ASIATIC CHOLERA.
The Indian or Asiatic cholera, which first showed itself on British soil
in one or more houses on the Quay of Sunderland in the month of October,
1831, was a “new disease” in a more real sense than anything in this
country since the sweating sickness of 1485. The English profession had
been hearing a good deal about it for some years before it reached our
shores. The outbreak in Lower Bengal in 1817, from which the modern
history of cholera dates, had been the subject of reports and essays by
Anglo-Indian physicians and surgeons; an extensive prevalence of it in the
Madras Presidency shortly after, as well as in Mauritius in 1819 and 1829,
had been observed by other medical men in the service of the East India
Company or of the British army or navy. Many who had seen cholera in
India, and some who had written upon it, returned to England in due
course, so that the formidable new pestilence of the East began to be
heard of in medical circles at home. Various essays upon it issued from
the English press between 1821 and 1830[1475]; and in 1825 it appeared for
the first time, and at considerable length, in the pages of an English
systematic treatise, the new edition of Dr Mason Good’s ‘Study of
Medicine.’
Previous to 1829, Asiatic cholera had obtained no footing in Europe. The
first great movement westwards from India through Central Asia, which was
continuous with the memorable eruption in Bengal after the rains of 1817,
had reached to Astrakhan, at the mouths of the Volga, and had there caused
the deaths of some 144 persons in September, 1823. Another progress
westwards from India, after an interval of six years, reached the soil of
European Russia in the Government of Orenburg in August 1829, the
mortality in the whole province during the autumn and winter (to February,
1830) amounting to about one thousand. A much more severe epidemic of it
arose in the summer of 1830 in the town and province of Astrakhan
(supposed to have been introduced by an infected brig from Baku), which
spread with enormous rapidity, destroying in the course of a month some
four thousand in Astrakhan itself and upwards of twenty thousand in other
parts of the province[1476]. Thus established in the basin of the Volga,
Asiatic cholera overran the whole of Russia. Before the spring of 1831 it
had entered Hungary and Poland, and in the end of May had reached Danzig
and other German ports on the Baltic and North Seas. Lord Heytesbury, the
British Ambassador at St Petersburg, had sent home a despatch upon it
early in 1831; in April, the Admiralty issued orders for a strict
quarantine of all arrivals from Russia at British ports, which were
afterwards extended to arrivals from all ports abroad invaded or
threatened by cholera. On 20 June a royal proclamation ordering various
precautions was issued, and next day a Board of Health was gazetted,
composed of leading physicians in London and of the medical heads of
departments, with Sir Henry Halford as president. Local Boards of Health
were formed voluntarily in many parts of the country during the summer of
1831. Two medical men were at the same time commissioned by the Government
to proceed to Russia to study the disease there, their letters to the
Board of Health commencing from the 1st of July. The growing interest in
the disease as it came nearer called forth another crop of writings, some
of them based on old Indian experience, others speculative[1477]. The most
important of these was the treatise by Orton, which had been published in
its original form at Madras in 1820. Writing from Yorkshire in August,
1831, he surmised (with a proviso that no one could say confidently what
might happen) that Asiatic cholera might be expected to be a mild
visitation upon Britain at large, falling most upon the large
manufacturing towns in which typhus was common, but that it would be “far
otherwise” with Ireland owing to its chronic poverty, distress and
over-population. By a singular chance the only town which he specially
mentioned in England was Sunderland, where, he had been told by Dr Clanny,
there had been an unusual number of cases of malignant cholera nostras in
the early part of the autumn: “it is greatly to be feared,” he said, “that
those are but the skirts of the approaching shower[1478].”
In other places besides Sunderland there had been perhaps more than the
usual amount of summer diarrhoea in 1831. Dr Burne, in his London
dispensary reports, entered on the 2nd and 16th July an unusual prevalence
of “dysenteric diarrhoea and cholera,” and cases of scarlet fever of an
“adynamic” type or with a tendency to fatal collapse[1479]. (Clanny
observed the same type of scarlatina at Sunderland along with some
typhus.) Choleraic disorders were uncommonly rife on board the ships of
war in the Medway[1480]. A succession of twenty-four cases at Port
Glasgow, from 2 July to 2 August, chiefly among workers in Riga flax, gave
rise to an alarm of the real Asiatic cholera, the more readily that the
first case was fatal (the only death)[1481]. Similar alarms arose at Leith
and Hull.
Asiatic Cholera at Sunderland in October, 1831.
In the end of July and in August, Sunderland and the adjoining villages
and farms in the valley of the Wear were visited with “a very general
prevalence of the indigenous cholera of the country, bearing in most
instances its usual leading feature--that of excessive bilious
discharges[1482].” Few, who were not attacked with actual cholera nostras,
were altogether free, it was said, from diarrhoea or disordered digestion.
Many of the choleraic cases were unusually malignant, of which the
following are instances:
Allison, aged fifty, a painter of earthenware residing in a low
situation on the bank of the Wear two miles above the town, was
attacked at 4 a.m. on the 5th of August with vomiting and purging of a
watery whitish fluid, like oatmeal and water. His hands and feet were
cold, his skin covered with clammy sweat, his face livid and the
expression anxious, his eyes sunken, his lips blue, thirst excessive,
his breath cold, his voice weak and husky, and his pulse almost
imperceptible. He passed into a stage of reactive fever and got well.
Arnott, a farm-labourer on the opposite bank of the Wear from the man
Allison, was seized at 2 a.m. on the 8th August with precisely the
same symptoms, and died in twelve hours. Neither he nor Allison had
any intercourse or relation with seamen or the shipping of
Sunderland[1483]. Another case on the 8th of August came to light
afterwards. A woman in the village of West Bolden, four miles from
Sunderland, on the Newcastle road, was found by a surgeon from the
town to be suffering from choleraic sickness, of which she died twelve
hours from its onset[1484].
A week after these cases in the country not far from Sunderland, there
occurred the death, on 14 August, of one of the Wear pilots named
Henry. He had been troubled with diarrhoea for some time before, but
not so as to keep him from his occupation. Having gone down in the
direction of Flamborough Head to look for ships, he picked up a vessel
between that and the Wear, piloted her in, and, a few days after,
piloted her out again. The identity of the vessel was never traced,
but it was alleged that she had come from an infected port abroad. The
last time Henry was in his boat he was seized with violent vomiting
and purging, and died at his house after an illness of twenty hours. A
brother pilot, who looked in at the house on the day of his death,
fell into a similar choleraic disorder, but recovered[1485]. On the
28th of August a shipwright died of the same; also about the end of
August two persons at a distance of four or five miles from
Sunderland. In September, it is said, there were other cases and
fatalities. Early in October the authentic particulars of cholera in
Sunderland begin. Dixon attended one case, which was fatal on the 9th
October. Another case, which came to light three months after, was
that of a girl of twelve, named Hazard, residing on the Fish Quay, who
was well enough on Sunday the 16th October to have been twice at
church. She was seized in the middle of the night following with the
sudden and appalling symptoms of choleraic disease and died on the
Monday afternoon[1486]. A few doors off on the same quay lived a
keelman named Sproat, aged sixty; he occupied a large, clean,
well-ventilated room on the first-floor of a house in the most open
part of the quay, opposite to a crowded part of the anchorage. He was
in failing health, and had been troubled with diarrhoea for a week or
ten days previous to the 19th October, on which day he had to give up
work. Next day, Thursday, the 20th, a surgeon who had been sent for
found him vomiting and purging, but not at all collapsed, with no
thirst, and in good spirits. He improved so much that on Friday he had
toasted cheese for supper and on Saturday a mutton chop for dinner,
after which he went out to his keel on the river for a few minutes. On
his return he was seized with rigor, cramps, vomiting and purging.
Medical aid was not sent for until seven on Sunday morning, when he
was found in a sinking state, pulseless, speaking in a husky whisper,
his face livid and pinched, his limbs cramped, the purgings like “meal
washings.” He continued like that for three days, and died on
Wednesday, the 26th October, at noon.
This came to be reckoned the first death from Asiatic cholera in England.
His grandchild, a girl of eleven, while moving about the room an hour
after the death, was suddenly seized with faintness, pains in the
stomach-region, vomiting and purging of watery matters; she was taken
to the Infirmary and soon got well. The day after his father’s death,
Thursday, the 27th October, William Sproat, junior, a fine athletic
young keelman, who had attended on his parent during his illness, was
found lying in a low damp cellar near to the Fish Quay, suffering from
choleraic symptoms; he had been ill only a few hours, and was removed
(with his daughter as above) to the Infirmary the same evening. He
became gradually worse: on the 30th he was continually throwing
himself about, moaning and biting the bedclothes; on the 31st he was
lying on his back comatose, his eyes open, the pupils wide and
insensible, and the breathing stertorous, in which state he died the
same day. An old nurse at the Infirmary (Turnbull) helped to place the
body in the coffin, went to bed in a state of considerable fear, and
was seized at one in the morning with symptoms of cholera, of which
she died after a few hours.
Meanwhile there had been two other fatal cases unconnected with the
Sproats or the Fish Quay. On the quay of Monk Wearmouth, across the
river, lived a shoemaker named Rodenburg, aged thirty-five. He
occupied a poor hovel and had a large family, but he was in good work
and wages. On Sunday, the 30th October, he had pork for dinner, and
what was left of it for supper. In the middle of the night he was
seized with vomiting, and with purging of a fluid like water-gruel in
vast quantities; when visited by the medical men, he spoke in a husky
whisper, his nails were blue, his skin livid, covered by cold sweat,
his limbs cramped. The spasms ceased about nine o’clock on Monday
morning; about noon he asked to be raised in bed, and died as they
were raising him. On the very same night, between Sunday and Monday, a
keelman named Wilson, who lived with his wife in a decent room in the
High Street, and had attended the Methodist chapel on Sunday, was
seized with cholera at 4 a.m. on Monday, and died the same afternoon
at three.
These six cases within a few days, all fatal but that of the girl of
eleven, looked like the real Asiatic disease. Kell, an army
assistant-surgeon stationed at Sunderland with the reserve companies of
the 82nd Regiment, had suspected that the earlier case of the pilot Henry
was true Asiatic cholera (which he had seen in Mauritius in 1829), and had
written to the Board of Health. At a meeting of the faculty at the
Infirmary on the morning after the admission of Sproat junior and his
child (28th October), Kell urged upon them that the disease was Asiatic
cholera, but all the twelve present, save Dr Clanny, who was in the chair,
maintained that it was common indigenous cholera. However, when the
younger Sproat died, and the nurse after him, and two others in different
parts of the town, a full meeting of medical men at the Exchange came
unanimously to the opinion that these were cases of “spasmodic cholera.” A
meeting of the Board of Health and leading citizens was at once held, who
were informed that, in the unanimous opinion of the medical gentlemen of
the town, “spasmodic cholera prevailed in Sunderland.” The authorities in
London having been kept informed (principally by Kell), a surgeon of
Indian experience was sent down by the Board of Health on the 5th
November, and a colonel by the lords of the Council on the 6th, to act as
commissioners.
It happened that no more cases occurred for three days after the death
of the nurse at the Infirmary; so that the doctors, like Pharaoh in
the intervals between the plagues of Egypt, were beginning to repent
of their diagnosis. The shipping trade of Sunderland was threatened by
these newspaper alarms, and by the presence of two Government
commissioners in the town; while Kell was demanding a ship of war off
the mouth of the Wear, and a battery on shore, to make the quarantine
respected. The Marquis of Londonderry, interested in the coal-trade,
wrote to the _Standard_ that the alarm was false. The magistrates,
shipowners and leading residents, who had met on the 9th November to
raise money for a cholera hospital, assembled again in various public
meetings or caucuses on the 10th and 11th, and passed resolutions that
there was no Indian or other foreign imported cholera in Sunderland,
that it was a wicked and malicious falsehood to say there was, and
that there was no need of quarantine on the Wear. One of these
meetings was attended by fifteen medical men (most of them from the
residential suburb of Bishop Wearmouth), who severally expressed the
opinion in various terms, that the recent fatal cases were aggravated
cases of English cholera, not contagious or infectious, while three
more sent letters backing up Lord Londonderry and the shipowners. On
the 12th of November, twenty-seven medical men signed a declaration to
the same effect. Some of these remained unconvinced by the progress of
events, Dixon arguing as late as 23 January, 1832, that the epidemic
in Sunderland, which was by that time over, had been one of
“spontaneous malignant cholera.”
Two new seizures occurred on the 7th November, none on the 8th, seven on
the 9th, one on the 10th, and so on for fully six weeks longer until
Christmas, when the cases became very occasional, so that on the 9th of
January, 1832, Sunderland was declared by the Board of Health to be free
of cholera. The largest number of seizures reported on one day was
nineteen on the 8th of December; on the 10th of that month there were
sixty-three cases under treatment at once; the whole number of cases from
23rd October to 31st December was 418, of which 202 were fatal; the whole
deaths at Sunderland by the cholera of 1831-32 are given at 215, so that
the epidemic exhausted itself there before it had well begun elsewhere in
the country. The effect of it upon the death-rate is shown in a comparison
of the burials for November and December in three successive years[1487]:
_Burials in the parish of Sunderland._
November December
1829 29 44
1830 39 76
1831 122 127
The way by which the virus entered Sunderland was never traced. It was
known, however, that deaths from cholera had occurred among the crews of
Sunderland ships lying at Cronstadt and Riga; and as it was the practice
for vessels owned in Sunderland to come home from their summer trading
towards the end of the season, so as to lay up during the winter, it was
suspected that the clothes of some of the dead men had been brought over
and sent ashore. The quarantine in the Wear was far from effective: the
station was higher up the river than the loading moorings, so that
suspected ships had to pass through a crowd of ordinary shipping to get to
it. It appears that hardly any ships were quarantined, except some from
Dutch ports where no cholera then existed.
This first experience of Asiatic cholera on British soil brought out very
clearly one character of the infection which was seen to attend it
everywhere during the following year, and has always attended it in every
subsequent invasion of the disease. The virus, for all its opportunities,
showed a marked preference for, an almost exclusive selection of the
lowest and least cleanly localities, and a considerable preference for
persons of drunken or negligent habits. Sunderland consisted of three
parts--the parish so named, the parish of Bishop Wearmouth, which was the
west end of Sunderland or the residential quarter of the wealthier class,
and across the river the parish of Monk Wearmouth, with the adjoining
Shore. The cholera was almost wholly confined to Sunderland proper;
Ainsworth says that no cases occurred, to his knowledge, in the parish of
Bishop Wearmouth, and not above six in Monk Wearmouth; another gave six or
eight cases in each of these parishes, but increased the estimate to
eighteen or twenty in each according to later information. Bishop
Wearmouth stood about seventy feet higher than the highest part of
Sunderland; it was well built, and its population of 14,462 (with 363 more
in the Pans), included the whole of the wealthier class with the trades
dependent on them. Monk Wearmouth, with a population of 1498, and the
adjoining Shore with a population of 6051, were irregularly built on the
north bank, and occupied by the same class (keelmen, sailors, labourers
and workmen in the coal, iron and shipping trades) as Sunderland itself;
but for some reason, connected perhaps with its soil and elevation, it
escaped with a very few cases of cholera[1488]. The parish of Sunderland,
with a population of 18,916, was not all visited equally. The focus of the
cholera, says Ainsworth, was the town moor, a large piece of pasture-land
stretching to the sea-shore at the south-east end of the town, having a
subsoil tenacious of water, marshy in the winter months, and its roads
almost impassable. Upon this open space was deposited, and left to
accumulate for weeks together, the filth from the narrow lanes and
passages of the low-lying and crowded quarter at the seaward end of the
parish, to the south of the High Street. Some of the streets occupied by
the poorer class consisted of old residences of the well-to-do, now
divided into tenements. Certain streets had as many as a dozen or twenty
common middens, “let in” to the street fronts of houses and covered by
trap-doors, in which the domestic refuse and sweepings of the street were
collected as a source of profit, and sold at stated times to farmers for
manure. Most of the attacks happened in this low-lying part of Sunderland,
with a soil and foundations sodden with filth, houses overcrowded and
badly ventilated, and its residents subject to the alternations of excess
and want (with much pawning of clothes, &c.) peculiar to a port from which
one or two hundred sail would leave with a fair wind or arrive in the
river together[1489]. About four hundred were attacked in a population of
eighteen thousand during a space of two months. The cases among the
wealthier classes were nearly all in the households of medical men:--the
mother of one doctor, living with him, died of Asiatic cholera, the wife
of another came safely through an attack, one or more medical men had the
symptoms in one degree or another. In the end of November, five old people
in the poor’s house were fatally attacked all at once, in different parts
of the building. A cholera hospital had been provided at an early stage of
the outbreak, but the relatives of those attacked seldom permitted their
removal to it, a prejudice against it having been aroused by the
post-mortem examination of the first victims. Most of the cases were
accordingly treated at their homes, which were “always crowded to excess
by the immediate attendants or relatives, and by others from mere
curiosity.” A fund of two thousand pounds was raised for the distressed
families, to which the Government gave one hundred. Sunderland became for
two or three weeks a centre of interest to medical men, who came to see
the cholera from various parts of England, Ireland and Scotland, while MM.
