The 1832 cholera epidemic in East London

Thus did the fatal disease rise like a demon bent on destruction; it took its course, not heeding mountain, sea nor clime; death was its object, man its victim, and the uttermost ends of the world its destination; wherever its cold hand was extended - the people died .... Death struggled with time itself, and gnawed the moments that separated him from his victim. [1]

The 'Cholera Morbus' was first described near Jessore, India, in 1817. In 1823 it had spread to Russia; by 1831 it was in Hamburg, and the first case in East London was on 12th February, 1832. For all the romance and fear attached to this seemingly inevitable march across the world, only about 800 persons died of the disease in the East End. In 1832 more people died of tuberculosis than cholera, and a child born of a labourer in Bethnal Green had a life expectancy of only 16 years. However, cholera evoked a response in social terms, and a contribution to the development of public health, of far more significance that its effect on mortality at the time.

Although the 'Cholera Morbus' is what we now call just cholera, the terms 'Asiatic', 'spasmodic', 'malignant', 'contagious' and 'blue' were also used to describe this new disease, generally thought to be a more serious form of the contagious cholera already well known. It was confused with, or thought to be the same as, 'common' or 'English' cholera, dysentery and food poisoning frequent in this country during the summer months. What actually caused the disease or how it was spread, was not understood until well after 1832 but it is now clear that the bacterium Vibrio comma, if drunk in water contaminated with infected sewage, causes a mild fever that usually gets better within a week. A poison produced by the bacterium however stimulates a profuse diarrhoea that may prove fatal if the vast quantities of water and salts lost are not replaced. Thus it is not a serious disease if treated correctly, but doctors in the 1830's generally tried to restrict fluid intake, to prescribe emetics and purgatives, and even to bleed their patients, trying to 'equalize the circulation'. [2]

The disease was first noticed among British troops in India, and vivid accounts appeared in the press of the effects of cholera in St. Petersburg, Russia. This first hand knowledge of the disease, and reports of the mortality it could cause in large cities, led the Privy Council to put all ships for Russia arriving in England under quarantine in January 1831. The Privy Council had set up a Central Board of Health in 1805, after concern about yellow fever arriving in Britain. This was reconstituted, and met daily from June 1831 to May 1832. It issued circulars and gave advice to parochial Vestry Committees, who were responsible for the precautionary measures taken within their own parishes.

As the disease spread west to Hamburg, all ships from Baltic ports were put under quarantine. Those arriving in London had to spend 10 days in Standgate Creek, near Deptford, before a doctor gave the ship a clean bill of health.

the last three days of this period to be bona fide employed under proper supervision in opening hatches .... and ventilating the spaces between decks by Windsails, and opening, airing and washing the Sailors' clothes and bedding. [3]

Vessels from Sunderland were put in quarantine by the end of November 1831, soon after the cholera had arrived there. The measures were not completely effective, as the first cases in London occurred on the river, mostly on colliers from the Tyne.

During December and January there were a large number of cases of suspected cholera in London, and the prospect of an epidemic received a lot of attention. Even a play was produced, called 'Cholera Morbus, or Love and Fright', in which a man dispersed a crowd in terror by shouting 'collar her' after a girl who had picked his pocket, allowing her to run free. The Times thought this an outrage and an indecency. [4]

Of the 48 cases investigated by the Central Board before February, probably only one or two on the river were the Asiatic cholera; the illness of John Potts received the most attention, although it was only dysentery. He was a sailor recently arrived from Sunderland on the collier Mould, and waiting to work north on the Dirt. Taken ill with vomiting and cramps, he was removed to Shadwell Workhouse, where he soon died, on 18th January. A postmortem examination was performed, and a twenty-inch length of his intestines carried to the Central Board at Whitehall by the parish beadle. The inquest was held in the George and Dragon public house on Shadwell High Street, and was attended by representatives from all the neighbouring parishes, but the verdict was that 'the deceased had died by the visitation of God, from natural causes, and not from the Cholera Morbus'. [5]

