King Cholera ......... stories of Public Health

I have been reflecting on those awful diseases that stalked our cities, towns and villages just over 170 years ago.

Of these Cholera was regarded by many as the worst and was often referred to as “Deadly” or “King Cholera” It is an infection caused by contaminated food and water. The main symptoms are diarrhoea and vomiting, and if untreated will continue until the patient becomes severely dehydrated. In the final stages a cholera victim will bring up what was called rice water and is almost clear liquid with fishy smell and resemble living skeletons.

Its impact was always going to be worst in the overcrowded and unsanitary parts of the city where large numbers were crowded together in back to back housing and narrow enclosed courts.

Span Court off Artillery Street is a fine example of a court and survived into the 1960s.

There are vivid descriptions of these places in the 1840s by writers like Frederick Engels, Leon Faucher and Dr Kay, as well as official reports.

The Report of the General Board of Health on the Epidemic Cholera of 1848 & 1849, drew attention to the fact that in the Market Street district of Manchester half the cases of Cholera were from the inhabitants of courts and cellar dwellings, which were in close proximity to open privies where the water supply was of a “poor quality” often served several cottages and was generally only “turned on for an hour day”

More revealing are the case notes of Dr Henry Gaulter who experienced the first outbreak of Cholera during the May to December of 1832. He kept a detailed record of the first three hundred patients he attended describing their physical condition, the onset of the disease and their living conditions but was forced to abandon the exercise as the numbers increased.

 Here are the fit, not so fit and in many cases undernourished residents of streets which were overcrowded and dirty, like Martha Chorlton aged 57 of 10 John Street Ancoats, who lived in a “locality, crowding, filth, &c. Street in a very populous and poor neighbourhood.”*

Or Thomas Cavanagh aged 5 and his mother Elizabeth who lived at 5 Wakefield-street Little Ireland which “fronted an open area but an impure stream whose channel does the function of a sewer, passes by the door to adjoining field where it collects and stagnates: house and inhabitants very filthy: three children and two adults on a straw bed.” 

And so it goes on but not all the streets were dirty and not all those who would contract the disease were poor. The rich had servants who may have had relatives in the more depressed parts of the city and might walk the disease in by the servant’s entrance.

Nor should we forget that the wealthy often lived in close proximity to run down areas. So that very posh set of late 18th century houses on St John Street off Deansgate was just  next door to Spam Court and surrounded by roads where there was overcrowding and Cholera.

Perhaps also we should be careful not to over state the impact of the disease on the city. There were just over 142,000 people in the city of which according to Gaulter 1,325 died.  But then there is the danger of falling into that callous numbers game which judges deaths in terms of statistics while for the individual just one death is a tragedy.

And the chances were that for those who contracted it death was a pretty strong out come. So for those who caught Cholera in Manchester over 50% would die while in Chorlton on Medlock the figure was 38% and in Salford 30%. These are not odds that I would fancy.

Nor I think should we feel that it was just the cities and towns that suffered. Rural areas were equally unsanitary and diseases like typhus and typhoid were according to the Poor Law Commissioners real threats in the countryside.

Which of course brings us to Chorlton, and in the next few weeks I shall be reporting on child mortality, sickness and public health in our own township but in the meantime I am happy to say that the worst is over here on Beech Road.

Picture; Span Court, south side of Artillery Street, J.Ryder, 1965 m00211, courtesy of Manchester Libraries, Information and Archives, Manchester City Council, http://images.manchester.gov.uk/index.php?session=pass & New Wakefield Street, Little Ireland today from the collection of Andrew Simpson

 Sources, Gaulter Henry, The Origin and Progress of the Malignant Cholera, 1833, London, & Appendix A, To the Report of the General Board of Health on the Epidemic Cholera of 1848 & 1849, 1850, London

* Gaulter

“that plague has entered almost every house in the village which contains children.”

The April and May of 1886 were anxious times for any in the township with children for we were in the grip of a measles epidemic.

This according to one resident “has been ranging for many weeks now” with the result that “between two hundred and three hundred of our children have been attacked and five or six have died.”*

And the issue was bound up with bigger concerns of the general lack of sanitation and the tardiness of the public health authorities to act in the face of the epidemic

There had been growing disquiet about the high level of pollution in Chorlton Brook since at least 1875 with the local board a decade later commenting that it “is being constantly polluted with the sewage and other liquid refuse of several large manufacturing towns” and “emits most noxious odours and offensive gases which pollute the air.”**

And in 1881 a government inquiry called for the closing of the parish churchyard because the place was not only full but in an effort to accommodate more bodies, the authorities had resorted to removing some and burying others within 22 inches of the surface.  Added to this there was the assertion that there “were a great number of houses here which are jerry built... and one or two spots where hollow places have been filled up with stuff which is nothing more than night soil.”