Magendie and Guillot came from Paris, and M. Dubuc from Rouen.
The symptoms and morbid anatomy of cholera as it was known in India were
seen without ambiguity in the Sunderland epidemic. In a few cases death
followed very quickly without the distinctive intestinal symptoms; but
usually the unmistakeable thing was a sudden seizure, often in the night
after a hearty supper, marked by profuse “meal-and-water” or
“rice-and-water” purging, by vomiting, faintness or sinking at the pit of
the stomach, thirst, pulselessness, cramps of the limbs, restless tossing,
coldness, blueness and clamminess of the surface, and shrunken features.
The _facies Hippocratica_ had not been seen on so extensive a scale in
England since the sweating sickness of three hundred years before. The
end was sometimes in deep coma, at other times in delirium with convulsive
or spasmodic movements. The chief point in the morbid anatomy was the
engorgement of the lungs, great veins, and right side of the heart, from
which the disease was named “cholera asphyxia.” The blood was thick and
tarry[1490].
Extension of Cholera to the Tyne, December, 1831.
Before Sunderland had been declared by the Board of Health to be free of
cholera, on the 7th of January, 1832, the infection had gained a footing
in Newcastle, Gateshead, North Shields, Houghton-le-Spring, and some
places on the road to Edinburgh. The mildness of that winter was somewhat
favourable to its diffusion; in November there had been some days of
severe frost in the midst of generally mild weather, December was warmer
than usual, the pastures being green and spring-like, while January was
warm and dry almost beyond precedent. The first cases in new centres were
usually tramps or others who had come from Sunderland[1491]; but there
were some puzzling attacks. Thus Dixon says that on 12th December, 1831,
he visited a woman of fifty who died of cholera after twelve hours, “in a
lonely district unconnected in situation with any previously infected
place,” and where there had been no personal liability to contagion; a
young man lodging in the house died three days after with the same
symptoms.
At Newcastle, as at Sunderland, fatal cases of choleraic disease were
discovered from the beginning of autumn; one such, on 4 August, at the
village of Team, two miles to the south-west of Newcastle, was said to
have been as little of the nature of bilious cholera, and as truly
spasmodic cholera, as those in the subsequent great epidemic. Another
suspicious death occurred a little below Newcastle on the 26th
October, the same day as the first acknowledged death from the Asiatic
disease in Sunderland. A month passed before the next death, marked by
spasmodic and non-bilious symptoms, occurred at Newcastle--on the 26th
November.
At length, on the 7th of December, 1831, the Asiatic cholera was declared
to be in the town. The earliest cases of it were found in low-lying poor
houses along the river[1492]. Gateshead, on the south bank of the Tyne,
had only two cases until a day or two before Christmas; at length, on
Christmas-day, there was a sudden explosion of the infection
simultaneously at many points.
“On the 25th [December, 1831] about one o’clock,” wrote Brady[1493],
“we were assailed by a third and fourth example of the disease, and
before the next morning at ten o’clock, very considerable numbers had
fallen sacrifices to its pestilential ravages. Within a space of
twelve hours it spread itself over a diameter of two miles, and
appeared to pay but very little distinction to altitude of situation,
for the higher parts of the town were laid under its stroke in an
equal degree, or nearly so, with the lower. Pipewellgate, Hillgate,
the banks above Pipewellgate, Oakwellgate, the lanes leading from it,
Jackson’s chare, Nun’s Lane, Wreckington, Gateshead Low Fell, Low
Team--situations as different in their external character as can well
be conceived--were all indiscriminately exposed to its fury.”
Greenhow’s summary of this remarkable explosion on the afternoon and night
of Christmas-day is that “at nearly fifty different points cases occurred
almost at the same instant.” The attack at Gateshead was short and severe;
at Newcastle it was less concentrated and of longer duration, affecting
the population in the low and dissolute localities along the river, such
as Sandgate and the Close, while there were two or three fatalities about
the 6th January among the wealthier residents. The hospital cases in
Newcastle and Gateshead to the 9th of February were:
Cases Deaths
Sandgate Hospital 55 23
Castle Hospital 12 8
St John’s and St Andrew’s 15 8
Gateshead Hospital 36 21
--- --
118 60
As at Sunderland, the bulk of the cases were treated at their homes--1330
cases, with 437 deaths, to the 9th of February. As the whole number of
deaths at Newcastle and Gateshead, while the cholera of 1832 lasted, was
801 in the returns to the Board of Health, it would appear that the
epidemic had dragged on through the spring and perhaps the summer, which
were its seasons elsewhere.
The colliers’ villages on both sides of the Tyne for two or three miles
above and below Newcastle and Gateshead were sharply visited at the same
time. Below Newcastle, on the north bank, it invaded Dent’s Hole, a dirty
narrow lane along the margin of the river, overhung by its banks, filled
with mud and filth rising in heaps above the thresholds of the houses;
also on the same side, Walker, Howden-Pans, and so on to North Shields; on
the south side below Gateshead it visited Felling and other villages.
South Shields and Westoe escaped for several weeks, but at length about
the 20th of February the epidemic began there and caused 147 deaths before
it ceased.
Some of the worst village outbreaks occurred above Newcastle on both sides
of the river. Swalwel, a low dirty village of iron-workers, near the
confluence of the Derwent with the Tyne had a very virulent attack.
Dunston, another low-lying village on the south bank, two miles above
Gateshead, subject to inundation from the small tributary stream running
through it, had twenty-three deaths among the 400 inhabitants in about a
fortnight, most of the victims being old, dissipated and debilitated. On
the other hand, Whickam Fell, standing on the hill between Dunston and
Swalwel, escaped with only one case, while Bensham, another elevated
village between Gateshead and Dunston, escaped altogether; just as Byker,
a high-lying village on the north bank, only half a mile from Dent’s Hole,
had but a single mild case.
On the north bank above Newcastle the disease was most severe in the
villages of Bell’s Close, Lemington and Newburn. The epidemic in the last
of these was indeed unparalleled. As in all the other villages attacked,
the epidemic was soon over, but not before two-thirds of the inhabitants
had suffered either from choleraic diarrhoea or cholera proper. Newburn
was a village of some 131 houses, built in the face of the high north bank
of the river five miles above Newcastle, its population being 550. The
houses stood in two rows, one above the other, the church and churchyard
standing in open ground midway between the lower and upper streets of the
village; a small stream ran through it to the Tyne. The inhabitants were
mostly wherrymen, coal labourers, or glassworkers; they were a healthy
community, above indigence, housed in clean, neat, comfortably furnished
clay-floored cottages. The first case of cholera, in a man who lived close
to the brook, proved fatal on the 4th of January, 1832. There was no new
case until the 10th, after which there were several deaths every day. From
the night of the 15th until noon of the 16th fifty were attacked, twelve
or thirteen of them with the worst kind of spasmodic cholera, the rest
with diarrhoea. By the 2nd of February the epidemic was over. Three
hundred and twenty had either cholera or cholerine, of whom fifty-seven
died (the Board of Health return gives 274 cases and 65 deaths to 25
January), the daily deaths having been as follows[1494]:
_Cholera in Newburn, near Newcastle, 1832._
Deaths
Jan. 4 1
11 4
12 3
13 4
14 6
15 5
16 6
17 3
18 5
19 3
20 3
21 2
22 3
23 2
24 2
25 1
26 2
27 1
28}
29} 1
The other chief centres of cholera in the northern coal district, besides
those mentioned, were Houghton-le-Spring and Hetton (which had together
311 cases and 66 deaths to the 28 of January), the colliery village of
Earsden, and the port of Tynemouth.
The Cholera of 1832 in Scotland.
It was not until April that the infection began to show itself on the same
scale in other parts of England. The next parts of the kingdom to be
invaded after the Wear and the Tyne were the coal and iron districts of
East Lothian and Lanarkshire, the cities of Edinburgh and Glasgow becoming
infected soon after. A fatal case, in a destitute tramping sailor occurred
at Doncaster, in the beginning of January, but led to no outbreak; two
fatal cases occurred at Morpeth about the same time, the second of the two
in a bagman who had just spent three days making his rounds in Newcastle
and the infected villages near it. It was on the high road to Edinburgh,
at Haddington, Tranent and Musselburgh, that the next focus of cholera was
established. Previous to the 14th of January there had been 47 cases, with
18 deaths, in and near Haddington, among the miners and others of the
labouring class. At Tranent, seven miles nearer Edinburgh on the main
road, with a population of 1700 miners and labourers, a boy died of
cholera on the 18th January, the infection spreading so rapidly that
before the 25th there had been 61 attacks with 26 deaths, which rose to
205 attacks and 60 deaths by the 8th of February. A few cases occurred
also at North Berwick and a good many at Preston Pans; while Musselburgh
became the scene of one of the most deadly outbreaks in the whole history.
Musselburgh, with Fisherrow, was not then the place of villas which it
afterwards became, but was occupied by a working class, who combined the
three industries of coal-mining, weaving or other factory work, and
fishing. To add to the ordinary insanitary risks of such a combination,
some fifteen hundred hands had been out of work for two months, and were
in “a state of great misery.” The first case of cholera appeared there on
Wednesday, the 18th January, three days after the first death at Tranent.
The virulence and certainty of the infection will appear from the
following by D. M. Moir, the distinguished author of _Mansie Waugh_ and
other writings in prose or verse, who practised his profession at
Musselburgh:
“A girl at Musselburgh, whose mother kept a lodging-house, was found
in a state of complete collapse on the morning of Thursday, the 19th
January--the day after the first appearance of the pestilence. She
died on that afternoon, between five and six, and was buried by
moonlight the same evening.... The mother during the night of Saturday
was also similarly seized, and fell a victim on the following noon.
Her sister, who had walked from Leith on the same morning to condole
with her in her family distress, was immediately affected on entering
the house; but her symptoms being overlooked in the misery around her,
medical assistance was not called in, until, on the return of the
nieces from the interment, their aunt was discovered dead on the floor
of the dwelling. Her husband, Baxter, a man of intemperate habits,
came out to enquire into her fate; and immediately on his return home
to Leith was seized with the distemper and died.”
In three weeks there were more deaths from cholera than from all causes in
the whole of an ordinary year. To the 22nd of February, just over a month
from its outbreak, the disease had attacked 435, of whom 193 died. The
medical profession (the senior of whom was a man of original talent,
Thomas Brown, author of an essay on smallpox, in 1808, and one on the
Indian cholera in 1824), were greatly taxed by the numerous calls upon
them: Moir met one night a young colleague who complained of feeling ill,
and was advised by the former to go home at once; he continued his rounds
for an hour longer, and died of cholera next morning. Edinburgh, only five
miles distant, was in constant communication with Musselburgh; and at
length three or four cases appeared in the city in persons who had been at
the infected place. The Edinburgh cases, however, did not multiply
rapidly; to the 8th of February, there had been 8 cases with four deaths;
to the 28th of February, 35 cases, with 18 deaths; to the 20th of March,
39 cases, with 20 deaths. On the other hand, the suburb of Water of Leith,
had 48 cases, with 23 deaths at the same date. On the 6th April, 1832, the
figures for Edinburgh and certain of its suburbs respectively were:
Cases Deaths
Portobello 44 24
Water of Leith 58 30
Canonmills 18 12
Duddingston 10 3
Edinburgh 62 38
Of the border towns, Hawick was infected on the 14th January, probably
from Morpeth, and had a not very extensive epidemic, of somewhat mild
type[1495]. Coldstream, on the Tweed, a few miles above Berwick, had 109
cases and 37 deaths to the 20th of March.
Meanwhile the infection had sought out the weak spots in the west of
Scotland--the mining and weaving villages in Lanarkshire, the city of
Glasgow and the manufacturing town of Paisley. On Sunday, the 22nd
January, a boy was taken ill in church at Kirkintilloch (a village on the
Forth and Clyde canal, seven miles north-east of Glasgow), and died next
morning: that was the first case in the west of Scotland. Cases multiplied
in Kirkintilloch, so that by the 6th of March there had been thirty-two
deaths, but no more for the rest of the season. A few days after the boy
was seized in church there, a first case occurred in the mining village of
Coatbridge, six or seven miles to the south-east, in an old man living in
a “back land” in very poor circumstances, who had not been in
Kirkintilloch nor had communication with such as had been there; other
cases followed slowly, and at length there was a more severe outbreak.
Glasgow at once took precautions. A Board of Health had been formed there
early in the summer of 1831. In February, it had command of £8000 raised
by voluntary subscriptions, and it made provision of 236 cholera beds in
five hospitals. The theatres were closed, and “evening sermons”
discouraged; while all the passenger boats (for a time also the goods
barges) on the Forth and Clyde canal, and on the Monkland canal (near to
which was Coatbridge) were stopped. District committees were formed in all
parts of the city.
The first victim was Janet Lindsay, a drunken old woman who lodged
with widow Proudfoot and her daughter in Todd’s Close, Goosedubs; she
was asthmatic, and had not been beyond the Goosedubs for weeks. Her
seizure, with vomiting and purging, was on the afternoon of Thursday,
9th February, and her death on Saturday morning. Also on the 9th
February, in the suburb of Woodside, remote from Goosedubs, the infant
of one McGie was attacked with cholera, suffered much from cramps on
the 10th and died on the 11th, the father, mother and others of the
family afterwards suffering from cholera. The third case, fatal in a
few hours, appeared early in the morning of Friday the 10th in a boy
living in Millroad Street, a mile east of the Goosedubs, who had been
subject to diarrhoea for some weeks. The fourth victim was a gardener
in Macalpine Street, a locality also remote from the Goosedubs and in
the opposite direction from Millroad Street, who had walked three
miles to Pollokshaws on the 9th, and had partaken of tea with friends
at Crossmyloof on his way back, in excellent health: he was seized at
midnight with purging, and died on the afternoon of the second day.