The Central Board had been supervising activity in the parishes for three months when the cholera did arrive in London, in February 1832. The Vestry Committees had been asked to form local boards of health on 20 October; there was little initial response, but a flurry of activity followed the news of the arrival of cholera in Sunderland on 5 November. With the encouragement of the two Central Board Inspectors for East London all the parishes formed boards, apart from Holy Trinity Minories where the Vestry asked the Clerk and Wardens of the Liberty to use their 'discretion' as necessary 'on the spur of the moment'. [6]

Most of the boards seem to have examined the cleanliness of their parishes, and cleared nuisances off the streets. There were initially no powers for statutory cleansing of private property, but Poplar Board of Health kept a free supply of brushes, buckets and unslaked lime at the Town Hall for the poorer inhabitants to borrow. Surviving accounts of the living conditions paint a picture of overflowing cesspits, pigs in the backyard, and inadequate drainage and water supply. In Spitalfields,

The low houses are all huddled together in close and dark lanes and alleys, presenting at first sight an appearance of non-habitation, so dilapidated are the doors and windows:- in every room of the houses, whole families, parents, children and aged grandfathers swarm together. [7]

Cross Street, Poplar, was not in a particularly dirty area, but the report of the Board of Health says it:

wants cleaning, especially a pool of stagnant water at the top of Mary Street which has no protection against children falling in, one case having occurred, where the child would have been smothered had it not been for the timely assistance of its mother and a boy. NB the pigs which wander about these parts turning up the earth and heaping up ashes etc., contribute to the nuisance. [8]

Drainage in East London was very poor, as indeed it was over the whole of London. The Commissioners of Sewers, set up by Henry VIII, collected a rate and were meant to maintain the sewers in their area. However, many of the sewers were open ditches, and those which did run underground had not always been properly surveyed, so that the course became blocked up. The worst drain was the 'Black Ditch', an open sewer running from the parish of Christ Church Spitalfields and emptying into Limehouse Dock. The Tower Hamlets Commissioners of Sewers had made an attempt to drain it by diverting the flow, but this had made the stream stagnant and more offensive. The Act for the Prevention of the Cholera Morbus came into force in February 1832 and allowed boards to perform some compulsory cleansing of houses for the first time, but was passed too late to have much effect on the epidemic already in progress.

Water was supplied to London by private companies, the New River Company and the East London Water Company serving respectively the inland and riverside parts of East London. The East London Water Company took its water directly from the River Lea north of Bow, and despite having recently replaced the wooden mains piping, the mortality from cholera was very high in the area it served. Only about a third of houses were supplied directly, most people relying on pumps in the street.

Ordering the provision of cholera hospitals was the other major measure the Central Board took, and all the local parishes made some arrangements, except the Hamlets of Mile End Old and New Towns, Bromley and Spitalfields. The London Hospital, in common with other voluntary hospitals in London, affirmed its general rule not to admit anyone with infectious diseases. All new patients were examined in the waiting hall before admission, to check for any symptoms of cholera. A ward for cholera victims was set up first in the Library, and then in the attic above Harrison Ward, but only for patients already in the hospital who happened to catch the disease.

Limehouse, Wapping, Shadwell, Whitechapel and Bethnal Green converted parts of their already crowded workhouses into wards, but the Central Board favoured the use of detached houses, where the risk of contagion was less. The only good surviving description of one of these hospitals is of the one in St. George's in the East. It was in two adjoining houses on Vinegar Lane, with a back entrance from Sun Tavern Fields. The Board of Health:

had provided 16 beds, with entirely new bedding, nurses, a surgeon to attend on the patients, and pipe conductors of steam, to convey heat to the afflicted persons and beds. [They] had also provided a litter, made of wicker, and which could be covered in at pleasure, for the easy removal of persons from their houses; and immediately under the patients a portable steam apparatus, which would act to keep the patient warm during his conveyance through the open air. The hospital ... was situated in the most airy part of the parish. [9]

Although there had been a number of Central Board circulars on hospitals, only Poplar had actually set one up by the time cholera had reached London, and the other parishes made more or less hurried attempts to rent houses or convert parts of their already overcrowded workhouses in early February.

