Oxford History: Cholera

 

 

 

The following extract from a booklet by the Surgeon to the Radcliffe Infirmary analyses the 1832 cholera outbreak, when nearly 1% of the population of the city caught the disease. He was writing in March 1848; and the second outbreak (which he foresaw) struck the next year.

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W. P. Ormerod, On the Sanatory [sic] Condition of Oxford
(Oxford: The Ashmolean Society, 1848), pp. 37–48

… Thus far we have alluded to the ordinary diseases of this country; but the preparations going on through the kingdom to meet the disease which seventeen years since first reached this country, and which is now again advancing towards us on its old track, and with similar characters, render an examination of its occurrence here in 1832 a matter of especial interest. The use of the materials for an examination of this point has been kindly granted by the Board of the Radcliffe Infirmary, in whose possession are the records of the visitation of cholera in 1832, arranged, and in many parts written by the Chairman of the Board of Health, the Rev. Vaughan Thomas. In these, as well as in the Memorials of the Malignant Cholera, 1832, presented to the members of the Board of Health by the Chairman, a most a complete account of the cholera in Oxford exists; and in them is contained that information which so soon again, in all probability, is to be practically employed.

The cholera appeared in England on Oct. 26, 1831, and reached Oxford in about eight months, on June 24, 1832. The last case of cholera occurred in Oxford Nov. 28, 1832, and the last case in England on December 31 of the same year. The disease prevailed here chiefly during the months of July, August, and September, the same period in which England suffered most. The number of cases in Oxford and St. Clement’s, without St. Giles’, amounted to one hundred and seventy-four, of which eighty-six died, and eighty-eight recovered; the number of cases in Oxford as compared with other towns of England, being, that of one hundred and twenty-six places, consisting of large towns or parts especially visited by cholera, about one hundred suffered more than Oxford, and only about twenty-five less. The number of cases in places near Oxford was, in reference to the population, per cent., in Blackthorne about twenty, in Bicester seven, in Merton village, Oxon, six and a half, and in Oxford thirteen sixteenths. The places in England which suffered less in proportion to the population than Oxford are however not such as one would suppose less liable to epidemic disease, amongst them being Norwich, Bradford, Portsmouth, Wigan, Stockport, Bolton, Chester, Preston, Birmingham, and Halifax.

The cholera appears to have affected the great part of Oxford more or less, St. Michael’s, St. Mary the Virgin, and St. John’s being the only parishes in which it did not occur. The stress of the disease fell however on St. Clement’s, St. Ebbe’s, and St. Thomas’, for although twenty-seven cases occurred in St. Mary Magdalene, St. Aldate’s, St. Peter-le-Bailey, St. Peter in the East, All Saints’, Holywell, and St. Martin’s, they were in twenty-two different localities, and nearly one half of them in St. Aldate’s and its courts. These twenty-seven cases occurred, with two exceptions, during the early period of the epidemic, none occurring later than the last week in August.

The locality of three cases is not mentioned, but whilst twenty-seven cases were scattered over seven parishes, one hundred and forty-four cases occurred in three parishes alone: namely, thirty-one in St. Ebbe’s, forty in St. Thomas’s, and seventy-three or more than the number in these two parishes together in St. Clement’s alone.

It has just been mentioned that the twenty-seven cases in the parishes lightly visited occurred chiefly about one time, but in the three parishes which suffered most the disease made a regular progress.

The disease commenced in the last week in June [the disease is understood here and in the annexed table to commence at the time of seizure, and not on its being reported] 1832, in the County Jail, then containing one hundred and thirty-five male prisoners; it destroyed three persons during that and the following week, all in one division of the prison, whilst every prisoner in the same division was affected with the bowel complaint; but in no other division of the prison did the affection occur. In the three following weeks several cases occurred in Wood Street, Bridge Street, Church Street, Littlegate, and especially in Godfrey’s Row, all in St. Ebbe’s, and then cholera ceased to appear in these localities with one exception; it then fixed itself for two weeks in Bull Street in the same neighbourhood. Thus by the 28th of July twenty-six cases of cholera had occurred in St. Ebbe’s, and ten in the County Jail and St. Thomas’ together, but not a single case in St. Clement’s.

At the end of July the cholera almost ceased to occur in St. Ebbe’s; but appearing in the New Hamel of St. Thomas’, there attacked twenty-one persons in the three following weeks, then completely left this locality and only appeared in St Thomas’ afterwards in detached parts here and there. The disease thus affected, first, St. Ebbe’s, and on its subsidence there, appeared in a severe form in a distant part of St. Thomas’, and by the middle of August had nearly ceased in both those parishes.

By the middle of August, only two spots in St. Clement’s had suffered, one in the High Road and the other in the Cowley Road; but the cholera now fixed itself in the streets on the left of the High Road, in three weeks attacked forty-six persons there, and then nearly ceased till October, when a few cases occurred again there and in St. Thomas.