The fifth case was in Partick on the 11th, the sixth in Bridgegate on
the 12th, not far from the close in the Goosedubs where the first case
had occurred. On the 17th the first of many cases occurred in Paisley,
and on the same day there was a case at Maryhill (population of some
500), followed by six more before the next afternoon. Thus there were,
besides the case of cholera in the very heart of old Glasgow,
half-a-dozen other cases the same day or in the next day or two, at
scattered points all round the city. About fifty of the neighbours had
visited Janet Lindsay in Todd’s Close, and some had helped to lay her
out. The next case in the close was of a woman who had stopped in the
street to talk with the widow Proudfoot shortly after the body had
been removed; this woman was seized at seven next morning (Sunday, the
12th Feb.), and died in the hospital after twenty-four hours. Three
days passed, and then there occurred two other cases, both fatal, in
Todd’s Close, one of them being the widow Proudfoot herself, who
refused to be taken to the hospital, and would receive no other
medicine or cordial but whisky. No other cases occurred in the close
for several weeks; but within a range of two hundred yards of it there
were 46 cases from the 13th to the 29th of February. It was, indeed to
this region of Glasgow, the Goosedubs and the Wynds, that the
infection was chiefly confined for the first few weeks; it was
especially severe in Francis’s Close, Broomielaw, a collection of
small wretched hovels, in which some twenty died of cholera[1496]. The
state of the three old Wynds of Glasgow and of other the like
localities has been already referred to under a date a year or two
before the outbreak of cholera (supra p. 598).
No better instance could be given of the inscrutable ways in which the
infection of cholera found out the weak places and the likely subjects
than the explosion in the Glasgow Town’s Hospital or pauper infirmary on
the 22nd of February, some twelve days after the first cases in various
parts of the city and suburbs.
The infirmary, built in two blocks on the north bank of the Clyde,
contained 395 inmates occupying 296 beds, some 60 or 70 of whom were
insane or fatuous. The fatuous lived in ground-floor cells of the
north block, from seven to eleven feet square, with a stone vaulted
roof, a stone floor, no fireplace, damp from situation and want of
sun, but all the more damp from being often washed owing to the
uncleanly habits of the inmates. At eight on the morning of the 22nd
February two fatuous paupers in adjoining cells were found cold and
pulseless; they had vomited and purged during the night, although they
had been well the evening before; each of the two cells had three beds
with five occupants. One of the two seized died next day, the other
recovered in a week, having had severe spasms and a degree of
collapse. Cases appeared almost at the same time in various parts of
the building, most of them in scattered individuals, but in one
instance in as many as five together in a garret holding twenty-two.
From the 22nd February to the 9th of March there were 64 attacks of
cholera in this pauper institution[1497]. Besides the five deaths in
the Sunderland Workhouse, this was the first of many instances of the
remarkable invasion of such institutions.
Until July the infection had been limited in Glasgow to certain of the
lowest localities, and even in these it had declined almost to extinction
in the last week of May. As the summer advanced it increased somewhat
again, and in the first days of August it took a sudden start, reaching a
maximum of 181 attacks in one day, and 817 in a week. It was no longer
confined to the poorest districts, but became diffused all over Glasgow,
so that “there was scarcely a street where one or more cases did not
occur.” From this enormous prevalence in August, it declined again in
September, but once more took a start in the last few days of that month
and in the first week or two of October. The last outburst was ascribed to
the effects of the Glasgow public holiday on 28 September, to celebrate
the passing of the Reform Bill for Scotland, but the course of the
epidemic clearly followed the season, being precisely parallel in
Edinburgh, in Dumfries and in the coast towns of Fife. From the middle of
October, the disease declined rapidly and was extinct before the middle of
November. The following table shows week by week the number of new cases
reported daily to the Board of Health, and the deaths in each week[1498].
_Cholera in Glasgow, 1832 (population 202,426)._
Week New
ending cases Deaths
Feb. 19 62 21
26 113 46
Mar. 4 68 39
11 85 60
18 94 50
25 150 61
April 1 138 74
8 112 57
15 99 50
22 120 60
29 71 40
May 6 71 39
13 73 39
20 41 31
27 21 11
June 3 6 7
10 45 17
17 72 39
24 168 70
July 1 127 72
8 131 62
15 143 68
22 229 101
29 218 113
Aug. 5 817 356
12 699 339
Aug. 19 483 228
26 419 178
Sept. 2 231 122
9 117 50
16 60 31
23 84 33
30 165 90
Oct. 7 310 140
14 173 95
21 95 58
28 47 29
Nov. 4 41 18
11 10 11
---- ----
Total 6208 3005
The effect of the epidemic upon the general mortality of Glasgow is shown
in the table of deaths from all causes and from cholera month by month,
compiled from the burial registers, which make the cholera deaths 161 more
than the returns to the Board of Health.
_Glasgow Mortality in 1832._
All Cholera
deaths deaths
Jan. 824 --
Feb. 874 87
March 955 264
April 816 229
May 677 125
June 783 196
July 990 441
Aug. 1755 1222
Sept. 749 243
Oct. 755 334
Nov. 529 25
Dec. 571 --
------ ----
10,278 3166
While the cholera lasted (12 Feb.-11 Nov.) the burials from all other or
ordinary causes were 4958; in the corresponding nine months of 1831 they
were 4862, having been excessive in that year owing to fever. The baptisms
from 15 December, 1831, to 14 December, 1832, were 3388; so that the
cholera alone destroyed nearly as many lives, chiefly adult, as there were
children born in the year.
Upwards of a thousand of the cases were treated at the Albion Street
Hospital, under the direction of Dr Lawrie, who had had a large experience
of cholera in India. His statistics are as follows[1499]:
_Albion Street Cholera Hospital, Glasgow, Feb.-Sept. 1832._
Males Females Both sexes Percentages
Cases Deaths Cases Deaths Cases Deaths of deaths
370 251 662 419 1032 670 64·9
Percentages
Ages Cases Deaths of deaths
0-7 43 25 58·1
7-20 93 47 50·5
20-30 231 112 48·8
30-40 211 137 64·9
40-50 204 136 66·1
50-60 116 95 81·0
Over 60 134 120 89·5
_Monthly Cases and Deaths._
Percentages
Cases Deaths of deaths
Feb. 40 33 82·5
March 97 69 71·1
April 122 81 66·3
May 56 40 71·4
June 126 94 74·5
July 240 143 59·5
Aug. 273 176 64·4
Sept. 64 33 51·5
The noteworthy points are: first, the great excess of women admitted,
which was observed also at Edinburgh; secondly, the higher rate of
fatality at the two extremes of life, which is the rule in some other
infections; and thirdly, the lower ratio of deaths to cases during the
height of the epidemic in the end of summer, which is explained, as
Craigie remarked for Edinburgh, simply by the fact that the infection was
no longer in the worst localities, but was attacking “a greater number of
persons, and consequently much better constitutions.”
The Glasgow cholera of 1832 was far more destructive than that of
Edinburgh per head of the population, according to the following:
Glasgow Edinburgh
Population 202,426 136,301
Attacks of Cholera 6208 1886
Deaths by Cholera 3005 1065
The fluctuations of the epidemic in the two cities were closely parallel.
In Edinburgh from the middle of February to the middle of June the new
cases usually ranged from five to ten or fifteen a day, with an occasional
excess, as on the 29th of April when there were twenty-six persons seized.
As in Glasgow, there was a marked lull in the end of May and beginning of
June, after which the seizures became more common and remained somewhat
steady to the end of July, some days having as many as twenty attacks. The
largest number in one day in August was nineteen, the September maximum
sixteen (on the 28th). Edinburgh thus missed the enormous outburst that
Glasgow had in August, while the September experiences were much the same
in the two cities. The first week of October, which was the time of a
second maximum in Glasgow (far below that of August), was the worst time
of the whole epidemic in Edinburgh, the cases coming from all parts of the
city, as in Glasgow they had done in August.
_Successive days of most extensive Cholera in Edinburgh, 1832._
New cases
Oct. 1 22
2 23
3 44
4 45
5 23
6 30
7 27
8 18
9 13
10 26
This gives 214 cases in the week ending 7th October, as compared with
Glasgow’s 310 in the same week.
At the Castle Hill Cholera Hospital, 318 were admitted and 187 died. The
ages, with the rates of fatality at each age-period, agree closely with
those already given for the chief hospital in Glasgow. The smaller ratio
of hospital fatality in the second half of the epidemic was perhaps more
marked in Edinburgh: 119 cases, with 85 deaths, from the opening of the
hospital to 5 July; 199 cases, with 97 deaths, from 5 July to the closing
of the hospital. That larger proportion of recoveries may have been due in
part, Craigie thinks, to better methods of treatment; but, in his opinion,
it was mainly owing to the greater number of strong constitutions among
those attacked over a wider area of the city.
Beyond the statistics and other particulars for Glasgow and Edinburgh, and
the minute accounts of the first outbreaks in the beginning of the year,
there is little exactly recorded of the cholera of 1832 in the rest of
Scotland; but the following table, compiled according to counties from the
alphabetical list of the London Board of Health, will serve to show the
epidemic in outline.
_Deaths by Asiatic Cholera in Scotland, 1832._
No. of
places Places with highest mortalities
Counties Deaths attacked in each county
Caithness 96 iii Wick 69, Thurso 26, Latheron 1
Sutherland -- --
Ross and Cromarty 102 vii Tain 55, Dingwall 17, Avoch 12,
Cromarty 11, Several villages no
return
Inverness-shire 191 iii Inverness 177
Nairnshire 5 i Nairn 5
Moray -- --
Banffshire 15 i Rathven (Buckie) 15
Aberdeenshire 108 ii Aberdeen and Footdee 99, Collieston 9
Kincardine -- --
Forfarshire 552 iv Dundee 512, Cupar Angus 17, Arbroath
13, Liff and Benvie 10
Perthshire 81 v Perth 66, Auchterarder 7, Kenmore 4,
Tulliallan 3
Fife and Kinross 301 xii Cupar and district 108, Kirkaldy and
Dunnikier 104, Dysart 39, Wester
Wemyss 17, Kinghorn 15,
Burntisland 13, Anstruther 10,
Leven 14, St Andrews 5
East Lothian 213 vii Tranent 78, Haddington 65, Dunbar
etc. 38, Prestonpans 28
Berwickshire 41 Coldstream 41
Midlothian 1780 xiii Edinburgh 1065, Suburbs of, 146,
Leith 267, Musselburgh and
Fisherrow 202, Newhaven 52,
Portobello 33
Linlithgowshire -- --
Clackmannanshire 75 i Clackmannan 75
Stirlingshire 247 x Alloa 72, Stirling 35, Falkirk 36,
Larbert 31, Balfron 28, St
Ninian’s 15, Bothkenner 10,
Carriden 13, Grangemouth 8
Lanarkshire 3575 xii Glasgow 3005, Pollokshaws 143, Govan
77, Old Monkland 125, Rutherglen
65
Renfrewshire 1001 xi Paisley 444, Greenock 436, Port
Glasgow 69
Dumbartonshire 86 iii Dumbarton 67, Bonhill 13, Helensburgh
6
Bute 14 i Rothesay 14
Argyle 35 ii Inverary 25, Campbelltown 10
Ayrshire 466 x Kilmarnock 205, Ayr 190, Dairy 22,
Irvine 19
Kirkcudbrightshire 133 iv Troqueer (Maxwelltown) 125,
Kirkcudbright 3
Dumfriesshire 441 v Dumfries 418, Caerlaverock 15
Roxburghshire 34 i Hawick 34 (second outbreak only).
Near Glasgow numerous centres of cholera were established, among which
Paisley, Greenock and Dumbarton suffered heavily during the same space as
Glasgow, from February to November. Rothesay, Campbelltown and Inverary
had epidemics in spring or early summer. In June and July the infection
was carried effectually into Ayrshire (an earlier importation to Doura,
near Kilwinning, in March, having proved abortive) and caused great
mortalities at Kilmarnock[1500] and Ayr[1501], as well as much alarm and a
good many deaths at Dalry, Irvine and Loudoun. In the latter half of
September a most disastrous outbreak began in Dumfries and in the
neighbouring Maxwelltown[1502].
The epidemic in Leith and Newhaven proceeded at the same time as in
Edinburgh. Another important centre was the midland coal-field of
Stirlingshire and Lanarkshire, where the mortality was mostly autumnal.
Perth had been reached early in March, Dundee at the end of April, the
latter having a visitation on the same scale as Glasgow, Edinburgh,
Paisley and Greenock. From Dundee, Cupar Fife was infected about the
middle of August, and had a severe epidemic almost confined to
paupers[1503]. In the autumn there was much cholera among the fishing
population from Thurso to Dunbar and Berwick. Inverness had been infected
early in May, and was probably the centre from which the disease spread in
the end of summer, during the herring fishery, to the coast towns and
fishing villages, as well as to Tain and Dingwall. Only a few of these
places made returns to the Board of Health; but it is probable from what
Hugh Miller relates of the villages near Cromarty that the disease had
been more widely spread. That author has described the condition of things
in his native town. Its landlocked bay had been made a quarantine station,
and was full of shipping flying the yellow flag. Cholera had “more than
decimated” the villages of Portmahomak and Inver, and was prevalent in the
parishes of Nigg and Urquhart, with the towns of Inverness, Nairn, Avoch,
Dingwall and Rosemarkie. The numerous dead at Inver were buried in the
sand, infected cottages had been burned down, the infected hamlets of
Hilton and Balintore had been shut off from the neighbouring country by a
cordon[1504]. The citizens of Cromarty, hitherto untouched, followed the
advice of Miller at a public meeting and took the law into their own
hands, guarding all the approaches to their peninsula and subjecting all
arrivals to fumigation with sulphur and to some undescribed application of
chloride of lime. The infection, however, got in by an unguarded channel.
A Cromarty fisherman had died of cholera at Wick; his clothes had been
ordered to be burned, but a brother of the dead man, who was in Wick at
the time, secured some of them and brought them home. He kept them in his
chest for a month before he ventured to open it. Next day he was seized
with cholera and died in two days. Thereafter the disease crept about the
streets and lanes for weeks, striking down both the hale and the worn-out.
Pitch and tar were kept burning during the night at the openings of the
infected lanes; the clothes of the dead were burned; many of the fishers
left their cottages and lived in the caves on the hill until the danger
was past[1505].
Among the numerous fishing villages of the Moray Firth, Buckie is the only
one given as severely touched by the infection (fifteen deaths). Only one
small village of the Aberdeenshire coast, Collieston, is known to have had
cholera (nine deaths)[1506]. The Aberdeen epidemic was not severe, and
appears to have been mostly in the fishers’ quarter. The Montrose district
escaped altogether in 1832; but in June, 1833, the true Asiatic cholera
broke out in the fishing villages of Ferryden and Boddin, on the opposite
shore of the South Esk from Montrose. Arbroath had a few deaths in August,
1832, while several of the small towns on the coast of Fife had from that
time to the end of the year visitations which were only less alarming than
those on the south side of the Firth of Forth at the beginning of the
year. To sum up the epidemic in Scotland, it caused nearly ten thousand
deaths, of which Glasgow and its suburbs had about one-third, Edinburgh,
Leith, Dundee, Greenock, Paisley and Dumfries, another third, while a
large part of the remainder occurred among the mining and fishing
populations[1507].
The Cholera of 1832 in Ireland.
The forecast of Orton in the summer of 1831, that Ireland would be the
chosen soil of the Asiatic pestilence owing to the state of misery, at
that time, of the mass of its people, was realized in a measure. But the
cholera in Ireland, as elsewhere in Europe, showed itself chiefly as an
urban disease, falling disastrously upon the poorest quarters of Dublin,
Limerick, Cork, Galway, Sligo, Drogheda and other towns, but by no means
seriously upon the immense population who occupied the country cabins.
Scotland, indeed, had a higher ratio of cholera deaths than Ireland per
head of the population; whereas Dublin had nearly twice as many deaths as
Glasgow, their populations being almost exactly equal (about 200,000), and
Cork had nearly the same number as Liverpool. The following table gives
the comparison of the three divisions of the United Kingdom, including the
cholera deaths of 1831 in England, but not those of 1833, which were more
numerous in Ireland than elsewhere.