The parishes of East London were certainly not well prepared for the first cases of cholera. The local boards were free to do largely as they wanted, and were not guaranteed support from the Vestry Committees; the Limehouse and Ratcliffe boards received little co-operation or money from their parishes. A long-standing conflict between the Vestry and local Magistrates of St. Dunstan's, Stepney, resulted in the formation of a 'voluntary' board. This spoke out against excessive expenditure, asked for a public subscription, and proclaimed 'the poor want bread not warm baths and physic'. [10]

The attitude of each board was strictly parochial, and anyone who was not the proven responsibility of a parish would receive no aid, nor even burial. Thus when the captain of a vessel moored off Hermitage Pier, Wapping, was brought ashore in a state of collapse, and it could not be decided which parish his ship was moored nearest, he was left lying alone on the wharf.

While it was a well-meaning body, the Central Board had very few actual powers, and the preventative measures it recommended were inadequate to control the disease. As The Courier observed:

If, instead of many pompous regulations about the means of curing cholera, we were to think of the means of preventing it, by feeding the hungry and clothing the naked, it should be more to our credit as men and Christians. [11]

After the first death in Sunderland, on 26 October 1831, the epidemic spread to Newcastle and then northwest to Scotland. The disease reached London by the sea, and there were a few probable cases of cholera on the river in January and February 1832. John James, a ship scraper two days off the Elizabeth from Sunderland, was the first death ashore, in Rotherhithe on 11 February. North of the river the first case was that of Sarah Ferguson, taken ill on the afternoon of Sunday the 12th. She was quickly moved from White's Rents, Nightingale Lane, to Limehouse Workhouse, where she died eight hours later. Her extremities turned a blue colour shortly before death, confirming this was indeed the 'Asiatic' or 'blue' cholera. In life she had been:

of robust health and gained a living by picking up coals and pieces of timber along the riverside, and was in the habit, even in the most inclement weather, of wading knee deep in the water and mud. [12]

Another woman, Mary Shea, and her daughter Caroline, were taken ill at the same time and both died. All three were buried as soon as possible in deep graves in the corner of the churchyard.

There was immediately considerable panic not only in Limehouse but the whole of London. Almost any mild bowel problem was thought to be cholera and even 12 horses that died of a 'rapid febrile disease' at Taylor's brewery, Limehouse, were rumoured to be victims of the epidemic. [13] As the disease carried off relatively few people in its early stages, this alarm subsided a little, although East London found itself almost in quarantine. The chairman of a meeting of the Mechanics Institute in Limehouse failed to attend for fear of catching the disease, and a member wrote to him that 'gentlemen at the west end of the town are mightily afraid of the cholera; he hoped they would get their share of it.' The Marquis of Stafford would not permit his staff to venture east of Charing Cross, and had post thrown into his house from the street. [14]

The Central Board soon took special precautions on the river, using the frigate HMS Dover as a cholera hospital. The Admiralty had offered another frigate HMS Grampus as a hospital as early as November 1831 but the Central Board did not take up the offer until cholera was actually in London. The Dover was first moored near Limehouse, then off Hermitage Pier, Wapping, from the end of May. On board were a lieutenant, eight crew, medical staff and nurses; female nurses had to be taken on board from Greenwich after the original male crew refused to attend the sick. A boat rowed along the river front every day, and collected any new patients.

The doctor in charge, Surgeon Inlay, treated 64 patients in the first two months of the epidemic, mostly off colliers - the Formosa, the Blessing, the Blossom, the Maxwell and others lying off Hermitage Wharf and Stone Stairs. It could not have been an easy job, as Inlay and his three nurses all got diarrhoea themselves.

There was always trouble over where the bodies could be buried. Poplar was closest to where the Dover was first moored, but together with Limehouse, maintained that the bodies should be buried on open ground south of the river, by the convicts' cemetery at Woolwich. This Inlay was forced to do, after the first bodies had spent a week on the ship - despite orders sent down to Poplar from the Central Board.

There are no reliable figures on the number of deaths from cholera. Parish returns were made daily to the Central Board but stopped in early May when the epidemic was officially declared over in London. In fact it seems from contemporary accounts and the Bills of Mortality for the Metropolis that the early period of the epidemic, from February to late April, was followed by a considerable increase in mortality from early July to late August. This accounted for about two-thirds of the total number of deaths, which amounted to at least 3,000 in the whole of London, and over 800 in the east. Of this 800 about 300 were along the riverfront, and 263 were reported in Whitechapel alone. Over twice as many people caught the disease and recovered as died, so there were probably around 2,500 cases in East London. It does seem that many cases and deaths were ignored or not reported in some parishes, notably Bethnal Green.

