Cholera: Tracking the First Truly Global Disease

June 14, 2004

A new and terrifying disease struck England in October of 1831 and quickly spread across the kingdom. Over the next two years, thousands died from this mysterious illness, so virulent that a person could be in good health at dawn and be buried at dusk.

Citizens lived in terror, sealing their doors and windows at night against the feared "night air." There was no cure.

Symptoms began with vomiting, diarrhea, and fever, which violently dehydrated the body: Soon the patients' skin turned bluish grey, they began to writhe with muscle spasms, their eyes sank in their sockets, and they grew cold as their pulse flickered—and vanished.

The disease was Asiatic cholera, also known as spasmodic cholera of India, its place of origin. A huge epidemic in Bengal in 1917 first drew the attention of European physicians.

Over the next decades, cholera spread widely over trade routes, becoming the world's first truly global disease, infecting people from China to the Middle East and from Europe to the United States.

A second epidemic struck England in 1848 to 1849, killing between 50,000 and 70,000 in England and Wales. A third outbreak in 1854 left over 30,000 people dead in London alone.

Doctors understood little about this horrible illness, but tried, often in vain, to save their patients with anything from laudanum (an opium tincture) and brandy to blood letting.

"The cholera," said the British Annual Register for 1932, "left medical men as it had found them—confirmed in the most opposite opinions, or in total ignorance as to its nature, its cure, and the causes of its origin, if endemic—or the mode of transmission, if it were infectious."

Grim Living Conditions

It was indeed infectious—and grim, urban living conditions fueled its spread. With the rise of the industrial age, lack of work in rural English villages prompted large migrations to cities.

In the first half of the 19th century, London's population soared to 2.5 million people. The city had become one of Europe's trading and manufacturing capitals, producing everything from woolen cloth to weapons. Families flocked to urban centers along with their livestock, often living eight or nine to a room beside their animals in tenement buildings.

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