When the cholera existed in Oxford, the mortality was nearly in the same rate as regards the locality; thus, in the seven parishes which suffered least, and in the three which suffered most, the disease was fatal in nearly the same degree, namely, in rather less than half the cases, but with the exception of some few cases at last the mortality decreased slowly from the beginning, always however increasing suddenly on attacking a new locality, to decrease again as suddenly before leaving the part. Thus taking the number of recoveries at one hundred in each of the three following periods, the number of deaths in June with July would be about one hundred and fifty-seven, in August seventy-eight, and in September fifty-six. Again, the sudden rise in the mortality on any new part being attacked was shewn on the three occasions in which the disease commenced: 1st. in St. Thomas’, with St. Ebbe’s and Godfrey’s Row; 2nd. in Bull Street, with High Street and Cowley Road, St. Clement’s; and 3rd. in Caroline and George Streets: on which three occasions the proportion of recoveries was as low as one fourth, or even one-sixth at the commencement, to become one-half, two-thirds, and even four-fifths on the subsidence of the affection in the same parts.

In considering the localities of typhus fever, the frequency of epidemic and contagious diseases in the same places was especially dwelt on; as by attention to such pats a large mass of disease is relieved. It was also shewn that twelve districts of Oxford suffered especially from fever and epidemic diseases during the period under consideration — the years 1844, 45, 46.

It remains now to be considered how far cholera attacked the same parts; and it appears that of these twelve districts cholera visited seven, and was in the streets adjacent to and surrounding four. Of the twelfth I have no record, namely, Summertown in St. Giles’.

Sixteen years have gone by since the cholera was here, yet the same districts which were then attacked are still more or less completely the great centres of disease; but the importance of the subject justifies a consideration of any thing which might seem to throw light on its probable locality, if it again occurred. During the summer months of 1846 a great increase of fever and diarrhœa occurred here, and it is most important to note in what parts these two diseases especially increased; the one so similar to cholera in its choice of locality, that it seemed at times in 1832 to take its place, the other so like cholera in its characters, that some persons have pronounced them to be one and the same thing. It was in four districts that this increase took place: 1. The block of streets lying between the University Printing Office and the Canal, extending also to Observatory Street, Walton Place (now south-west Walton Street), and Little Clarendon Street. 2. Between Fisher Row and the Hamel. 3. Between St. Ebbe’s Church and Bridport Street, extending to Speedwell Street. 4. In the streets of St. Clement’s between the Headington road and the Cherwell.

It is hardly necessary to repeat the four great points on which the cholera fixed itself — Godfrey’s Row, Bull Street, the New Hamel, and St. Clement’s. These four spots are however in the four districts just described; for the New Hamel is the present Jericho Gardens, close to and part of the buildings beyond the University Printing Office; Godfrey’s Row is amongst the courts near St. Ebbe’s Church; Bull Street between that Church and the Friars; and St. Clement’s, the remaining district, though much healthier, still retains a prominent position amongst the localities of fever.

Thus, whether we take the cholera of 1832, the mass of epidemic disease during 1844, 45, 46, or the sudden increase of fever and diarrhœa during a particularly unhealthy season, 1846, the attention is drawn to nearly the same districts, and to which the means employed for relieving either ordinary disease or the occasional attacks of a severe epidemic would seem especially applicable.

These localities have been visited, and the condition of them is noted under the different parishes. It may however be of interest to know the general features of the parts.

In visiting the various parts of the town the inhabitants have often complained of serious inconvenience, but they have also spoke [sic] with gratitude of the exertions of the commissioners and private owners in their behalf. It has often appeared so plain that great good might be done by simply doing well what is supposed to be done so, and by performing generally what is only done here and there, that suggestions of what might be done with great benefit and very little expense, have been added in some cases.

The large open drains of Oxford consist of two classes, those not communicating with any great source of water, and those forming branches of the river. To the former class belong the open drains of Jericho and Church Street St. Thomas’: drains full of decomposing matters, with sluggish streams of the foulest kind, and running through parts which suffer severely from disease. To the second class belong the open streams of St. Thomas’, St. Ebbe’s, and St. Aldate’s, which at times are full of water, whilst at other times they hardly flow at all; into these streams a great number of small drains open, and the exposure of the water amongst the houses to the open air appears to be connected with the high mortality from contagious diseases in their neighbourhood, especially in St. Aldate’s.

A large number of courts are situated close to these open drains, and in some cases the houses extend partly over them, an entire court or a single house being thus exposed to the most unwholesome nuisance, and in several instances the locality being also marked by the occurrence of fatal disease. It is worthy of note, in connection with the open branches of the river, to mark the great excess of mortality in the parishes lying below the high part of Oxford, namely, St. Clement’s, St. Aldate’s, St. Thomas’, and St. Ebbe’s, those parts which at the present moment (March 6) border so closely on the flooded lands, and which on the subsidence of the water are exposed to the vapour produced by the drying of a large tract of meadowland.