Population in 1831 Cholera deaths
England and Wales 13,897,187 21,882
Ireland 7,784,539 20,070
Scotland 2,365,114 9592
The first undoubted case of Asiatic cholera was found in Dublin on 22
March, 1832. On the 25th of that month, Harty, who was physician to all
the Dublin prisons, notified to the Board of Health cases in the Richmond
Bridewell which he believed to be true spasmodic or malignant
cholera[1508]. It was reported from Cork on the 12th of April, from
Belfast on the 14th, Tralee on the 28th, Galway on the 12th of May,
Limerick on the 14th, Tuam the 4th of June, Waterford the 1st of July, but
not until 21 August from Wexford and about the same time from Londonderry.
Doubtless remoteness from the ordinary routes of vagrants was the reason
why the infection was later in some places, such as Wexford. The old
Liberties of Dublin, which harboured crowds of beggars in dilapidated
tenement-houses, became a focus of virulent infection. As the summer
advanced whole families in some of the most wretched lanes were cut off;
news from Dublin on 29 June says that the pestilence was worst in Sycamore
Alley, in a single house of which twenty persons had died in the course
of four or five days[1509]. Certain streets sent fifty patients to the
Cholera Hospital for one sent by other streets that were seemingly no
better off[1510]. The great hospital in Grange Gorman Lane, capable of
holding 700 and sometimes occupied by 500, would on some nights or early
mornings (from midnight to 7 a.m.) receive forty or fifty new cases, and
within a week would be having at the same hours only two applications.
During four successive days it admitted a total of 285 cases, during the
next four days 497 cases, and during four days a fortnight later only 134
cases. The worst time was from the 10th to the 14th of July, when 615 were
admitted. A day or two of rain seemed always to send up the number of
cases carried to the hospital[1511]. Until the beginning of June hardly
anyone under fifteen was attacked; but in July the attacks of children
were about one in thirteen or fourteen of adults, a case of pure cholera
having been observed in an infant three weeks old. As at Glasgow and
Edinburgh, more women than men were taken to the hospital (138·17 females
to 100 males)[1512].
As the infection spread in Dublin during the early summer a panic arose in
the city, and alarm over the whole province of Leinster. Runners, as in
the old times of the torch of war, were to be seen hurrying everywhere
through the neighbouring counties carrying a smouldering peat, of which
they left a small portion at every cabin in their direct line, with a
sacred obligation upon the inmates to carry the charm to seven other
houses, and the following exhortation: “The plague has broken out; take
this, and while it burns offer up seven paters, three aves, and a credo in
the name of God and the holy St John that the plague may be stopped”! Men,
women and children scoured the country with the charmed turf in every
direction, “each endeavouring to be foremost in finding unserved houses.”
One man in the Bog of Allen had to run thirty miles before he had
discharged the obligation laid upon him[1513]. It does not appear,
however, that the infection was at all general among the scattered
cabins, hamlets or even considerable villages. In the rural parts of
Wicklow there were only eight deaths from it, in Fermanagh four, in county
Derry three, in Armagh thirteen, in Carlow none until the next year. In
Clare the deaths in country districts were more than twice as many as in
Ennis and other towns of the county. In Sligo county, again, there were
only 62 deaths among the peasantry to 698 in the towns, nearly the whole
of the latter total belonging to the county town and seaport. The epidemic
in Sligo town was one of the worst in Ireland. It was reported that forty
or fifty were buried in one day in a trench, one-half of them without
coffins but wrapped in tarred sailcloth. It is said, also, that seven of
the medical men died of cholera in the course of three months[1514].
Thousands of the population, which numbered about 14,000, fled from the
town, the wealthier paying large sums for a room or two in a country
cottage, the poorer living in tents or sleeping under the hedges. In
August the guard of the mail coach which ran from Sligo by way of Strabane
to Londonderry was taken with cholera on the road and died at the latter
town, no case having occurred in Londonderry up to that time[1515].
The outbreak at Drogheda was as sudden and disastrous as at Sligo. At
Belfast also the disease began with enormous fatality, but, according to
the table, the deaths eventually were few in proportion to the attacks.
The other towns which had highest mortalities were Cork, Limerick, Galway
and Kilkenny--all seaports except the last. In Waterford the great
outbreak was delayed until 1833.
Many of the counties had more deaths among the peasantry in 1833 than in
1832, Limerick county in particular. The following instance is related of
a small hamlet about a mile to the south-east of Armagh:
The hamlet consisted of five or six dwellings on both sides of the
road. On the 19th July, 1833, a man in delicate health, who had
received a jar of sea-water two days before, and had drunk three or
four pints of it, was seized with cramps, and blueness and collapse,
after the purging induced by the sea-water; he died on the 20th and
was buried on the 21st. His brother, who lived next door under the
same roof, was seized with cholera on the evening of the 21st, having
attended the funeral, and died comatose after five or six days’
illness. A man who lived across the road, and had also been at the
funeral of No. 1, was seized with cholera the same evening (21st), and
died in forty-eight hours. On the night of his burial his son aged
thirteen and a married daughter who lived in the house were seized,
the boy dying the same night “very black,” and the daughter after a
lingering illness of five or six days. The only other attacked was a
girl, who recovered under treatment by bleeding &c.[1516]
In 1833 the whole number of deaths assigned to cholera in country places
was 2,756, while 2,552 deaths were reported from the towns. It appears to
be accepted (by Wilde) that true Asiatic cholera lingered in Ireland until
1834, and that it had caused a considerable part of the 4,419 deaths
assigned to “cholera” under that year in the Census of 1841. There is one
reference to undoubted cases of the Asiatic type in 1834 in Ross, Nenagh
and other places in the same district[1517].
Assuming that all the deaths so called in the three years 1832, 1833 and
1834 were true Asiatic cholera, that imported infection accounted for 1 in
5·68 deaths from all causes in Munster, 1 in 5·98 in Leinster, 1 in 9·86
in Connaught and 1 in 15·15 in Ulster. The proportion of attacks to
fatalities in eight of the principal towns in the following table varies
much, Belfast having comparatively few deaths for all its many cases, and
Kilkenny three deaths to about five cases: these differences must have
depended upon the number of cases of “cholerine” or diarrhoea which
attended the true “spasmodic” or collapse-cholera, and may or may not have
been counted in the returns.
_Deaths from Asiatic Cholera in Ireland, 1832-33._
1832 1833
No. of
Country Town Country Town places with
deaths deaths deaths deaths Cholera
LEINSTER
Carlow -- -- 64 116 vi
Dublin 460 187 32 17 xxiv
_Dublin City_ -- 5632 -- 166
Kildare 108 72 55 104 xi
Kilkenny 91 14 130 29 ix
_Kilkenny City_ -- 296 -- 144
King’s 40 288 10 -- v
Longford 22 63 -- -- iii
Louth 115 189 -- -- viii
Meath 61 105 81 113 vii
_Drogheda Town_ -- 491 -- --
Queen’s 17 111 16 -- iv
Westmeath 18 121 84 5 iv
Wexford 126 362 24 150 v
Wicklow 8 40 -- 23 iv
MUNSTER
Clare 453 281 166 8 xiii
Cork 325 1028 466 240 xxxv
_Cork City_ -- 1385 -- 234
Kerry 87 440 109 181 viii
Limerick 82 4 668 173 xvi
_Limerick City_ -- 1105 -- --
Tipperary 198 910 224 208 xii
Waterford 52 52 48 79 ix
_Waterford City_ -- 24 -- 245
ULSTER
Antrim 70 66 -- 75 v
_Belfast Town_ -- 418 -- --
Armagh 13 57 2 -- vi
Cavan 21 11 70 51 vi
Donegal 37 139 141 -- vii
Down 110 423 65 37 xiv
Fermanagh 4 50 -- 9 iv
Londonderry 3 222 -- -- iv
Monaghan 64 50 13 43 iv
Tyrone 100 193 17 9 ix
CONNAUGHT
Galway 141 430 82 -- xii
_Galway Town_ -- 596 -- --
Leitrim 1 -- 101 -- vi
Mayo 151 325 12 68 xi
Roscommon 47 105 38 25 vii
Sligo 62 698 25 -- iv
The Cholera of 1832 in England.
The certainty that Asiatic cholera was at Sunderland in November and at
Newcastle in December, 1831, led to quarantine of ships arriving in the
Thames from the Wear and the Tyne. The early numbers of the ‘Cholera
Gazette’ published lists of vessels from these northern coal ports
detained at Stangate Creek on the Medway[1518]. At length about the middle
of February, 1832, three suspicious cases occurred together in
Rotherhithe, one of them being of a man who had been scraping the bottom
of a Sunderland vessel. Other cases came close upon these in the parishes
on both sides of the Thames from Rotherhithe and Limehouse to Lambeth and
Chelsea, especially in the Southwark parishes.
The diagnosis of Asiatic cholera was vehemently contested for several
weeks by a section of the profession, who frequented the Westminster
Medical Society and had for their organ the ‘London Medical and Surgical
Journal.’ The slow progress of the disease at first, and the apparent
extinction of it for a week or two at the end of May (as at Glasgow and
elsewhere in Scotland in the same weeks) encouraged these doubts, although
the 994 fatalities in 1848 cases from 14 February to 15 May were quite
unlike any experience of cholera nostras. After the river-side parishes,
cases were reported most from other crowded parts, such as St Giles’s in
the Fields. From the middle of June the infection became more severe and
widely spread, still making the river-side parishes its chief seat, but
extending beyond Southwark on one side, and on the north side to such
localities as Fetter Lane, Field Lane and parts of the City. From the 15th
of June to the 31st October the cases in London were 9142 and the deaths
4266; in November and December only thirty more cases were known, of which
one half were fatal. The total for the year in London came to 11,020 cases
with 5275 deaths. This was admitted to have been for Asiatic cholera a
slight and partial visitation of the metropolis. London with a population
of a million and a half had actually fewer deaths than Dublin with its two
hundred thousand inhabitants. Paris had more cholera deaths in one week of
April (5523 deaths, April 8-14) than London had in all the year.
_The Asiatic Cholera of 1831-32 in England._
No. of
places Places with highest
Deaths attacked mortalities in each county
London 5275
Surrey, part of -- --
Kent 135 xi Minster (Sheerness) 38
Sussex -- --
Hampshire 91 ii Portsmouth 86, _Southampton no
return_
Berkshire 52 iv Wantage 27
Middlesex, part of 62 iv Uxbridge 34, Edmonton 11
Buckinghamshire 105 iv Aylesbury 60, Olney 22
Oxfordshire 219 xii Oxford 86, Bicester 64
Northamptonshire -- --
Huntingdonshire 45 iii Fenstanton 21, Ramsey 20, St Ives 4
Bedfordshire 40 ii Bedford 36
Cambridgeshire 208 iv Whittlesea 97, Ely 61, Wisbech 41
Essex 38 iv Barking 18, Chelmsford 10
Suffolk 1 i Woodbridge 1
Norfolk 232 vi Norwich 129, Lynn 49, Denver 27,
_Yarmouth no return_
Wiltshire 14 ii Chippenham 9, Farley 5, _Salisbury
no return_
Dorset 19 ii Bridport 16, Charmouth 3
Devon 1901 xxvii Plymouth 702, Devonport 228, East
Stonehouse 133, Exeter 386
Cornwall 308 xi St Paul 81, Penzance 64
Somerset 142 v Paulton 66, Bath 49, Tiverton 23
Gloucestershire 932 viii Bristol 630, Clifton 64, Gloucester
123, Tewkesbury 76, Upton 34
Herefordshire -- --
Shropshire 158 vii Shrewsbury 75, Oldbury 37, Madeley 27
Staffordshire 1870 xiv Bilston 693, Tipton 281, Sedgley
231, Wolverhampton 193, King’s
Winsford 83, Wednesbury 78,
Walsall 77, Newcastle-u.-Lyme 60,
W. Bromwich 59, Darlaston 57,
Stoke 46
Worcestershire 579 xi Dudley 77, Worcester 79,
Kidderminster 67, Droitwich 63,
Redditch 38
Warwickshire 188 xii Nuneaton 56, Coleshill 32,
Birmingham 21
Leicestershire 5 i Castle Donington 5
Rutland -- --
Lincolnshire 80 viii Gainsborough 41, Owston 17
Nottinghamshire 352 vii Nottingham and suburbs 322, Newark 25
Derbyshire 16 i Derby 16
Cheshire 111 vi Northwich 30, Stockport 29, Runcorn
18, Nantwich 14, Chester 14,
Brimmington 6
Lancashire 2835 xiv Liverpool 1523, Manchester 706,
Salford 216, Warrington 168,
Lancaster 114, Wigan 30
West Riding, York 1416 xxvii {Leeds 702, Sheffield 402, Hull 300,
East Riding, York 507 iiii { York 185, Wakefield 62, Rotherham
North Riding, York 47 ii { 34, Selby 32, Goole 36, Bradford
{ 30, Whitby 27, Doncaster 26
Durham 850 viii Sunderland 215, Gateshead 148, S.
Shields 147, Stockton 126, Jarrow
and Hebburn 70, Hetton &c. 97
Northumberland 1394 xiv Newcastle 801, Villages near 259,
N. Shields &c. 98, Berwick 84,
Tweedmouth 72, Blyth 42
Cumberland 702 vii Carlisle 265, Whitehaven 244,
Workington 119, Maryport 42,
Cockermouth 25, Allonby 4
Westmoreland 68 i Kendal 68
Monmouth 15 ii Newport 13, Abergavenny 2
South Wales 343 vii Merthyr Tydvil 160, Swansea 152,
Haverfordwest 16
North Wales 140 viii Denbigh 47, Carnarvon 30, Flint 18,
Newtown 17
Isle of Man 146 i Douglas 146
It will appear from the annexed table (here compiled according to counties
for the first time) that the cholera of 1832 visited most parts of
England. The dates of outbreak at each place (omitted in the table) show
that its great seasons everywhere, except at Sunderland, Newcastle and
Musselburgh, were the summer and autumn. New centres or foci of infection
were made in all directions, and in a good many small places there were
epidemics which produced much alarm although the figures look
insignificant in the statistical table. Some counties, such as
Leicestershire, Herefordshire, Derbyshire, Northamptonshire,
Lincolnshire, Suffolk, Sussex, Dorset, Wiltshire, and several of the Welsh
counties, escaped with a few cases at perhaps one village or town. Some
towns, such as Birmingham, Cheltenham, Cambridge and Hereford, had only a
few cases (or none) in 1832 as in the later epidemics in England. Most of
the towns which now head the list of high death-rates by common summer
diarrhoea, chiefly infantile (as in the preceding chapter), had only a few
imported cases but no real epidemic extension; these were Preston,
Blackburn, Bury, Rochdale, Oldham, Bolton, Halifax, Leicester and
Coventry; while Bradford, Stockport and Wigan had comparatively few. The
greater epidemics, besides those which started the disease at Sunderland
and Newcastle, were, in order of time, at Hull and Goole, Liverpool,
Manchester, Warrington, Leeds, Sheffield, Nottingham, Bristol, Plymouth,
with Devonport and Stonehouse, Southampton, Portsmouth, Exeter, Salisbury,
various towns of the Black Country in South Staffordshire, Dudley, Merthyr
Tydvil, Carlisle, Whitehaven, with other ports of the Cumberland
coal-fields, and Douglas in the Isle of Man. Devonshire, Cornwall, the
West Riding of Yorkshire, Worcestershire and Warwickshire had each a large
number of minor centres, besides the greater foci at Plymouth and Exeter,
and at Leeds and Sheffield. The severity of the disease in some parts of
England called forth a few special accounts, from which certain
representative details may be taken.