All the deaths in February were of Irish labourers or north country seamen, before the disease spread inland towards Whitechapel. Doctors could not agree on its exact symptoms, so it is easier to describe cases individually than in general.

Elizabeth Connolly was aged 53 and lived in White's Rents, Limehouse. On 16 February she ate a dinner of ox's cheek, and thought her feeling of illness the next day was due to this first meal of meat for a week or two. At 1.30 pm she was returning from a shop, where she had bought some herring, when diarrhoea started, forcing her to stop at a house on the way home. This continued, with vomiting, until 5 pm, when she called a doctor. She was taken to the workhouse, where a hot-air bath, an emetic, an enema and brandy did not prevent her dying at 3 am.

Another case is that of John Salmon, who lived in White's Yard off Rosemary Lane in Wapping. He, like Sarah Ferguson, picked wood and coals by the riverside. It was not until after three days of diarrhoea and vomiting that he called for medical help, at noon on 24 February. Until 8 pm that evening he was treated at home, with laudanum, brandy and other stimulants, external treatment of hot flannels, friction with coarse blankets, and bottles filled with hot water. His condition worsened, so he was taken to the cholera hospital, but died at midnight that night. [15]

What then were the reactions of those whom the disease attacked? Certainly there was a lot of confusion about its existence and significance, as The Courier commented:

'The disease is undoubtedly in London, and undoubtedly it will spread' say one party.

'The disease is not in London, and it will not spread', say the other.

'The woman died of the real malignant cholera', say the Doctors on the other.

'It is a mere alarm of the Anti-Reformers', says a member of the Political Union.

'It has been spread through interested motives; the druggists shops are profiting by it', says a Newspaper correspondent.

'It is the last blow to the commerce of London, already declining under the competition of Liverpool and the other northern ports', thunders the 'leading journal'. [16]

Although the Industrial Revolution and the expansion of colonial trade had increased the prosperity of London, its secondary importance as a centre of industry, and the development of rival provincial ports, meant that the river was not so busy as it might have been. Quarantine of incoming ships was thus unpopular with merchants and ships' owners, and was lifted as soon as the cholera reached London. However, outgoing vessels were put in quarantine at their port of destination, an action which was blamed for even more loss of trade and unemployment. There was not such an active lobby as in Sunderland, where business interest dominated the Local Boards of Health, and issued statements that there was no cholera at all in the town. The Times blamed the arrival of cholera in London on commercial interests but did not actually accuse any ships of breaking quarantine.

People by the river refused to believe in the existence of the disease, thinking it to be a form of the 'common' cholera always present in the area. When sailors caught the disease, they would not allow themselves to be taken on board the Dover until in a state of complete collapse, and the boat that collected patients from their vessels was the butt of frequent hoaxes and much abuse from the seamen. But the coal whippers and other people on shore were adamant that a vessel with a case of cholera aboard should immediately be towed back into quarantine. [17]

The silk industry, concentrated in a small area of Spitalfields and Bethnal Green, was in a period of decline in the early 1830s. The repeal of the Spitalfields Acts in 1824 and the removal of import restrictions in 1826 had been welcomed at the time by manufacturers, but it had become clear that London could not compete with imports of patterned French silk and the production of plain silks was cheaper in the provinces, where child and female labour were used in factories. There had been virtually no mechanization in London, and one employer, Barret Wadden, had reduced his workforce of handweavers from 300 to 60 or 70 in the six years up to 1832. About two-thirds of the looms in Bethnal Green and Spitalfields were idle. There were 6,000 registered for parish aid in Bethnal Green alone, and the Vestry were unable to pay all the necessary relief from the poor rates. This led to unrest among the workless, and in late February 1832, a man and two women were arrested for breaking the windows of an overseer's house, after being refused aid, and a large mob had gathered as the police arrived.