The street gutters in the lower part of St. Ebbe’s have little incline, and are often full of drain water: whereas those of the chief part of St. Clement’s, from the natural slope, carry off the fluid matters more rapidly.

Cesspools are exceedingly common, and independently of their unhealthiness under all circumstances in the immediate neighbourhood of houses, there are serious inconveniences from their not being attended to. Thus in one instance the drain-water at times floods the court, and not unfrequently the odours pass up into the confined courts from the imperfection of the drain. In one place there is a kind of small cesspool in the course of a drain, immediately in front of a house-door, only covered by a wooden door: and in another there is a cesspool forming an open pond at the end of a court.

There appears to be great irregularity in the period at which the cesspools are cleaned out, the whole thing being sometimes left almost to chance. The sweeping and cleansing of many courts are also very irregular. In a large number of courts the drain is insufficiently guarded to present smells passing up, or so choked up at times as to prevent things passing down. In one case, the house where fatal fever existed was just opposite a drain of this kind; and of all the things likely to render a court unhealthy, none appears to be more calculated or more common in its occurrence. The court, and even the house, appears to be flooded in some cases with foul water from this cause. At times also a drain passes under a cottage floor or a house cellar, and renders parts of the house almost unbearable.

Too great stress cannot be laid on the necessity of setting the paving and drainage of the courts in good order. Many of the courts are narrow, confined, and hardly admit fresh air; and in others the floor, from being earthen, or full of holes, is soaked with drain water; in such cases the inhabitants cannot get rid of the refuse, are exposed to the most unwholesome smells, and almost destitute of fresh air. In one most ruinous court, the surface drain is stopped up by a post, placed to support part of a falling house. There is great want in most courts of some place to put ashes and solid refuse in: these matters scattered about the court decompose and putrefy, as well as stop up the drain; if collected, they should be frequently and regularly removed.

It is hardly necessary to add to the evidence already existing relative to the anxiety of the poor themselves in many cases for some improvement in the cleanliness and drainage of the courts. Their houses, though often as neglected as their persons, not unfrequently in the dirtiest courts present a clean and tidy appearance, whilst they themselves almost apologize for living in such places, or for not removing when their children die of fever, alledging [sic] their want of means to move or take any dwelling bearing a higher price.
There are some nuisances which the poor complain of heavily, which are kept by some of their own class; lodging-houses for travellers, dog-kennels, and bone-houses.

The lodging-houses seem to receive any body, and the persons so admitted often violate all rules of decency in not availing themselves of the ordinary means of convenience adopted by the inhabitants of the courts; but as the poor people say, “They are here to-day and gone to-morrow, and what hold can be had on them?” Independently of this inconvenience, houses like these should be narrowly watched, not only from the unhealthy crowding of persons in them, but from the probability of contagious diseases commencing in them in consequence of the arrival of travellers in a state of disease.

Dog-kennels were complained of in two places. In one court there was a large heap of refuse, and the other court was dirty.

There are yards in which depositories of bones are kept, bones being of considerable, and, during the last few years of rapidly increasing value; and there is one establishment of this kind on a large scale in St. Thomas’. Such a place must be very unwholesome, and the smell of it was complained of by the neighbours. In addition to bones kept for agricultural purposes, cinder heaps covered and guarded with the greatest care, and small refuse heaps, have been met with in different parts, all kept for farmers. This point is important, as shewing the trouble which persons are willing to take to collect even small quantities of refuse, and is strongly in favour of the more extended use , which might be calculated on for the general mass of refuse collected throughout the town.

There are four things which require being placed under proper regulations in all towns: pigsties, cowsheds, slaughterhouses, and manure repositories. Pigsties of an exceedingly dirty kind are found in some of the back courts and streets. There is a large cowshed in one part where fever existed, and here the annoyance is at times so great that the persons opposite are obliged to close the windows. In another part there is a court with a house, cowshed, and slaughterhouse behind: these are all very clean, but fever prevailed here for two years consecutively.

In one locality there is a large manure-depot, consisting of heaps of refuse of great size and of the foulest kind: this is especially deserving attention, as it is immediately opposite houses, and is one of the most unhealthy localities of Oxford.

One remark may still be added in conclusion — Experience has shewn that great improvement has often been effected in unhealthy courts and streets by mere cleanliness and ventilation; but it has also shewn that the cleansing of drains with the emptying of cess-pools during the occurrence of contagious disease is at times rather an evil than a good, by exposing a large mass of decomposing material to the open air. The time therefore for adopting such measures is limited, and may be considered as terminating at the period when epidemic diseases particularly exist.

During the three years 1844, 45, 46 fever and diarrhœa were fatal in the different quarters of the year to the following number of persons in Oxford:

The mortality from fever began to increase in June, and had become severe in August, in which latter month the deaths from diarrhœa, after having increased considerably in July, rose to 38 per cent. of the sum for the entire year. The period in which any measures attended with the exposure of a large mass of foul or putrid matters are best conducted may therefore be considered as terminating most properly in the month of June.

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