England and Ireland, then jumped the Atlantic to North America. Again, tens of thousands died.
Drink up
We now know something that nineteenth-century people did not: cholera is spread by contaminated water. A look at living conditions in that era helps explain cholera’s global reach. In England, for example, the population was at an all-time high. People were pouring in from the countryside to towns and cities in search of higher wages. Thousands of workers were jammed into cramped, dark, poorly ventilated housing. Why dark? Since 1696, the Window Tax imposed a duty on dwellings with more than six windows. Clear glass was a luxury. To show off theirwealth, the super-rich demanded homes with as many windows as structurally possible. Landlords, on the other hand, and even some members of the middle class, installed few windows. They even bricked over windows in some buildings to stay below the taxable number. People rarely washed their hands in those days, and in their gloomy, stuffy homes, they couldn’t see well enough to clean.
Sanitation was inadequate to nonexistent. Although flush toilets had been used in England since at least the sixteenth century (Queen Elizabeth I got hers in 1597), most human waste was disposed of in pit outhouses. A landlord might provide one over-burdened, rarely emptied privy to serve thirty families. When it overflowed, fecal matter was deposited elsewhere: in cellars, in ditches, or in the street. In London, human waste would eventually end up draining into the Thames River, a malodorous sewer nicknamed “the Big Stink” that was also the final repository of butchers’ offal, tannery effluent, and household garbage. It was the city’s main source of drinking water.
Under such conditions, disease was rampant. Aside from cholera, people suffered from “summer diarrhea” and epidemics of waterborne typhoid, lice-borne typhus, tuberculosis, influenza, and more. People died at rates not seen since the Black Death. Cities needed a continuous flow of new people from the relatively healthy countryside just to keep their population level. No wonder large families were encouraged.
Death rates were highest among the poor. They ate bad food and got little of it. They lived in small, poorly constructed, hard-to-heat dwellings awash in human waste. They wore the theadbare castoffs of their betters. Ill-fed, ill-housed, and ill-clothed, their immune systems compromised, it is no wonder the poor died young. Britain’s upper classes assured themselves that this grotesque disparity was divinely ordained. Poverty was not an economic or social problem but a spiritual condition, a punishment for sin. With the passage of the 1832 Anatomy Act, poverty also became, in effect, a crime. Postmortem dissection by surgeons, anatomists, and medical students, formerly a punishment inflicted only on the very worst condemned criminals, now became instead the fate of paupers unable to pay for their own burials. The Poor Law Amendment of 1834 tightened the noose, outlawing cash charity to the unemployed poor and forcing them into the prison-like workhouse—even orphans, the elderly, and the disabled.
Edwin Chadwick, a reforming civil servant, documented the conditions affecting the poor with his
Report on the Sanitary Condition of the Labouring Population of Great Britain,
presented to Parliament in 1842. Chadwick asserted that the squalid existence of Britain’s poor was involuntary. He compared it unfavorably to American slavery. Chadwick also revealed that country people lived longer than townsfolk. In a city like Leeds, laborers could expect to die, on average, at age seventeen. Tradesmen died in their mid-twenties. Even the privileged gentry usually survived only into their forties. You might make more money in a city, but you wouldn’t live long to enjoy it.
Next they’ll want health insurance
Chadwick, who lived to be ninety, thought this a waste. He was an advocate of utilitarianism, the belief that
Learning to Kill: Stories