water in cooking, or for drink, be avoided.
- Let the wearing of wet and insufficient clothing be avoided.
- Let a flannel or woolen belt be worn round the belly. (This has been serviceable in checking the tendency to bowel complaint, so common during the prevalence of Cholera. The disease has, in this country, been always found to commence with a looseness in the bowels, and in this stage is very tractable. It should, however, be noticed that the looseness is frequently attended by pain or uneasiness, and fatal delay has often occurred from the notion that Cholera must be attended with cramps. In the earlier stage here referred to, there is often no gripping or cramp, and it is at this period that the disease can be most easily arrested.)
- Let personal cleanliness be carefully observed.
- Let every cause tending to depress the moral and physical energies be carefully avoided; let exposure to extremes of heat and cold be avoided.
- Let crowding of persons within houses and apartments be avoided.
- Let sleeping in low or damp rooms be avoided.
- Let fires be kept up during the night in sleeping or adjoining apartments, the night being the period of most danger from attack, especially under exposure to cold or damp.
- Let all bedding and clothing be daily exposed during winter and spring to the fire, and in summer to the heat of the sun.
- Let the dead be buried in places remote from the habitation of the living.
These 22 rules were then summed up by the author:
“By timely adoption of simple means such as these, Cholera or any other epidemic will be made to lose its venom; so true is it that ‘internal sanatory arrangements, and not quarantine and sanatory lines, are the safeguards of nations.'”
While Victorians may have thought this good advice, the bacterium responsible for cholera was not isolated until 1854 by an Italian anatomist. Even then its exact nature was still unknown. Ultimately, attempts at understanding cholera fell upon the shoulders of a German physician and pioneering microbiologist named Robert Koch. He determined in 1884 that the causative agent of cholera was Vibrio cholerae. Despite his discovery and despite cholera inoculations for humans occurring in 1885 and a vaccine being developed in July of 1892, cholera pandemics continued to exist into the early twentieth century.
- Ellis, Benjamin Franklin, The Western Miscellany, Volume 1, 1849