Tory Radicals embraced the Malthusian principles of 'political economy', maintaining that any help given to the poor would only enable them to multiply faster, in the long run causing more suffering. Many respectable people thought it best to give little help to the workless and ill, even in the face of quite obvious suffering. The press largely agreed:

with respect to those persons who are supposed to contribute greatly to the spread of the disease, Beggars and Vagrants ... we call for the vigorous execution of the law ... surely with our highly effective Police, we may be freed from this scourge. [18]

Certain middle-class philanthropists, however, formed organisations such as the Spitalfields Soup Society and the Bethnal Green Benevolent Society to distribute clothes and food to the poor. A soup kitchen was set up in the yard of Limehouse workhouse, to be maintained by public subscription. Some of the poor, it seems, welcomed this aid brought by the threat of cholera.

We really, for your sakes, offer our sincere thanks to 'the dreadful Plague' and hope he will continue to take you under his protection, at any rate he will not leave us until you are provided for the winter.

wrote The Poor Man 's Guardian. Others thought that the cholera was an attempt by the Government to poison the poor, and reduce the size of the population. [19]

A National Day of Fasting and Prayer was called in February, to be held on the 21st March, as 'the disease ... was proof of the judgement of God among us'. [20] The Fast was announced in Parliament after the Strangers' Gallery had been cleared; a speech deplored the sins and state of the nation, the 'houses of the nobles and gentry entered and robbed'. The Poor Man's Guardian replied 'No, no; to tell the poor to fast would indeed be superfluous', as they were lucky to eat meat once a week, let alone be able to forgo it. [21] It was called a 'farce' day, and the National Union of Working Classes wanted all to have a 'feast' day instead, calling a large public meeting in Finsbury Square for the 21st.

On this day, despite the 500 police quartered in Spitalfields, about 1,000 members of the Trades Union of Bethnal Green and Spitalfields marched west. Meeting the police in Windmill Street, by Finsbury Square their leader advised them publicly to disperse, after which they disappeared, and then marched up Bishopsgate Street, brushing aside a few police and proceeding northwards.

The same day, a crowd reported to be about 500 threatened to demolish the Bethnal Green Workhouse, but desisted, although only 25 police were present. [22] Politically the cholera was not an important issue after this, becoming overshadowed by the first Reform Bill, about to pass through Parliament. Once the disease was seen to be less serious than in Paris, where more than 9,000 had died in the first month of the epidemic, the popular attention paid to it declined.

Amongst the medical profession, the exact nature of cholera was the cause of much debate; a large proportion of doctors adhered to the 'non-contagion' theory of disease, that it did not spread from person to person but could arise spontaneously, as a result of bad air. The Westminster Medical Society followed this line, and insisted the disease was an altered form of 'common cholera'. The popular London Medical Gazette and many doctors were content to agree that there was a serious disease in London, and discussed means of prevention and cure, rather than the origin of cholera or its causes.

Fear of cholera produced a brisk trade in medicines, so much that there had been a feeling abroad that the medical men have been getting up to what is vulgarly called a job, and that the accounts of the disease have been magnified and exaggerated for purposes not the most praiseworthy. [23]

The value of preparations that appeared, such as 'Rymer's Peruvian Tonic Drops', 'Asiatic Antipestilential Essence' or 'Hancock's Anti-Cholera Galoshes' is not recorded, but many of the medicines were based on brandy, as this examination at the Thames Police Office suggests. Mary Wilson, a 'dashing Cyprian', was accused of theft from the captain of the collier Juno:

The prosecutor met the accused in Shadwell, and after taking sundry drops of 'Anti-Cholera' which made him feel 'half seas over', he accompanied the prisoner to a house of ill fame, where she succeeded in robbing him.

As the magistrate said, the captain had made an ill voyage of it. [24]

When someone did actually contract the disease, it was customary for the ill person to be surrounded by as many of his family and friends as possible, often packed into small rooms. The closeness of the atmosphere was thought to cause more illness, and doctors wanted to isolate their patients and move them as quickly as possible to a better ventilated hospital, though this in fact could have made little difference either to the patients or to the spread of the disease.