The most disastrous outbreak in all England was at Bilston, in the centre
of the Black Country, near Wolverhampton[1519]. The first cases in that
part of England were at Dudley early in June, in some travelling German
broom-sellers. In the end of June a canal boatman from Manchester died of
cholera in his boat four miles from Wolverhampton; the boat was sunk. In
the first week of July another canal boatman died of cholera at Tipton,
after returning from Liverpool. The infection became established during
July in the parish of Tipton, thickly peopled with miners and
iron-workers[1520]. At length on the 4th of August a case occurred in the
adjoining town of Bilston, about two and a half miles to the south-east of
Wolverhampton.
Bilston was a town of 14,492 inhabitants, nearly all of the working
class. It was irregularly built on high ground, full of forges and
surrounded by mines. Its soil was perfectly dry “from the water having
been drawn off for the purpose of getting the mines[1521].” The
streets were for the most part wide and open; many houses stood in
courts and back yards, but the town was so irregularly built as not to
be densely crowded. The Birmingham and Staffordshire Canal passed
through the whole length of the township, and there was one small
brook traversing the town. The people usually earned good wages, but
trade had been depressed since March, 1832. There was a good deal of
drunkenness among them, and a peculiar addiction to the sports for
which the Black Country is still celebrated, including at that time
bull-baiting. The public health was in general good, the deaths having
been 23 in May, 31 in June, and 25 in July. The churchyard of the
original chapel was full; a new chapel had been built, and a
burial-ground consecrated, in 1831. Bilston wake had been held on 29th
July, 1832, with the usual orgies notwithstanding the depression of
trade. On the night of Friday the 3rd of August a married woman in
Temple Street, occupying a poor and filthy house, who had supped
heartily on pig’s fry and had drunk freely of small beer, was seized
with purging, which turned to fatal spasmodic cholera. Within an hour
medical aid was sought for two more cases of the same in poor and
filthy houses in Bridge Street and Hall Street, about four hundred
yards from each other and from the house in Temple Street. At the back
of the latter was a most offensive pigsty, and beyond the pigsty a
poor cottage in which lived a widow and four children; cholera
attacked them, two of the children dying on the 6th August and another
on the 7th. The night of the 9th of August was most oppressively hot.
In the week ending the 10th August there had been 150 cases and 36
deaths from cholera. On the 10th the disease appeared in a new quarter
to the west, called Wynn’s Fold; the 12th was again an oppressively
hot day, followed by rain over-night. On the 14th the disease began
its ravages in Etlingshall Lane, at the western end of the township, a
mile from the scene of the first outbreak. The attacks in the week
ending 17 August had risen to 616 and the deaths to 133. On the 16th
it was remarked that the flies had disappeared and the swallows with
them; both came back together when the epidemic was declining. Whole
families were now being cut off, father, mother and perhaps three
children. Mr Leigh, the curate of the parish, went on the 18th to
Birmingham to secure a supply of coffins and medical aid, the medical
men of the town being worn out (two of them died a few days after).
The deaths between the 19th and 26th of August numbered 309. On the
latter date a dispensary was opened, after which the proportion of
fatalities to attacks became less. On the 18th of September, the last
death occurred, and the epidemic was over, having attacked 3568 in a
population of 14,492, and destroyed 742, of whom 594 were over ten
years of age. The following is the complete bill:
_Cholera at Bilston, 1832._
Week Deaths under
ending Attacks Death ten years
Aug. 10 150 36 5
17 616 133 23
24 924 298 58
31 832 184 34
Sept. 7 694 62 18
14 250 23 6
21 102 6 4
---- --- ---
3568 742 148
No fewer than 450 Bilston children under the age of twelve were left
orphans by the cholera; for them a national subscription was made to
the amount of £8536. 8_s._ 7_d._, and applied to the building and
support of a Cholera Orphan School, which was opened on the 3rd of
August, 1833, the first anniversary of the outbreak of cholera in the
town.
In the adjoining parish of Sedgley, although the deaths were only 290
in a larger population (20,577), the infection was as severe in
certain places. “Sometimes a whole hamlet seemed to be smitten all at
once, so that, in some of the streets, or rather rows of tenements,
there was scarcely a house without one sick, or dying, or dead.” At
Tipton, in one family of 14 no fewer than 12 died; and in eight
different tenements every inhabitant was swept off. At Dudley one had
a narrow escape of being buried alive. In twelve parishes or
townships, with a population of 160,000, cholera attacked about 10,000
and cut off about 2000. The effects of the pestilence were all the
more terrible from its swiftness, for in each parish it was in full
vigour not above a month. The population of miners and iron-workers, a
rough set addicted to brutal sports and to drunkenness, could not
believe that brandy was not a specific, and made it circulate at
funerals to fortify against infection. A reformation of morals and
revival of religion is said to have followed the scourge[1522]. The
following is the list of chief centres in the Black Country:
Cholera
deaths
Bilston 693
Tipton 281
Sedgley 231
Dudley 277
Wolverhampton 193
King’s Winford 83
Wednesbury 78
Walsall 77
Newcastle-under-Lyme 60
West Bromwich 59
Darlaston 57
Stoke-on-Trent 46
Wolverhampton, which was one of the chief Staffordshire centres of the
next cholera in 1849, got off somewhat easily in 1832 with 576 attacks
(193 deaths), or one in forty of the population.
It was most common and fatal in a lane called Caribee Island, a narrow
filthy cul-de-sac with an open stagnant ditch down the middle,
inhabited chiefly by poor Irish. The influence of ground soaked with
sewage was shown also in the frequency of cases of cholera among
persons in easy circumstances in the residential locality of
Darlington Street--“a wide airy street consisting of two rows of
houses at its upper end, nearest the centre of the town, but of only
one at the lower part, where it is a raised causeway, open on one side
to the gardens and meadows beyond. The lower rooms of the houses,
being below the level of the street, are consequently very damp; and
within a few yards of the backs of these houses runs a wide ditch, the
main sewer of that side of the town, which is dammed up and diverted
into several large cesspools, or receptacles for the mud and filth
which it deposits. These, in warm weather, emit such offensive
exhalations as to be almost intolerable to the persons who live near
them.... It is singular that this was the only part of the town in
which persons in easy circumstances took the disease[1523].”
The cholera had reached Liverpool in the end of April (perhaps from Hull
and York), and attacked 4912 in a population of 230,000, causing 1523
deaths before the end of autumn. The very large number of cellar-dwellings
and back-to-back houses in the town at that time favoured the infection;
but Liverpool was on all subsequent occasions one of the worst centres.
Two incidents in 1832 are connected with ships.
On 18 May, 1832, the ‘Brutus,’ of 384 tons, sailed from Liverpool for
Quebec, with a crew of 19, and 330 emigrants who were pauper families
from agricultural districts sent to Canada at the cost of their
respective poor-law Unions. The emigrants were ill-provided with
bedding and clothes, and the ship was under-provisioned. Two days
after sailing, or seven days, or nine days (accounts differing), a
case of cholera occurred in an adult, who recovered. Other cases
quickly followed, with enormous fatality, until the deaths reached 24
in a day. On the 3rd of June the captain put back for Liverpool, his
provisions having run short, and his drugs (laudanum) being exhausted.
By the time the ship reached Liverpool there had been 117 cases of
cholera (of which four were among the crew) and 81 deaths, seven cases
remaining at her arrival, of which two ended fatally, making the
deaths 83[1524].
Another Liverpool incident is noteworthy:
“One morning a mate and one or two men, who had gone to bed the
preceding evening in good health on a vessel lying in one of the
Liverpool docks, were found suffering from cholera. The men were
immediately removed to a hospital and the vessel ordered into the
river; when another vessel, with a healthy crew took its situation in
the dock: the next morning all the hands on board the second vessel
fell sick of the cholera. Upon examining the dock in this part, a
large sewer was found to empty itself immediately under the spot where
these vessels had been placed[1525].”
One of the ablest accounts of the cholera of 1832 was that by Dr Gaulter,
of Manchester. The deaths there were 706, and 216 in Salford; but it
appeared surprising that, being so many and widely spread, they should not
have been many more.
An inspection by the local Board of Health two months before the first
case appeared “disclosed in the quarters of the poor--a name that
might be almost taken [at that time] as a synonym with that of the
working classes--such scenes of filth and crowding and dilapidation,
such habits of intemperance and low sensuality, and in some districts
such unmitigated want and wretchedness,” that the picture correctly
drawn seemed to many a malicious libel. From that picture, “it was
certainly to have been expected that nearly the whole mass of the
working population would have been swept away by the disease.” There
were few good sewers, and it would have required £300,000 to sewer
Manchester thoroughly. As it was, the infection progressed slowly
from the first case on 17th May until the end of July[1526]. It was
the same in Salford, where it “crept about slowly for three or four
weeks attacking solitary individuals or single families in streets and
situations the most distant and unconnected, and then suddenly fixing
itself in the lower and most populous part of the town.” It was in the
end of July and beginning of August that the sharp outburst took place
in Manchester also. An old soldier well known in the streets as a
seller of matches, who “could take a pint of rum without winking,”
died of cholera in Allen’s Court. His body was allowed to lie in the
house two days and a half. In four houses of Allen’s Court, 17 cases
occurred within forty-eight hours, of which 14 were fatal; this court
was afterwards known as Cholera Court. In the same few days the
infection was most deadly in Back Hart Street, “infamous as a nest of
vagabonds and harlots,” and in a street behind it, in which nearly the
whole of fourteen attacks ended fatally. Blakely Street, a bad fever
locality in the time of Ferriar (_supra_, p. 150), had the most
malignant kind of cholera in its lodging-houses. It was remarked that
few of the factory hands took it: of 1520 employed in Birley and
Kirk’s mill, only 4 were attacked during the epidemic; more women than
men took cholera, and generally those that were employed about
dwelling-houses were the victims[1527].
The whole cholera bill at Manchester was as follows:
_Progress of the Epidemic._
Attacks
May 4
June 37
July 108
August 650
Sept. 261
Oct. 172
Nov. 33
Dec. 2
Jan. 2
_Ages of the patients._
Attacks Deaths
1-15 199 101
15-25 153 53
25-35 264 98
35-45 192 93
45-55 197 116
55-65 120 85
65-80 85 68
Three cholera hospitals were provided in Manchester, at which about
one-half of all the cases were received:
Cases Deaths
Swan Street Hospital 443 234
Knott Mill Hospital 242 122
Chorlton on Medlock Hospital 29 17
At their homes 697 335
In Salford all the patients were treated at their homes--644 with 197
deaths; there were also 60 cases among the prisoners in the New Bailey,
with 19 deaths.
The Swan Street Hospital was the occasion of a remarkable cholera riot
on the 2nd of September. A mob numbering several thousand persons
filled the streets near the hospital; in the thick of it was carried a
small coffin, from which the headless trunk of a child was taken at
intervals and shown to the crowd. The child had died of cholera in the
hospital and the body had been examined _post mortem_. Some rumours of
this had gone abroad, the body was exhumed, and was found
unaccountably mangled. This was the time when intense feeling had been
roused all over the country by the procuring of bodies for anatomical
dissection, the prejudice extending to the ordinary pathological
inspection also. At Sunderland the holding of two or three necropsies
had turned the people against the Cholera Hospital. At Dublin there
was a rigid rule that no body was to be examined after death in the
great cholera hospital of some 700 beds. The body of the child exhumed
at Manchester had been found with the head severed, and the rioters
declared that it had been murdered. They broke into the hospital,
carried off the patients to their homes, and wrecked the furniture and
fittings of the wards. The military was at length called out to clear
the streets[1528].
The epidemic of cholera at Bristol reproduced most of the incidents at
other places. There had been numerous suspicious cases of choleraic
disease in the early summer, including an outbreak in the gaol in the
first week of July.
The first unequivocal cases occurred on the 11th July in a filthy
court, in strangers from Bath where there was then no cholera. About
the same time the infection showed itself at several places apart,
especially in the destitute suburb of St Philip, in the south-east of
the city. One of the worst centres was the city Poorhouse, in which
268 cases with 94 deaths occurred from the 24th July to the 20th
August. The largest number of seizures on one day was 79 on the 17th
August, the largest number of deaths 33 on the 15th. After that it
gradually declined, and was over by the middle of November. The
attacks reported were 1612, the deaths 626; but these figures came
short of the truth, as many cases were not reported, and the burials
from all causes were in excess of the average for the season after
deducting the reported cholera deaths. Although it fell at Bristol, as
elsewhere, upon the poorest quarters and the most abandoned or
destitute class, yet it showed caprices among these. Marsh Street, the
abode of the lower Irish, and one of the most thickly peopled parts of
the city, was the last place visited. Lewin’s Mead, a low and crowded
quarter, had only a few scattered cases[1529].
Little is known of the great epidemic in Plymouth, Devonport, and East
Stonehouse, beyond the gross result that it caused 1063 deaths in the town
and the two dockyards[1530]. Of the outbreak at Southampton not even the
figures are known, the only important omission, besides the epidemic at
Salisbury, in the whole of the cholera of 1832. On the other hand the
Exeter cholera has been related at greater length than any[1531].
It was mainly an autumnal outbreak, the largest number of attacks on
one day being 89 on the 13th August, and the maximum daily burials 30
a few days before. The total attacks were 1135, the deaths 345; they
were chiefly in the south-western suburb of the city, among the poorer
class, the two St Mary parishes having 3·65 and 3·26 per cent. of
their population attacked, the parish of St George 3·41, St John 2·73,
and Trinity 1·54, while two whole parishes had no cases.
Somewhat late in the autumn the infection spread through Cornwall. Its
general prevalence was also late in the South Wales mining district
(insignificant compared with its enormous ravages there in the next
cholera of 1849) and in Carlisle, in Whitehaven and the other seaports of
Cumberland. Hartlepool, for all its nearness to the original centre of
cholera infection in Sunderland, was one of the last places to be
infected, in the autumn of 1832[1532].
The Central Board of Health made no report upon the cholera of 1832,
unless a document sent to the king (William IV.) may have consisted of
something more than the alphabetical list of infected places, with dates
and numbers, which Sir James Clark found some years after in a drawer of
the royal library. But some lessons of the epidemic were obvious without
the aid of an official report. The late summer and autumn was undoubtedly
its chief season--except in places where the poison had, as it were, spent
itself in the winter or early spring, such as Sunderland and Musselburgh.
A subsidence and seeming extinction of the epidemic in spring and early
summer was observed at Glasgow and Edinburgh as well as in London; but it
was far otherwise in Paris, where sixteen thousand deaths occurred in the
single month of April[1533]. As to locality, the infection seemed to
prefer low grounds, such as the shore quarters of seaports and the banks
of rivers. The town moor of Sunderland, around which the infection found
its first habitat in Britain, appeared to be a typical cholera soil--a wet
bottom of tenacious clay, almost impassable in winter from the water
standing in it, the surface covered with heaps of excremental and other
refuse from the crowded lanes near it. But the greatest centre of cholera
in England in 1832, the town of Bilston, seemed to be the reverse of
this--a rising ground from which the water had been drained away by the
numerous mines of coal, iron and limestone all round it. Again, in towns
or villages built upon a slope or on heights and hollows, such as
Gateshead, Newburn and Collieston (most of all in Quebec on the steep bank
of the St Lawrence), the infection did not confine itself to the lower
part only. But it was remarked that among the Tyneside villages several on
high ground escaped altogether, although within a mile or two of others
severely visited. This question of elevation comes up more definitely in
the cholera of 1849.
Another obvious thing in the epidemic of 1832 was that many of the first
victims were among the destitute, drunken or reckless class. But there
were innumerable exceptions, notably in Paris, where the multitude of
victims included several peers, deputies, diplomatic personages and the
prime minister.
