The Great Stink

All was calm in London coming into the 19th century. London was thriving: "In the first half of the nineteenth century, the population of London soared to 2.5 million, as thousands flocked to the capital to find work" (Cadbury 117). In 1858, on a summer day in Soho, the first victim fell ill. "...Mr G's heart stopped beating, barely twenty-four hours after showing the first symptoms of cholera. Within a few hours, another dozen Soho residents were dead" (Johnson 35). The Great Stink had begun with cholera's fearful attack.

"Cholera - the very word terrorized, conjuring up on the prospect of a terrifying and sudden death, often within hours. The early signs, debilitating diarrhea and vomiting causing severe dehydration, were followed all too soon by kidney failure and collapse, stilled only by death" (Cadbury 115).

As time passed, the epidemic spread and the death toll continued to rise. The fear stricken city was thrown into confusion as no one could postulate a solution nor prevention. The only warning that cholera was afoot was a great foul odor that preceded the victims' sickening. "Foul odors emanated from more than 200,000 cesspools across London, in alleyways, yards, even the basements of houses. It was not a smell that could be easily washed away" (Cadbury 117). "The pressure on London's 200,000 cesspools and the haphazard sewer system was exacerbated by the new "must-have" accessory of late Georgian England: the water closest, the toilet...With each new flush lavatory adding 160 gallons of waste and water, London's sanitation soon reached crisis point" (Cadbury 118).  By polluting their city, Londoners were enhancing cholera's advance.

Sewerage from a cesspool flowing to the river.

Sewerage from a cesspool flowing to the river

As cholera spread through London, people called for action. As some 54 citizens cried to the editor of the Times:

"THE EDITUR OF THE TIMES PAPER

Sur, -May we beg and beeseech your protection your proteckshion and power. We are Sur, as it may be, livin in a Wilderniss, so far as the rest of London knows anything of us, or as the rich and great people care about. We live in muck and filthe. We aint got no privies, no dust bins, no drains, no water splies, and no drain or suer in the hole place. The Suer Company in Greek Street, Soho Square, all great rich and powerful men, take no notice watsotnedever of our complaints. The Stenche of a Gully-hole is disgustin. We all of us suffur, and numbers are ill, and if the Colera comes Lord help us...

Teusday, Juley 3, 1849".

Doctors were not able to provide solutions to their patients.  "Ordinary doctors possessed no less unanimity in their treatment of cholera than the patent-medicine impresarios or the newspaper letter-writers. Sometimes the cholera was treated with leeches, based on the humoral theory that whatever seemed wrong with the patient should be removed from the patient : if the cholera sufferer's blood was unusually thick, thanks to dehydration, then the patient needed to lose more blood...Purgatives like Castor oil or rhubarb were widely prescribed. Physicians were also inclined to recommend brandy as a treatment, despite its known dehydrating effects" (Johnson 50). These "cures" did more harm than good.

"The tragic irony of cholera is that the disease has a shockingly sensible and low-tech cure: water. Cholera victims who were given water and electrolytes via intravenous and oral therapies reliably survive the illness...And indeed, one British doctor, Thomas Latta, hit upon this precise cure in 1832, months after the first outbreak, injecting salty water into the veins of the victims...Tragically, Latta's insight was lost in the swarming mass of cholera cures that emerged in the subsequent decades" (Johnson 45).

Although incorrect, two groups emerged from the chaotic mess; the contagionists and miasmatists. "Either cholera was some king of agent that passed from person to person, like the flu, or it somehow lingered in the "miasma" of unsanitary spaces" (Johnson 69). The miasma theory was widely accepted. "By the late 1840s the miasma theory had established a far more prestigious following: the sanitation commissioner, Edwin Chadwick; the city's main demographer, William Farr; along with many other public officials and members of Parliament" (Johnson 69). With all the misconceptions of cholera, one investigator found the correct theory: John Snow. "Snow was sure... that the key was water" (Cadbury 124).

Edwin Chadwick (1800 - 1890)

Edwin Chadwick (1800 - 1890)

The miasma theory arose from reports of unsanitary conditions. "The lawyer Edwin Chadwick, secretary to the Poor Law Commision, was one of many to draw attention to London's unsanitary living conditions. In 1842, he produced an uncompromising and influential paper, 'The Report on the Sanitary Condition of the Labouring Population of Great Britain.' Shocked by the squalor of the slums, he cited 'atmospheric impurities produced by decomposing animal and vegetable substances,' 'damp and filth,' and 'close and overcrowded dwellings" as leading inevitably to disease and epidemics. For Chadwick, the report marked the beginning of his own theory of cholera contagion-one that was to have terrible repercussions," (Cadbury 120). Chadwick's actions would strengthen the great cholera epidemic.  "Just as Snow was concocting his theory of cholera as a waterborne agent that had to be ingested to do harm, Chadwick was building an elaborate scheme that would deliver the cholera bacteria directly to the mouths of Londoners. (A modern bioterrorist couldn't have come up with a more ingenious and far-reaching scheme)" (Johnson 120). Ironically, Chadwick aided the Great Stink.

"He expressed the notion most famously-and most comically-in hist 1846 testimony to a parliamentary committee investigating the problem of London's sewage: 'All smell is, if it be intense, immediate acute disease; and eventually we may say that, by depressing the system and rendering it susceptible to the action of other causes , all smell is disease"' (Johnson 114).

Chadwick's incorrect belief of the miasma theory was adopted by many. His ideas even impacted Joseph Bazalgette who designed the sewer system believing the theory.

John Snow (1813-1858)

John Snow (1813-1858)

"Although a leading anesthetist, Snow devoted himself to developing his own theory of cholera contagion, moving closer to a conclusion with every day that passed. He felt certain he alone knew why thousands were dying of cholera all around him. He alone knew how it stole upon its victim so innocuously, soon to be racing through the blood, delivering destruction" (Cadbury 116). John Snow thought the miasma theory was pure madness, and began a search for a new theory.  He saw a pattern between deaths of the cholera victims. "What the notes showed were connections-connections between individuals, linked in life by their neighboring homes and, finally, by a common cause of death: the cholera" (Cadbury 115).

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The Ghost Map (UCLA)

John Snow's The Ghost Map

He developed the Ghost Map to show the pattern. The families of the deceased were near where their source of water, the Broad Street pump, "Of the eighty-three deaths recorded in Farr's list [of the victims], seventy-three were in houses that were closer to the Broad Street pump than to any other public water source. Of those seventy-three Snow had learned, sixty-one were habitual drinkers of Broad Street water" (Johnson 153). With his evidence, he developed a theory that cholera was waterborne, and he was able to remove the Broad Street pump.  "...Friday, September 8, exactly a week after the outbreak had first begun its awful rampage through Soho, the pump handle was removed" (Johnson 160).

"Dozens would die over the next week, but clearly the worst was over. When the final numbers were tallied, the severity of the outbreak shocked even those who had lived through it. Nearly seven hundred people living within 250 yards of the Broad Street pump had died in a period of less than two weeks. Broad Street's population had literally been decimated: ninety out 896 residents had perished" (Johnson 161).

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