If a doctor was called, and often one was not until the patient was nearly dead, his treatment was not always trusted. In late May 1832, two women in Johnson Street, Mile End Old Town, contracted cholera. Their friends thought the medicines sent by the parish doctor were only making the women worse, so they fed some to a cat, which shortly after died. A mob of them attacked two pupils of the doctor who came to examine the patients, and when more of the family subsequently became ill, they refused to be taken to hospital. [25]

A further reason for not wanting to go to the hospital was the fear of being used for dissection. The major hospitals had for some time been very short of cadavers, and there was a flourishing business for the 'resurrectionists'. The Central Board had asked for bodies of cholera victims to be wrapped in a tar-soaked blanket, and several shovelfuls of lime put in the coffin, not so much to disinfect the corpse as to make it unsuitable for dissection. Even this did not dissuade all the 'resurrectionists', however, as on at least two occasions the burial pit dug for cholera victims from the Dover at Woolwich was emptied, and sometimes only empty coffins were interred. The London Medical Gazette commented that these bodies could be readily identified in the dissecting rooms of major London hospitals by the amount of tar on their skins. Bodies from the Dover were subsequently buried in Plumstead, Kent, but even there the bodies of two sailors from the Justista were removed, and two people were caught carrying away two more. [26]

The Anatomy Act, being discussed in Parliament at this time, proposed allowing the bodies of paupers who died in the workhouse to be used for dissection. This produced an outcry from the poor, and a suspicion that any one taken to a cholera hospital might be killed and used for dissection. There were no demonstrations in London as dramatic as that in Dublin, where hospital cots were broken up and thrown into the River Liffey; but a visitor to London wrote that:

It is only a few days since an infuriated mob attacked the Cholera Hospital of St. George's in the East, and threatened to pull down the house and murder the surgeon exclaiming that they were 'Burking' the poor wretches who were admitted. At risk of his life one of the gentlemen in attendance rushed out and seized the ringleader, dragged him within the house and succeeded in fastening the door. 'Now', said he, 'wretch, you will not go out until you have asked every patient in the house how he has been treated, and you have heard his answer. You shall see the agonies of the sufferers, and the efforts made for their relief'. The man received from all grateful acknowledgements of the humanity exercised towards them, and being thoroughly humiliated, said, 'Sir, I am ashamed of myself: let me go out and explain to the mob'. He did so, and they presently dispersed. [27]

Burial of cholera victims was meant to take place within 12 hours of death, the body not entering the church itself. This was very unpopular, especially among the Irish, who kept a vigil or 'wake' over the body for several days after death. On a number of occasions police were used to break into the houses of Irish labourers and remove a body. In Wapping in July 1832 a family wanted to keep a body in their house for a week, so they could collect money from a funeral fund. At least occasionally, cholera victims were buried with undue haste: one being carried in a funeral procession down Bishopsgate Street in July 1832 was heard knocking from inside the coffin. [28]

The Central Board (which continued to answer letters despite being officially discontinued in May) maintained during the height of the epidemic in July and August that the cholera was merely endemic and occasional outbreaks were bound to occur. It is not clear whether this was a deliberate attempt to calm public opinion, or merely due to lack of information, as all the Central Board Inspectors had been dispensed with and there were no official returns from the parishes. However, by December nearly the whole country was free of cholera, though few areas had escaped the disease. The mortality in London was not especially high, the Black Country around Birmingham probably being the worst affected. The disease may have reappeared briefly the following summer, and again in 1837, but there was not another major epidemic until 1848.

Most of the precautionary measures were allowed to lapse, although Poplar kept their hospital in North Street, and Norton Folgate gave their street cleaner, the 'Scavenger', a longer contract. The Act for the Prevention of Cholera had however created a precedent for some compulsory cleansing, and more significantly had allowed discretionary payments to be made to the parishes from the Treasury if the parish poor rate was inadequate to pay for the necessary measures.

There was no official examination of the effects of the 1832 epidemic until the first report of the Metropolitan Sanitary Commission, in 1838, but the epidemic did leave behind it an awareness of the importance of public health. This prompted action by individuals such as Hector Gavin and Edwin Chadwick, whose investigations, carried out largely in East London, formed the basis for sanitary reforms later in the 19th century. There were, however, to be far more serious epidemics than that of 1832 before much real progress was made.

By Robert McR. Higgins

Notes

General Reference Books:

Norman Longmate, King Cholera (London 1966).

RJ. Morris, Cholera 1832 : the social response to an epidemic (London 1976).

Transcripts of Crown-copyright records in the Public Record Office appear by permission of the Controller of H.M. Stationery Office.