One of the most striking things in the habits or preferences of
cholera in 1832 was the early and unaccountable selection of the
inmates of lunatic asylums, the fatuous paupers of workhouses,
prisoners, or other immured persons badly housed and ill-fed. In most
of these cases it was a mystery how the poison of cholera had got
inside the walls. The earliest important instance was that of the Town
Hospital or pauper infirmary of Glasgow. Other instances were the
lunatic wards of Haslar Hospital, Hanwell asylum, Bethnal Green
lunatic asylum, Lancaster county asylum, the Manchester New Bailey,
situated in Salford, Coldbath Fields Prison, London, Clerkenwell
workhouse (65 deaths), Bristol poorhouse (94 deaths). In the remote
Westmoreland village of Hawkshead, thirteen miles from Kendal, cholera
appeared unaccountably among the sixteen inmates of the poorhouse,
attacking eight of them with sudden and severe symptoms so that four
died; it was impossible to trace the introduction of the virus, but
the poorhouse was nearly surrounded with stagnant water[1534].
Hardly anything was more keenly debated than the question as to how
cholera spread. It was not difficult to find some instances of infection
seemingly got from contact with living or dead cholera bodies: cases
suggestive of that occurred at Sunderland at the outset, and later in
Ireland more especially[1535]. In the Swan Street cholera hospital at
Manchester, eight nurses took the infection, of whom four died. But on the
whole the immunity of nurses (as in the Great Gorman Lane hospital of
Dublin) and of medical men was remarkable. Although constantly in the
presence of cholera patients, sometimes lingering over them, as in the
operation of blood-letting, very few took the disease. In Manchester only
one medical practitioner was known to have had an attack, a mild one.
Gaulter says that Dr Alsop, of Birmingham, and Mr Keane, of Warrington,
were the only two medical men known to him to have died of cholera in
England; but two of the Bilston doctors died in the height of the epidemic
there, one died at Musselburgh, seven at Sligo, and two at Enniskillen.
The truth of the matter in cholera appeared to be the same as in plague
and yellow fever, the two great infections that resembled cholera most
closely as soil-poisons: namely, that contagion from the persons of the
sick was a contingency, as Rush, of Philadelphia, had taught for yellow
fever in the end of last century, and Blane had taught after him. A
London writer stated this very fairly in 1832[1536]:
“I believe that this disease, like many other epidemic diseases,
although communicable by miasma in the atmosphere, and originating or
being producible from a peculiar state of that acting upon the earth,
is sometimes contagious (or communicable from person to person) and
sometimes not contagious. I believe the contagious nature of the
disease depends: first, upon the number accumulated in one place, and
the unhealthiness or ill-ventilated state of that place; or, in other
words, upon the degree in which the miasma is condensed; secondly,
upon the length of time a person remains exposed to the poison; third,
upon the debility, or morbid irritability, and consequent
susceptibility of the person’s frame, especially of the abdominal
viscera.” The miasmata of an apartment, to be strong enough to become
contagious, must arrive at a certain degree of concentration.
Cholera was, at all events, very different from typhus fever in the point
of contagiousness: for in the epidemics of the latter many medical men
fell victims, and the susceptibility to contagion was greater in
proportion to the health and vigour of those who mixed with the sick.
It was well understood in 1832 that foul linen, bedding and clothes were a
most certain means of carrying the poison, especially if they had been
kept concealed for a time, or packed away in a chest or bundle. This was
precisely the old experience of plague. The theory that the poison of
cholera was conveyed in the drinking-water, of which illustrations were
collected in 1849 and 1854, was not applied to any of the particular
outbreaks in 1832. But one writer made a guess at it, assuming, as Snow
did in 1849 and 1854, that the stomach and bowels were the organs by which
the virus entered the system:
“From an attentive observation of the course this epidemic has taken
in those places and countries which it has hitherto visited, I have
been induced to draw the conclusion that a noxious matter or poison,
being generated in the earth, has been diffused in the different
springs in such situations [therefore he suggests the filtering of
water through charcoal], and that this matter, being conveyed into the
stomach with the fluid in question, produces that train of symptoms
which, commencing in this organ, afterwards extends with more or less
rapidity to the rest of the body[1537].”
In the treatment of cholera in 1832 many things were tried. The view
taken of the pathology naturally determined the means of cure. To
check the premonitory diarrhoea was seen to be of the first
importance, and to that end laudanum or other form of opium was the
familiar means. Lawrie, at Glasgow, found it most satisfactory, at a
time when the profession in London were, as he says, denouncing it as
a pernicious error. Towards the end of the epidemic in Dublin, Graves
combined with the opium acetate of lead in large doses (a scruple of
acetate of lead with a grain of opium, divided into twelve pills, one
to be given every half-hour until the rice-water evacuations from the
stomach and bowels began to diminish)[1538]. Some professed to find
great benefit from blood-letting at a sufficiently early stage in the
attack[1539]. The enormous drain of the fluids, leaving the blood
thick or tarry, suggested to some that saline substances would be
beneficial. The saline treatment was indeed the principal subject of
writing during the year 1832. One way was to give saline drugs by the
mouth; another way was to inject into a vein a large quantity of
distilled water with some common salt and bicarbonate of soda
dissolved in it, the vein at the bend of the elbow being usually
chosen to operate on. Some were confident that they had saved lives in
this manner, others were equally clear that salines were useless. One
writer had abandoned salines by the mouth as a “most useless remedy,”
while he had not lost faith in their intravenous injection, four
having recovered out of twenty-three in which he had tried it. At
length, however, the intravenous use of salines was abandoned
also[1540].
It is well known that the greatest of all the lessons taught by cholera
was the need of sanitary reform. The disease in its successive visitations
so obviously sought out the spots of ground most befouled with excremental
and other filth as to bring home to everyone the dangers of the casual
disposal of town refuse. It was not until some years after the first visit
of cholera that much was done in the way of extending the main drainage of
towns, connecting the house-drainage systematically therewith, getting rid
of open nuisances in back yards, and protecting the water-supplies from
contamination. The Report of the Health of Towns Commission, 1844, was
“the great magazine from which sanitary reformers drew their
weapons[1541].” In the next few years an active school of sanitarians
arose, including Sutherland of Liverpool, Grainger of London, and others.
In 1848 was passed the first Public Health Act, administered by a Board of
Health, of which Lord Shaftesbury was chairman, Chadwick and Southwood
Smith members. London was excepted from the scope of the Act; but the City
had a most vigorous medical officer in the person of John Simon, whose
reports dealt with public sanitation on broad principles applicable to the
capital and the whole kingdom. The movement in favour of sanitation, thus
begun, received an irresistible impulse from the cholera of 1849, the
lessons of which were as obvious as those of 1832.
The cholera which reached Orenburg in 1829 and Astrakhan in 1830 lingered
in one part of Europe or another until 1837, Portugal and Spain having
been its chief theatre in 1833, the south of France in 1834, Italy in 1835
and 1836, Austria, the Tyrol, Bavaria and (for the second time) Poland and
the Baltic ports in 1837. In England, there was some revival of the seeds
of it in 1833, as many as 1454 deaths being put down to Asiatic cholera in
London from the 1st of August to the 7th of September. There was an
undoubted epidemic of it at the fishing village of Ferryden, near
Montrose, in June, 1833 (27 deaths during four weeks in a population of
700), the infection having been brought by one or more of the crew of the
smack ‘Eagle’ from the Thames[1542]. In Glasgow a case occurred in Boar
Head Close, High Street, on 30 May, 1833, which had the blueness, pinched
face, whispering voice and cold clammy skin of Asiatic cholera[1543]. In
Ireland there were a good many outbreaks in 1833, especially in villages
or hamlets, and it is believed that these were renewed in 1834. But the
most singular reappearance of cholera in the British Isles was in the
month of December, 1837, some two months after it is believed to have
ceased elsewhere in Europe. Outbreaks of true cholera in that month were
observed at several places in the south of Ireland-around Bere
Haven[1544], at Youghal, at Waterford, and at Dungarvan, where they went
so far as to form a board of health[1545]. It was suspected to have been
in Limehouse, on the Thames, in November. The most remarkable explosion of
it was in the month of January following (1838) among the inmates of the
Coventry House of Industry, of whom no fewer than 55 died in the course of
four weeks--a mortality from choleraic disease that could hardly be
explained on the hypothesis of cholera nostras even if the season had been
the proper one[1546].
The Cholera of 1848-49 in Scotland.
The invasion of cholera from India, which reached Britain in the autumn of
1848, had progressed as far as Peshawur and Cabul from 1842 to 1844, and
thereafter step by step continuously through Herat, Samarkand, Bokhara,
Astrabad and Teheran by the caravan routes. In the beginning of 1847 it
entered Russia by the two great interior waterways of the Volga and the
Don. Next year, 1848, it reached the German shores of the Baltic and North
Seas, and within a few weeks of its appearance at Hamburg, it was found
established on British soil at Edinburgh and Leith in the beginning of
October. The severe outburst which followed in the south of Scotland was
purely a winter epidemic, like that of Durham, Northumberland and East
Lothian on the last occasion in the winter of 1831-32. It will not be
necessary to give the details of the cholera of 1848-49 so fully as has
been done for 1831-32, but merely to notice special points.
The cholera of 1848 broke out almost simultaneously at Newhaven and
Edinburgh, on the 1st and 2nd of October, and at Leith on the 9th. At
Newhaven nearly the whole population was suffering from diarrhoea, in the
midst of which epidemic the true cholera raged for four weeks only, to the
28th October, attacking 30, of whom 20 died. In Leith the deaths were 185
(males 75, females 110). The Edinburgh outbreak lasted until the 18th of
January, 1849, causing 801 attacks, with 448 deaths (or 478 deaths, of
which 196 were males and 282 females). A cholera hospital was opened in
Surgeons’ Square on the 28th of October, the admissions and fatalities to
14th December being as follows:
Females Males Total
Admitted 152 96 248
Died 90 64 154
Of the whole 248 cases, the Grassmarket sent 42, the Cowgate 37, the
Canongate 33, College Wynd 16, High Street 14, and numerous scattered
localities of the New and Old towns one or more cases each. Severe
outbreaks took place also at Niddry, Restalrig and Loanhead, villages
close to Edinburgh[1547]. While this limited epidemic was proceeding in
and around the capital, the infection appeared in the mining region of
Carron at the head of the Firth of Forth, where there were some 400 cases
after the 6th of December, and in some other mining villages of the Scotch
midlands.
Glasgow was infected on the night of the 11th November, in the suburban
district of Springburn, on the north-west of the city close to the Forth
and Clyde Canal. The choice of this spot to begin upon was intelligible
enough in one way, but singular in another. Springburn had come into
existence as a poor village of weavers about the year 1820; before the
cholera year of 1832 it had grown to a population of 600, and was thought
a likely spot for cholera inasmuch as it was one of the most wretched
communities in Scotland. It occupied the site of a half-drained bog below
the level of the canal, from which the water percolated into its subsoil;
its houses were low, always damp, and full of filth. During all the
cholera in Glasgow in 1832 there had not been a case in Springburn until
the 6th of September, when a girl of the village came home with it and
died; during her brief illness she was visited by the greater part of the
villagers, but no other case occurred until six weeks after, on the 15th
of October[1548]. At this spot, where the cholera of 1832 may be said to
have left off, it began in 1848 with a sudden explosion of numerous
attacks scattered all over the locality; a doctor attended twenty-one
cases before he found two together in the same house or even in the same
lane. There had been forty cases there in November, before any case was
discovered in Glasgow; at length it seemed to spread from Springburn all
round as if from a centre, while it also lingered there longer than
anywhere else in the city and suburbs[1549]. On the 5th of December a case
was reported on the south bank of the Clyde, and another on the 9th in the
west end. Within a few days the disease fell upon all parts of the city
with the suddenness of a thunder shower; it reached a height in the
Christmas week, one day, the 30th December, having 158 burials from
cholera. After the orgies of the New Year there was a fresh outburst, 235
cases having been reported on the 5th of January. The proportion of
fatalities was as high as 60 per cent. at the beginning of the epidemic,
50 per cent. about Christmas and the New Year, and thereafter from 30 to
40 per cent. The epidemic was short and sharp, declining irregularly after
the first or second week of January, and ceasing, but for a few dropping
cases, about the 8th of March.
The deaths in Glasgow, which included many among the wealthier class and
made the festival season of 1848-49 to be long remembered, were about
3800, or 1·06 per cent. of the population (355,800), a higher total but a
lower ratio than in 1832, when the deaths, distributed over many more
weeks of the year and largely due to two revivals in August and October,
were 1·4 per cent. of the population. At Paisley there were 68 deaths from
26 December to 24 February, and at Charlestown 115 deaths all in some five
weeks from 15 January to 19 February.
It was in the same season of midwinter that the cholera burst suddenly
upon many mining villages of Lanarkshire and Ayrshire.
In that unlikely season there was an almost universal prevalence of
diarrhoea. At the mining village of Carnbroe, near Coatbridge, there
were five sudden attacks on the last night of the old year, one of
them fatal. On New Year’s day there were forty attacks, thirteen of
them fatal in a few hours. Terror seized the whole place: one man cut
his throat in sheer fright. Diarrhoea attacked 1100 of the 1200
inhabitants, and turned to spasmodic or rice-water cholera in 240 of
them, of whom 94 died, the rate of fatality being excessive only in
the first few days. By the end of February the epidemic was over.
In the town of Coatbridge, with a population of 4000, the various
grades of sickness were classified as follows:
Vomiting,
purging and Rice-water Deaths by
Diarrhoea cramp purging Cholera Cholera
2659 480 175 107 61
In the town of Hamilton, population 9000, the infection was most
malignant, 440 cases yielding 251 deaths from the 24th of December to
the 7th of March. The same ravages of winter cholera occurred at some
of the Ayrshire ironworks, such as Glengarnock, among a very rough and
drunken class, who were made more than ordinarily reckless and drunken
by this unaccountable visitation. It was also severe in Riccarton and
other mining villages round Kilmarnock, but less prevalent in that
town itself. Dumfries and Maxwelltown, which had been among the last
places visited by the cholera of 1832, were infected in the middle of
November, 1848, about the same time as Springburn near Glasgow. One of
the Dumfries doctors died of rapid cholera on the 10th December, the
parochial board fell into disputes with the faculty, and the infection
proceeded amidst great confusion in the poorest parts of the town,
causing about 250 deaths before Christmas. After that it subsided
quickly[1550].
The other centres in the south of Scotland were Selkirk (13 deaths),
Kelso (Dec. to end of Jan., maximum of 12 attacks in a day) and
Jedburgh, which last had escaped in 1832 but had now a very rapid and
extensive epidemic in its lower parts among drunken people especially.
A few cases occurred at Moffat, in December; a man who was seized in
crossing the hills died in a shepherd’s hut eight miles from Moffat
after twenty-one hours illness[1551].
The only recorded epidemic in the north of Scotland in the proper cholera
season, the summer of 1849, was at Dundee. But there was a small outbreak
in March and April at Campbelton (41 cases, 14 deaths) and Inverness (23
cases, 12 deaths)[1552].
The infection began in Dundee on the 29th of May, 1849, in Fish
Street, the filthiest part of the town. It prevailed in high and low
situations, but usually in the old localities of typhus fever. One
group of houses, said to have had a population of 100, had 40 deaths.
Dudhope Crescent, consisting of seventeen large five-storied tenement
houses occupied by clean and respectable people, had 57 deaths. In
about a fourth part of all the fatalities, death was from sudden
collapse; this was a feature of the 1849 cholera also in Ireland; but
in Dundee, as elsewhere, there was usually premonitory diarrhoea, and
a very general prevalence of diarrhoea which never came to true
cholera[1553].
