Is the past always another country? Reflections on the 1832 Cholera outbreak in the light of COVID-19

“Much, however, may be done, even in these difficult circumstances, by following the same principles of prudence, and by avoiding all unnecessary communication with the public out of doors; all articles of food, or other necessaries required by the family, should be placed in front of the house, after the person delivering them shall have retired.”

Paragraph 8 of the Privy Council announcement of the Board of Health’s rules and regulations made for the purpose of preventing the introduction and spreading of Cholera Morbus, 20 October 1831 (as reported in the London Gazette, 21 October 1831 p.2160)

We’re all presently socially-distanced, yet at the same time strangely brought together through a shared sense of adversity. Social media feeds are proliferating with suggestions of what to do to distract cooped-up children and adults. We’re all craving things to do and to think about which will give us reprise from the fundamentally uncertain situation that we all now find ourselves in.

Like everyone, I need sanity breaks away from thinking about Coronavirus. But also, I need something to chew on. Maybe its schadenfreude but I find I can take some strange, re-grounding and perspective-giving, comfort from reading about other pandemics and how society has been challenged by them. Perhaps it is their greater scale that comforts me, but maybe it’s also the fact that I’m reading about the past – and that therefore I’m reading about something once feared to be an existential threat to society, which was eventually overcome.

I’ve been reading into the circumstances of the UK’s 1831-32 Cholera outbreak and thinking about how individual citizens made sense of what was coming towards them, why it was happening and what to do about it. This journey is taking me to history books and also contemporary documents, particularly local newspapers, memoirs and government circulars through which I’m witnessing the birth of UK public health legislation.

Some of the ways of seeing the world that I’m encountering in these materials seem strange to modern sensibilities – with much talk of the power of prayer, the curative powers of brandy, the importance of keeping feet dry and loins warmly bound. There are also copious tracts on the dangers of immoderate eating, for example (the seemingly unhealthy, from our point of view) advice for all to abstain from:

“…fruit of all kinds, though ripe and even cooked, and whether dried or preserved. The most wholesome articles of vegetable diet are, well baked, but not new bread, rice, oatmeal and good potatoes. Pickles should be avoided…the diet should be solid rather than fluid: and those who have the means of choosing, should live principally on animal food…great moderation both in food and drink is absolutely essential to safety during the whole duration of the epidemic period.” (General Board of Health, 5 October 1848 Notification regarding the Nuisances Removal & Diseases Prevention Act 1848, as published in the London Gazette, 6 October 1848, p.3616)

But on the other hand much is bizarrely familiar. The state’s reaction to the spread of the Cholera virus westward across Europe was tentative. Naval quarantine measures were employed first, and then once the first cases appeared in Sunderland in the Autumn of 1831 the Government started to take steps to put in place a national requirement for Local Boards of Health to be established, and for the attendant surveillance and confinement of suspected and confirmed cases. The political establishment’s prevailing laissez faire attitude was somewhat suspended, with (temporary) introduction of free medical care for Cholera patients, funding for infection-related cleansing and plenty of nudge-like, semi-mandatory urgings that the public should in their own, and also in wider society’s best interest, become more immoderate in their social interaction.

Much of the base framework of UK medico-legal public health governance was forged in the exigencies of the 1831-32 outbreak. Whilst these were temporary measures (and lapsed once the outbreak ended) they set a precedent for a series of public health controls which were revived (temporarily) for future cholera outbreaks during the Victorian era, and which then became embedded as permanent (though rarely used) features of the statute book. For example, the statutory nuisances provisions nowadays to be found in the Environmental Protection Act 1990, and their now prosaic-seeming concern with tackling (for examples) “accumulations and deposits” thought to be “prejudicial to health or a nuisance” first appeared in the emergency powers enacted in the Cholera Prevention Act 1832, and had thereafter been revived temporarily in a series of Nuisance Removal Acts (in the 1840s) before they were rendered permanent via a series of Public Health Acts stretching through into the 1960s. After this, the whole field became rebranded as “Environmental Health”, and was thereafter subsumed within “Environmental Protection”.

Anyway, this (rather arid and technical) example of the continued legacy of the 1831-32 outbreak is but one lingering effect. I’m interested in how – more broadly – an outbreak nearly 200 years ago acts across time to shape how we think about and manage urban living today, and whether in ‘normal’ and in ‘exceptional’ times. Many (particularly in the 1960s and 1970s) have written this story from the point of view of sanitary reform (principally the rise of urban sewerage), using it as an exemplar of Modernist/Welfarist social progress. But this story, re-examined from the vantage of our less confident times, would make for an interesting re-telling – unpacking issues of urban memory, everyday and exceptional imaginaries, human-material relations and of the perception, communication and management of risk and uncertainty.

For now, lets close with the spookily apposite words of Robert Morris, writing in the introduction to his incisive 1976 book, Cholera 1832: The Social Response to an Epidemic (New York: Holmes & Meier). In reading the following, what strikes me is that pretty much everything that he is saying about the importance of understanding the lifeworld of those facing that outbreak, applies equally to our current situation. Morris starts by commenting upon studies of public reaction to natural disasters carried out in the 1950s and 60s (as part of planning for nuclear war):

“Panic was rare [in those studies] but the response these communities made to the shock or threat of disruption often revealed more of their working and values than a study of a normal situation could have done. The processes which normally allocated resources and maintained stability were seen reacting rapidly to a new situation. Individuals and groups revealed much about their scale of values because they had to make rapid choices between social claims which in normal times would never have come into conflict. Most studies revealed the prime claim which family had over work, friends and entertainment. Cholera was a creeping disaster so reaction was a little more studied and circumspect than reactions to a sudden impact disaster, but the manner in which it demanded attention and comment gave cholera the ability to reveal values, patterns of thought, patterns of social relationships and ways of allocating resources in the same way as a more sudden crisis.” (1976: 18)

He then continues:

“The reactions of groups and individuals were influences by their available resources and experience as well as by their values and expectations. Each situation tended to find the population divided into two groups, those with power and resources and those without. Those with power expected to take action against cholera. Those without were the likely victims. Each had a choice of action, quarantine, cleansing, medical provision, prayer or just doing nothing on the other. Values emerged in choices between life and property, between work and safety, between charitable action and governmental agencies. The resources of each group included material wealth, the value of their labour in the market, their social authority and prestige, their administrative and scientific skills and their technical ability. All these choices were influenced by the expectations which each group had of others, wage-earners of the medical profession, or of the local authority, and the administrator’s expectations of reactions to the circular he was drafting. These expectations were all based on past experience of the physical as well as social world”. (1976: 18-19)

Morris ends by pointing out that in 1832 Cholera acted as a lens, revealing to him the “morbid pathology” of British society as it stood in the early nineteenth century. Likewise, COVID-19 holds up a lens to contemporary British society. We need to be mindful of what our outbreak reveals about our lifeworld, and of how our actions and expectations in response to it will all similarly flow from our “past experience of the physical as well as social world”.

Image credit: New York City Sanatory Committee poster, 1849 https://www.nyhistory.org/exhibitions/plague-gotham-cholera-19th-century-new-york

 

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