The Most Feared Disease of the 19th Century

The year was 1854, and London was in the grip of yet another outbreak of cholera​—an intestinal ailment characterized by severe diarrhea and dehydration. The disease struck with alarming speed. Many who awoke in good health were dead by nightfall. There was no known cure.

IT WAS the most feared disease of the century, and the cause remained a mystery. Some thought cholera was contracted by inhaling offensive odors from decaying organic matter. Their suspicions were understandable. The River Thames, which coursed through London, emitted a horrible stench. Did the foul-smelling air carry the disease?

Five years earlier, a physician named John Snow had suggested that cholera was caused, not by contaminated air, but by contaminated water. Another physician, William Budd, believed that a funguslike living organism carried the disease.

During the 1854 epidemic, Snow tested his theory by studying the lives of those who had contracted cholera in the London district of Soho. ‘What do they have in common?’ he wondered. Snow’s investigation led to a startling discovery. All who contracted cholera in that district had obtained drinking water from the same street pump, and that water was contaminated by cholera-infected sewage!a

That same year saw another medical milestone when Italian scientist Filippo Pacini published a paper describing the living organism that caused cholera. For the most part, however, his research was ignored, along with the findings of Snow and Budd. The cholera scourge raged on​—that is, until 1858.

“The Great Stink”

Parliament had been sluggish about building a new sewage system to clean up the Thames, but the heat wave that arrived during the summer of 1858 forced the issue. The stench from the river that flowed past the House of Commons was so overwhelming that the politicians were forced to hang drapes soaked in disinfectant over their windows in an attempt to disguise the smell. What came to be called the Great Stink pushed Parliament into action. Within 18 days, it ordered the building of a new sewage system.

Huge drains were constructed to intercept sewage before it reached the river and then to transport it to the east of London, where it eventually flowed into the sea on the ebb tide. The results were dramatic. Once all London was connected to the new system, the cholera epidemics ended.

By now, there was no doubt: Cholera was not caused by foul air but by contaminated water or food. Also clear was the key to prevention​—sanitation.