The Cholera of 1849 in Ireland.
The cholera of 1849 found Ireland in a state of exhaustion and confusion.
The fever and dysentery that followed the great potato famines of 1845 and
1846 were still far from extinct; the workhouses, which had not existed in
1832, were full of paupers. The mortality of nearly half a million in the
famine years, and the emigration of perhaps three times as many, had
reduced greatly the population of the scattered cabins, hamlets and
villages; but the towns were more populous than ever from the immense
number of destitute persons that had gravitated to them. In these
circumstances it was not surprising that the cholera of 1849 should have
been more disastrous than that of 1832. The infection appeared first in
Belfast in November, 1848, in a man who had come with his family from
Edinburgh and had been admitted into the workhouse. Some thirty cases of
cholera among the inmates followed his death, and at length the infection
was started at large in the town, probably by a man who had been
discharged from the workhouse[1554]. The cholera of 1849 in the capital of
Ulster was more fatal than that of 1832, causing 969 deaths in 2705
attacks. Over Ireland generally its great season appears to have been, as
in England, the summer, and in part also the spring. Excepting Belfast,
the principal cities and towns had fewer deaths than in 1832; Dublin
having only 1664 as compared with 5632, Cork 1329, or nearly the same
number as in 1832, Limerick 746, which was about a fourth less, Galway
less, Waterford about the same as in 1832 and 1833 together, and Drogheda
as severe an epidemic as last time. But the smaller towns and the rural
districts generally suffered more. The deaths for all Ireland returned to
the Board of Health were 19,325, nearly the same total as in 1832; but
there were no returns included from Wicklow, Cavan, Fermanagh and Donegal,
and it is probable that the returns were otherwise incomplete, the census
taken in 1851 giving 30,156 cholera deaths under the year 1849, and 35,989
in the whole decennial period from 1841. The larger total was distributed
as follows:
Urban Rural In hospitals In workhouses
10,653 10,656 7964 6716
The number of rural deaths is much larger than in 1832. There were only a
few towns with over 2000 inhabitants that escaped--one in Connaught, six
in Munster, one out of forty-one in Leinster, while seventeen towns were
visited in Ulster. The counties of Dublin, Carlow, Clare and Galway
suffered most; of the smaller towns, Tralee and Dingle lost heavily, both
among the poor and the rich. The town of Ballinasloe, near the confluence
of the Suck with the Shannon, had 756 deaths from 23 April to 19 August, a
great part of them in the workhouse. In clinical characters, the cholera
of 1849 was noted in Ireland, as in Scotland and England, for the high
proportion of sudden fatalities, about one-third, without the warnings of
diarrhoea or the usual choleraic symptoms. It was remarked also that many
children under the age of seven died of cholera, about one in ten of all
ages. There was a second season in 1850, with 1768 deaths (according to
the census), but hardly comparable to the return of cholera in 1833 in the
country districts more particularly.
The Cholera of 1849 in England.
The brief but very severe epidemic of cholera in the south of Scotland in
midwinter was all over and done with for good before the disease really
began in England. Hull, which had a few cases on board ship in the end of
1848, about the same time as the infection began to rage in Edinburgh and
Leith, was spared its great visitation, the greatest in all England, until
the late summer and autumn[1555]. The progress of the infection in London
also was strangely different from that in Scotland. There were undoubted
cases in Bethnal Green and other out-parishes in the autumn of 1848, and
there seemed no reason why the infection should not run through the
population and exhaust itself at once, as in Glasgow. But it will appear
from the following table of the deaths in London that the real outburst
was delayed until the summer and autumn of 1849:
Cholera
deaths
1848
Sept. 11
Oct. 122
Nov. 215
Dec. 131
1849
Jan. 262
Feb. 181
March 73
April 9
May 13
June 246
July 1952
Aug. 4251
Sept. 6644
Oct. 464
Nov. 27
Although a certain number of deaths were returned in October and November,
1848, they came in twos or threes from many parishes of the metropolis and
made no great impression upon any one locality. It was not until the
beginning of December that the presence of cholera was fully realized,
owing to an extraordinary explosion of the disease in a huge pauper
institution at Tooting. The school contained about a thousand children, of
whom some three hundred took Asiatic cholera, with one hundred and eighty
deaths, in the course of three or four weeks: this was the whole cholera
mortality that the parish of Streatham had from first to last. In the
spring months the cases declined all over London in a very remarkable way,
so that it looked for a time as if the infection were extinct, just as in
1832. But in June there was a revival, and thereafter a steady increase to
the maximum of 6644 deaths in September. The table given under the year
1866 shows upon what parishes the mortality fell most--those of Southwark,
Bermondsey, Rotherhithe, Greenwich, Newington, Lambeth and Battersea on
the south side, of Westminster, the City and Liberties, Shoreditch,
Bethnal Green and Whitechapel on the north side of the Thames. It was a
more severe visitation per head of the inhabitants than that of 1832,
cutting off many beyond the limits of the destitute and reckless class who
were its most usual victims on the first occasion. Many of the respectable
class of workmen and small shopkeepers were among the victims. Several
medical men died of it, including one well-known surgeon, Mr Aston Key,
at his house in St Helen’s Place, Bishopsgate, on 23 August, after a few
hours’ illness. As in Ireland, and at Dundee, an unusually large
proportion of the London deaths, perhaps a fourth part, were from sudden
collapse and blueness, without premonitory diarrhoea or predominant
intestinal symptoms. Opinion was strongly against contagiousness in this
epidemic. There were 478 cases treated in St Bartholomew’s Hospital, but
not one of the nurses took cholera.
The infection seemed to find out the insanitary spots and to act
miasmatically upon the residents. The common remark in all parts of
England, Scotland and Ireland was that the localities that suffered most
from the typhus fever of 1847-48 suffered most also from cholera. The one
black spot in Kensington was a poor district on the north side of the
parish known as the Potteries, where an immense number of pigs were kept.
One of the most remarkable features of the cholera-seasons of 1848-49 was
the extensive prevalence of common bowel-complaints. Evidence of this has
been given for the south of Scotland just before or during the cholera of
midwinter, a season when diarrhoea is not usual. It was equally remarked
in England in the course of 1849. In the Taunton workhouse, where true
Asiatic cholera broke out in November, there had been many cases of
bowel-complaint, as well as of fever, in the spring (7 deaths from
dysentery and diarrhoea, 5 from fever). In the Exeter workhouse there were
eighteen deaths from dysentery in the end of the year, although there is
nothing said of cholera, which caused only 44 deaths in the whole city.
The efforts of the inspectors sent by the Board of Health were in great
part directed to finding out the cases of “premonitory” diarrhoea, by
house-to-house visitation, and insisting upon the importance of checking
it before it could turn to true cholera. Leeds will serve as an example of
English towns. In an incomplete survey after the month of July there were
found 5129 cases of simple diarrhoea, 1484 cases of dysentery, 1273 cases
of choleraic diarrhoea, and 1090 cases of true cholera[1556]. It was
something of a paradox that, with such excessive prevalence of ordinary
bowel-complaints, an unusual proportion of the cases of true cholera
proved quickly fatal with symptoms of collapse and asphyxia only.
Just as the first startling indication of the presence of Asiatic cholera
in London was the enormous fatality in the pauper school at Tooting in the
winter, so in some other towns the infection seemed to pick out workhouses
or prisons to begin upon. At Belfast there were forty cases in the
workhouse before there was one in the town. At Liverpool there were 28
cholera deaths in the first quarter of 1849, of which 8 were in the
workhouse. At Wakefield, 19 died of cholera in January, 16 of these in the
House of Correction. Among the people at large the infection made little
progress until the summer. In the first and second quarters of the year it
is heard of, but to a moderate extent, in the towns and colliery districts
of Durham and Northumberland, which were the scene of its earliest
outbreak in the winter of 1831-32. It was also beginning in the poorest
and filthiest parts of Liverpool, Bristol and Plymouth. Its great season
all over England was July, August and September, the incidence of the
disease according to counties being shown in the table. The right-hand
column, showing the number of deaths at the principal centres in each
county, must serve for a conspectus of the epidemic.
_Cholera Mortality in England and Wales in 1849._
Death-rate
per
1000
Deaths inhab. Principal centres in each county
England and Wales 53293 3·0
London 14137 6·2 Lambeth 1618, Newington 907,
Bermondsey 734, Southwark 1704
Surrey, part of 255 1·3
Kent, part of 1208 2·5 Gravesend, Milton, Rochester,
Chatham, Margate, Ramsgate,
Maidstone
Sussex 346 1·1 Hastings
Hampshire 1245 3·2 Portsmouth 568, Southampton 240
Berkshire 148 ·8
Middlesex 406 2·7 Edmonton, Barnet
Hertfordshire 323 1·9 Hitchin 127, Hertford 81, Watford
45
Buckinghamshire 175 1·2 Marlow, Wycombe 100
Oxfordshire 117 ·7 Oxford 44, Witney 33
Northamptonshire 141 ·7 Northampton 49, Peterborough 49
Huntingdonshire 14 ·2
Bedfordshire 72 ·6 Bedford 37, Biggleswade 28
Cambridgeshire 269 1·4 Wisbech 138, North Witchford 85
Essex 580 1·7 West Ham 134, Romford 163,
Rochford 105, Harwich
Suffolk 79 ·2 Ipswich 18, Mutford 27
Norfolk 223 ·5 Yarmouth 87, Norwich 38
Wiltshire 320 1·3 Salisbury 165, Devizes 67
Dorset 122 ·7 Weymouth 59, Poole 31
Devon 2366 4·2 Plymouth 830, Stonehouse 171,
Stoke Damerel 721, Plympton St
Mary 151, Tavistock 140,
Totnes 107
Cornwall 835 2·4 St Germans 236, Liskeard 132, St
Austell 135, Redruth 133
Somerset 923 2 Bridgewater 235, Keynsham 77, Bath
90, Bedminster 281
Gloucestershire 1465 3·5 Bristol 591, Tewkesbury 59,
Gloucester 119, Clifton 563,
Dursley 58
Herefordshire 1 ·01
Shropshire 316 1·3 Bridgnorth 75, Shrewsbury 116
Staffordshire 2672 4·4 Newcastle-under-Lyme 241,
Wolverhampton (incl. Bilston,
Tipton, Sedgley) 1365, Stoke
103, W. Bromwich 250, Dudley
412, Walsall 186
Worcestershire 432 1·7 Stourbridge 314
Warwickshire 293 ·6 Coventry 202, Birmingham 29,
Warwick 20
Leicestershire 8 ·08 Loughborough 7, Leicester 2
Rutlandshire 7 ·4
Lincolnshire 372 ·9 Gainsborough 246, Boston 35,
Grimsby 29
Nottinghamshire 137 ·5 East Retford 21, Basford 42,
Nottingham 18
Derbyshire 50 ·06 Derby 18
Cheshire 653 1·6 Nantwich 181, Runcorn 82,
Stockport 72, Birkenhead 139
Lancashire 8184 4·1 Liverpool and W. Derby 5308, Wigan
503, Manchester 878, Chorlton
280, Salford 237
West Riding 4151 3·2 Huddersfield 52, Bradford 426,
Hunslet 884, Dewsbury 224,
Wakefield 241, Pontefract &c.
238, Leeds 1439
East Riding 2140 8·7 Hull and Sculcoates 1834, York
174, Pocklington 37, Howden 58
North Riding 47 ·2 Whitby 10
Durham 1642 4·2 Darlington 4, Stockton 248, Durham
192, Hartlepool,
Chester-le-Street 134,
Sunderland 363, Gateshead 257,
S. Shields 201
Northumberland 1417 4·8 Newcastle 295, Tynemouth 815,
Alnwick 142
Cumberland 419 2·2 Carlisle 51, Cockermouth 282,
Whitehaven 79
Westmoreland 1 ·02
Monmouth 775 4·1 Newport 246, Pontypool 69,
Abergavenny 438
S. Wales 3544 6·1 Merthyr Tydvil 1682, Cardiff 396,
Neath 738, Llanelly 45,
Swansea 262, Carmarthen 142,
Crickhowell 95
N. Wales 245 ·6 Holywell 86, Montgomery 37,
Carnarvon 21
The highest rates in the table are for the East Riding, owing to Hull
(24·1), for South Wales, owing to Merthyr Tydvil (23·4), for
Northumberland and Durham, for Staffordshire, owing to the iron district
round Wolverhampton, for Devonshire, owing to Plymouth, for Lancashire,
owing to Liverpool, and for Monmouth, owing to a few mining places. The
miners suffered most, the lower class in the seaports next most severely.
The Black Country in the south of Staffordshire, which had been the worst
centre of the 1832 cholera, was again one of its chief centres in 1849,
the mortality falling most, as before, upon the town of Bilston, and next
to it upon Willenhall and Wolverhampton. But a great rival to the
Staffordshire coal and iron mining had sprung up since 1832 in Glamorgan;
and it was in this comparatively new region of miners that cholera in 1849
reproduced the Black Country horrors of 1832 and, indeed, surpassed them.
Merthyr Tydvil had sprung up more like a vast miners’ camp than like a
well-ordered municipality. Along the eastern side of the Taff valley,
on the slopes and in bottoms of the hills, but everywhere at an
elevation of some four or five hundred feet above the level of Cardiff
docks, were numerous groups of mean-looking miners’ cottages, with
their attendant ale-houses, small retail shops, schools and
meeting-houses. This peculiar township had drawn to itself the special
notice of the Health of Towns Commission in 1844: “From the poorer
inhabitants (who constitute the mass of the population) throwing all
slops and refuse into the nearest open gutter before their houses,
from the impeded course of such channels, and the scarcity of privies,
some parts of the town are complete networks of filth emitting noxious
exhalations.... During the rapid increase of the town no attention
seems to have been paid to its drainage.”
In this district the registrar had returned 162 deaths from “cholera”
in the year 1841, which must have been from an unusually severe type
of cholera nostras or British cholera. A first case of Asiatic cholera
occurred at Cardiff in a sailor on the 13th of May, 1849, a week after
there was a case at Lower Merthyr, and a week after that another at
Upper Merthyr. In the course of the summer the ravages of the disease
were enormous in the hilly mining regions of the interior of Glamorgan
and Monmouth, as well as severe in the seaports:
Merthyr Tydvil 1682
Cardiff 396
Neath 738
Swansea 262
Abergavenny district 438
Pontypool 69
Newport 246
The peculiar selection of the mining townships was well shown in the
district of Abergavenny: of 378 deaths from cholera in the third
quarter of 1849, only 9 occurred in Abergavenny town, while 157 were
at the iron-works of Tredegar and 210 at those of Aberystruth, just
as, in the winter preceding, the villages of the iron-works all round
Kilmarnock had been ravaged by cholera while there was little of it in
that town itself.
Another chief centre of cholera in 1849 was the port of Hull. Including
the district of Sculcoates, it had the following enormous mortalities from
cholera in four weeks of September: 398, 507, 524 and 171, the whole
epidemic from July to the 18th of October producing 2534 deaths[1557]. Its
neglect of scavenging became a classical instance of the favouring
conditions of cholera. An open space at Witham called the “muckgarths,”
from the refuse deposited upon it, was one of the worst centres, just as
the town moor of Sunderland, used for the same purpose, had been in
1831[1558]. In the other ports, Liverpool, with West Derby, Bristol with
Clifton, and Plymouth with East Stonehouse and Devonport, the infection
was most severe (see Table), and was observed to choose the poorest
streets, lanes and houses, where there had been most typhus for a year or
two before[1559]. On the Tyne, the greatest centre on this occasion was
not Newcastle, but Tynemouth. The city of Durham, which escaped the
cholera of 1832, had a severe visitation. The chief inland centres,
besides the mining districts of Staffordshire and Glamorgan, were
Manchester and the cloth-making towns of Airedale,--Leeds, Hunslet,
Bradford, Dewsbury, and some others in the West Riding. Most of the
Lancashire towns occupied with the cotton industry again escaped with
little cholera--Preston, Clitheroe, Oldham, Bury, Rochdale, Bolton,
Blackburn, Ashton and Chorley. Wigan had nearly twenty times as many
deaths as in 1832; on the other hand Sheffield had only a quarter of its
former cholera mortality, while Nottingham and Norwich had this time very
little. Birmingham, Leicester, Cheltenham, Hereford, Stafford, Ipswich,
Cambridge and Colchester were again almost or altogether free from
infection. The agricultural counties, notably the Eastern counties,
escaped once more with few centres of infection, and these unimportant.
Cumberland as a whole had fewer deaths than in 1832, while Cockermouth had
more. Exeter, which was severely visited on the former occasion, escaped
almost wholly, while Totnes and Tavistock, with the surrounding Dartmoor
country and other towns in Devon, had epidemics of the first degree for
their size. In England as a whole the cholera of 1849 was more severe
relatively to the numbers living than that of 1832, its great centres
having been the same, or of the same kind, on both occasions[1560].
The cholera of 1849 reproduced very closely the former characteristics.
The attacks were often in the night, especially in persons who had supped
heartily on the coarser kinds of savoury meat. With the same undoubted
preference for the poorer and more filthy quarters of towns, the infection
showed also a certain apparent caprice in fixing on some places and
avoiding others.
Thus at Leeds it was most malignant in the locality of York Street and
Marsh Lane (an old centre of plague and typhus), which had lately been
drained at a cost of some thousands of pounds, “whilst in the
adjoining district, which lies nearly level with the river, and will
scarcely admit of any sewerage, I have not heard,” writes the
registrar, “of a single case of cholera”--an experience similar to
that of a low-lying district of Bristol in 1832. At Liverpool, where
much had been undertaken for sanitation since the disastrous Irish
fever of 1847-48, the cholera appeared to Dr Duncan, the medical
officer of health, to attack sewered and unsewered streets
impartially. Another singular thing, which used to be noticed in the
plague and is observed in the malarial fevers of towns abroad, was the
choice of one side of a street only: thus, at Rotherhithe, in a street
where numerous deaths occurred, they were nearly all one side of the
street, in houses occupied by respectable private families, only one
house having been infected on the other side; at Bedford, two streets
showed the same thing.
In London, the least elevated parishes on both sides of the Thames were
again its chief seats. Dr Farr, the superintendent of statistics, deduced
the law that the death-rate from cholera in London was inversely as the
altitude of the parish, and he showed, by a somewhat rough grouping of the
cholera deaths, that the law applied to all England[1561]. An empirical
generality such as that may have some value; but it is the exceptions to
it that show the inward meaning of the fact.
Merthyr Tydvil, which was the worst cholera-spot in England with the
possible exception of Hull, was five hundred feet above the level of
Cardiff, its seaport, where the death-rate was much lower. Neath,
also, had much more cholera than Swansea. Newcastle-under-Lyme,
situated near the source of the Trent, and the highest town in the
course of that river, had a far more severe visitation of cholera than
any other town upon it all the way to its mouth. At Tavistock among
the Dartmoor hills, cholera “sat for many a week,” as Kingsley says,
“amid the dull brown haze, and sunburnt bents and dried-up
watercourses, of white dusty granite.” But the poorer and more
populous part of Tavistock was a somewhat peculiarly shut-in basin,
which was “very often involved in fog during the night.” The town had
escaped cholera in 1832, but one of its physicians, writing in 1841,
and recalling its dreadful plague of 1626, did not feel sure that it
would escape if cholera came back[1562]. Again, one thinks of
Salisbury as standing among high downs; but it had a wet subsoil, bad
sewerage, and bad water supply, and in 1849 it had 200 deaths from
cholera among all classes in two months[1563].
In the not very extensive outbreak at Sheffield, one of its chosen
seats was an elevated district called the Park, inhabited by colliers.
At Bedlington colliery, near Morpeth, the cholera deaths in November
were in the miners’ houses on the hill side. The elevated, airy and
clean village of Loanhead, near Edinburgh, had 46 deaths in its
population of 1200, during a few weeks of midwinter. In Dundee, built
upon a steep slope at the waterside, there were bad centres of cholera
in the higher parts as well as in the lower.
The determining thing appears to have been not so much the elevation as
the configuration of the ground; any basin, or cup, or shelving terrace,
any natural collecting-ground of moisture and organic refuse in the soil,
may become a seat of cholera, whether it be at the sea-level or several
hundred feet above it, provided it have a sufficient number of human
occupants and a mode of drainage inadequate to its peculiar needs. Such
was the situation of Merthyr Tydvil, of Neath, of Newcastle-under-Lyme, of
Tavistock, of some colliery villages, and of certain localities in towns
such as Dundee. Such, of course, was also the situation of the London
parishes next the river on the south and east, of Hull, of Plymouth, of
Liverpool, and of other seaports on estuaries. Neither altitude nor
configuration means anything for cholera unless the ground itself be full
of rotting filth. In all England and Scotland the cholera chose, as if by
an unerring instinct, those not very extensive mining parts of the
counties of Stafford, Glamorgan, Durham, Lanark and Ayr, which had as many
hundreds of inhabitants to the square mile, and as little provision for
the safe disposal of their excrements, as those village communities of
Lower Bengal in which the infection had become established since 1817 as
if it were an annual product of the soil.
The Report of the Board of Health brought to light many instances in which
it seemed probable that cholera had been favoured, if not induced, by the
water of wells contaminated with organic filth soaking through the ground
or entering with the surface water. This was especially the case at
Merthyr Tydvil. It was during the next cholera, that of 1854, that the
question of contaminated water came into great prominence, in connexion
both with wells and with the vast volumes of water supplied through the
mains of water companies.
The Cholera of 1853 at Newcastle and Gateshead.
The third visitation of Great Britain and Ireland by Asiatic Cholera was
in 1853-54. There had been none of it in any part of the kingdom since
1850; but it is not so clear that all other European countries, especially
Poland, were equally free from it. Whether due to a new approach from
Asia, or to a rekindling of smouldering fires, cholera appeared in the
Baltic ports in the summer of 1853, and soon after reached the Tyne. For
the third time a severe but localized epidemic was the prelude--this time
at Newcastle and Gateshead, just as in 1848 at Edinburgh, Glasgow and the
south of Scotland, and in 1831 at Sunderland and Newcastle.
In the cholera of 1849, which was the most general and the most severe
visitation that England has had, Newcastle escaped with a light visitation
and Gateshead with a moderate or average one, while Tynemouth (with North
Shields) had about twice as many deaths as Newcastle and Gateshead
together (12·9 deaths per 1000 inhabitants). In 1853 it was the turn of
Newcastle--for no better reason, perhaps, than its escape last time. The
very thorough and masterly inquiry by Messrs Simon, Bateman and Hume did,
indeed, reveal a most unwholesome state of things; but the town was no
worse or only a little worse than in 1849, when the cholera had dealt
lightly with it, and it was probably an average sample of the insanitary
condition of the greater English industrial towns in the time of their
rapid growth and before the period of well-ordered local government had
arrived. In some parts, such as Sandgate, the dwellings of the labouring
class were “not fit to live in”; in the newer mean suburbs, it was found,
as in Glasgow twenty years before, that cellars had become the
dwelling-places of a class who in former times lived above ground. Those
who had been dispossessed by the railways and other public structures had
not been provided for elsewhere; so that, with more trade and better
wages, the working class were worse housed than before. Overcrowding, for
which the ports on the Tyne and Wear are still pre-eminent, was then most
excessive. Only the better-class houses had the water laid on. Excremental
offences to sight and smell were everywhere. There was a system of main
sewers, passably good; but house-drainage or connexions with the main
drains were quite casual. The scavenging of the town was greatly
neglected. Piggeries, slaughter-houses and other such nuisances, were
uncontrolled. The burial-grounds were over-full. With all this the
death-rate of Newcastle could be low enough in a good year, such as 1844,
when it was 20·9 per 1000; in the year of the Irish fever, 1847, it rose
to 32·8; and in other years it fluctuated between those extremes,
according to the nature of the seasons[1564].
The cholera of 1853 was a sudden explosion in the heavy stagnant
atmosphere of the month of September. No one knew where the infection came
from; there were, of course, ships arriving from the Baltic, but no
particular source was ever traced. On the 30th or 31st of August, a case
occurred of the rapidly fatal kind; before a week there were about a
hundred attacks daily all over the town. From the 13th of September the
deaths in Newcastle mounted up rapidly as follows:
Cholera
deaths
Sept. 13 59
14 90
15 106
16 114
17 103
18 103
19 111
20 85
21 68
22 82
23 60
24 56
In the thirty days of September there were 1371 deaths, and some one or
two hundreds more in the first part of October, when the infection ceased
almost abruptly, the total of deaths to the 4th of November having been
1533. During the same time Gateshead with a population of 26,000, had 433
deaths, or in a ratio nearly equal to that of Newcastle. On the other hand
Tynemouth, with a population of 30,000, had only twelve deaths, several of
them in vagrants or other arrivals from Newcastle, the rest in a cluster
of pitmen’s cottages on the outskirts of North Shields.
It was freely rumoured at the time, and was even repeated with much
unction in so dry and deliberate a work as the report of the
Registrar-General, that the cholera at Newcastle and Gateshead in
September, 1853, was owing to the sudden contamination of the town’s
water with sewage. The facts about the water-supply are as follows:
Previous to 1848, Newcastle was supplied with Tyne water pumped up at
Elswick, and passed through the settling tanks and filtering beds. In
1848 the Whittle Dean Water Company, incorporated in 1845, had their
new supply ready, and the old company, with its pumping station at
Elswick, was superseded. The new supply was collected from landward
sources, and was apt to be peaty. There was a great demand upon it,
especially for public works (it was supplied to comparatively few
houses), so that the distribution in 1853 had increased 2½ times since
the company began in 1848. They had extended their collecting area to
meet this demand; but, owing probably to the drought, they found it
necessary on the 6th of July, 1853, to resort to the old
pumping-station at Elswick for about a third part of all the water
that flowed daily through the mains. This had gone on for eight weeks
before the epidemic began, and was promptly discontinued on 15
September, as soon as the possible danger from Tyne water was
realized. The pumping-station was higher up the river than the only
one of the Newcastle sewers that discharged in its vicinity. There
were complaints about the water, but these appear to have been chiefly
of the peaty colour or flavour, which came from the Whittle Dean part
of the mixture. The water from the mains was not equally bad at all
points, as if the suspected contamination might have occurred in its
transit through the town. Also the water of some wells was complained
of as offensive at the same time, which was the season of the year
when the springs are lowest. Gateshead was also supplied by the mains
of the Whittle Dean Company. It is clear from the report of the
Commissioners that they considered the water of Newcastle and
Gateshead to have been a very subordinate factor, if a factor at all,
in the epidemic of cholera.
The Cholera of 1854 in England.
The great epidemic at Newcastle and Gateshead was over by November, 1853,
those towns having no share in the general epidemic in England in 1854,
although it visited their near neighbour Tynemouth. The interest of the
cholera of 1854 centres chiefly in London[1565]. Few of the great foci of
infection in 1849 were visited severely. Liverpool, which never escaped,
had a moderate epidemic, Merthyr Tydvil also had about a fourth part of
its 1849 mortality, Dudley had the disease somewhat severely, while some
towns, such as Norwich, Wisbech and Sheffield, had more than usual. But
Plymouth, Hull, Bristol, Manchester, Leeds, the towns of the Black Country
and nearly all the populous places that had suffered heavily either in
1832 or in 1849, or on both occasions, escaped in 1854 with little cholera
or none[1566]. The table shows the incidence of the epidemic (as well as
that of 1866) according to counties.
_Cholera Mortality in England and Wales in 1854 and 1866._
1854 1866
Rate Rate
per per
Deaths 1000 Deaths 1000
England and Wales 20097 14378
-----------------------------------------------
London 10738 4·3 5596 1·9
Surrey, part of 252 1·2 82
Kent, part of 1056 2·1 284
Sussex 94 ·3 79
Hampshire 130 ·3 417 ·9
Berkshire 49 ·2 3
Middlesex, part of 380 2·4 51
Hertfordshire 97 ·5 9
Buckinghamshire 68 ·5 10
Oxfordshire 183 1·0 4
Northamptonshire 152 ·7 7
Huntingdonshire 18 ·3 1
Bedfordshire 61 ·4 22
Cambridgeshire 270 1·3 7
Essex 513 1·4 471 1·0
Suffolk 67 ·2 15
Norfolk 381 ·8 15
Wiltshire 60 ·2 11
Dorset 45 ·2 6
Devon 188 ·3 525 ·9
Cornwall 24 ·06 21
Somerset 21 ·04 68
Gloucestershire 260 ·6 39
Herefordshire 1 ·01 2
Shropshire 13 ·05 17
Staffordshire 426 ·6 30
Worcestershire 103 ·4 36
Warwickshire 89 ·2 15
Leicestershire 14 ·06 3
Rutlandshire 9 ·08 --
Lincolnshire 134 ·3 48
Nottinghamshire 80 ·3 1
Derbyshire 17 ·06 20
Cheshire 141 ·3 391
Lancashire 1775 ·8 2600 1·0
West Riding 470 ·3 283
East Riding 70 ·3 54
North Riding 84 ·4 21
Durham[1567] 2·9 352 ·6
Northumberland[1568] 5·7 224
Cumberland 35 ·2 32
Westmoreland 1 ·02 1
Monmouth 18 ·1 204
South Wales 887 1·4 2033 2·9
North Wales 34 ·08 256
Principal centres in each county
1854 1866
England and Wales
London South of Thames, Eastern Eastern parishes 3691
parishes
Surrey, part of
Kent, part of
Sussex
Hampshire Portsea Island 20, Portsea Island 129,
Southampton 48 Southampton 41
Berkshire
Middlesex, part of Brentford 196
Hertfordshire
Buckinghamshire
Oxfordshire
Northamptonshire Towcester 86
Huntingdonshire
Bedfordshire
Cambridgeshire Wisbech 176, Ely 46
Essex West Ham 124, Romford West Ham 389
113, Maldon 102
Suffolk
Norfolk Norwich 193, Yarmouth 41
Wiltshire
Dorset
Devon Plymouth 59, Stonehouse Exeter and St Thomas 247,
15, Devonport 2, Newton Abbot 57,
Bideford 46 Totnes 146
Cornwall
Somerset
Gloucestershire Bristol 76, Clifton 92,
Gloucester 48
Herefordshire
Shropshire
Staffordshire Dudley 256,
Wolverhampton 80
Worcestershire Worcester 45
Warwickshire
Leicestershire
Rutlandshire
Lincolnshire Great Grimsby 68
Nottinghamshire Worksop 27,
Nottingham 16
Derbyshire
Cheshire Chester
Lancashire Liverpool 1084, W. Derby Liverpool and W. Derby
206, Wigan 158 2122, Wigan 137
West Riding Sheffield 126, Dewsbury
66, Leeds 48
East Riding Hull 27
North Riding Whitby 33, Guisboro’ 30
Durham Stockton, Auckland,
Durham
Northumberland Newcastle 1431, Gateshead
525, Tynemouth 203
Cumberland
Westmoreland
Monmouth
South Wales Merthyr Tydvil 455, Swansea 521, Neath 520,
Cardiff 255, Neath 54, Llanelly 232, Merthyr
Brecon 54 Tydvil 229
North Wales