Here then was a real threat to public health made worse by the unwillingness of the authorities to close the schools during the epidemic with the result “that the plague has entered almost every house in the village which contains children.”

Of course the authorities and medical opinion sought to argue an alternative picture.  It was said by Dr Rains that the epidemic was “now passing away” and “the death rate has been very small.”

And at the heart of the rebuttal was the plain fact that “The death rate varies, as we all know, in the different townships, but the rate per 1,000 in different townships of children under five years of age in 1885 was as follows, Withington 3.3, Didsbury, 4.3, Chorlton-cum-Hardy 3.2 Burnage 5.5 showing very much in favour of Chorlton.”

But then there are statistics and dammed statistics, and when the figures are viewed over a longer period there may well have been less room for complacency.  Taking the years from 1881-4 together and comparing the death rate across the townships Chorlton recorded the highest deaths of under fives per thousand of the population.

But measles is not caused by poor sanitation.  And in the absence of hard evidence about the state of housing conditons it is difficult to draw a conclusion about the general threat to public health.

By the 1880s there were only six houses left which were wattle and daub which one Parliamentary Committee had argued were often no better than hovels.  True there were plenty of brick built cottages which were just one up one down and many that predated 1840 and there was still overcrowding in some of them.  But Dr Rains maintained that “the main drainage of the place being very good, that all dwellings are connected therewith, under the superintendence if the surveyor to the Local Board.”

Nor if he can be believed was there any evidence of Typhoid during the period which along with Cholera is a bed fellow of unsanitary conditions.

So despite the concerns over the smelly brook and the odd set of bones on the highway perhaps he was right when he asserted that people wanting to settle here could be confident that Chorlton was “more healthy than most others round Manchester whatever their elevation may be.”  And he had come “here for the good of my health in June 1868.”

Of course I might yet be proved wrong.  But then that is the fun of history. You do the research, draw the conclusions, write what you think and then something new pops up.  Well we shall see.

Location; Chorlton, Manchester

Pictures; extracts from the Manchester Guardian, 1885

*Samuel Norbury Williams, letter to the Manchester Guardian May 17th 1886.

**Pollution of streams in the Withington District, Manchester Guardian September 12 1885

Ours was a young community.... stories of Public Health

I think it must be the oldest picture of Chorlton children in the collection and I guess it was taken at the old school on the green. 

Even so when it was taken child mortality had improved and these youngsters could expect to survive into adulthood. 

But fifty or so years earlier it would have been a different story.  Despite the fact that ours was a young community with children out numbering all other age groups they were vulnerable to many different illnesses.  Amongst the very young in the warm weather they were prey to diarrhoeal infections and in late winter and early spring from respiratory ailments while school children could die from diphtheria and scarlet fever.  Added this all of them might be prone to mumps, skin diseases, sore throats chicken pox, coughs, colds, bronchitis and influenza.  So during the first half of the 19^th century of the 27 children under the age of two who died during this period 18 succumbed in the warm or hot months.

You first get a sense of this by trawling the census returns and looking for the missing children who didn’t make from the 1841 to the next ten years later and then there are the parish burial records which detail young lives caught short.

But it is the parish gravestones which more than any document brings you face to face with the awful sadness of child mortality.  William Chessyre was a month old when he was buried in 1831, Mary Bell Whitelegg and John Gresty just 3 months and William Cardrew Birley son of the Reverend William Birley and his wife Maria only five months.  Some families were unluckier than others.  The Holland’s lost three of their children between 1840 and 1841 and James Gresty buried his two young sons and his wife in just a year. *

Such events were common enough in both rural and urban settings and were partly at least due to the quality of drinking water which in our case was getting worse as the 19^th century wore on, so that by the 1880s most of our wells had according to one observer either dried up or were contaminated. 

Opposite; % of child burials in the parish church by age from 1800-1850

But in 1864 the first pipe bringing in mains water from Manchester was laid and a decade later the sewage works had been opened south of the village on the Mersey.  Not that this was all progress.

There were complaints about the state of both Chorlton and Longford Brooks which according to one newspaper were akin to open sewers and well into the 1880s there were hot spots of measles in the township.

All of which I suppose goes a little way to burst that rural rosy picture that some historians fall back on as the way things were in the country.

Location; Chorlton

Pictures; school children from the Lloyd collection, undated, gravestone, from the Parish church yard, 2011, from the collection of Andrew Simpson

Looking for our memorial to Manchester’s Cholera deaths

Now I may well have missed it, but I don’t think we have a memorial to those who perished in the great Cholera outbreak of 1832.

The Cholera Monument, Sheffield, 2006

And I say that because today I came across Sheffield’s monument to its Cholera victims, which stands just a bit west of the railway station, situated in grounds that were laid out in 1850, fifteen years after the monument was completed and seventeen years after the epidemic which killed 402 people.

402 victims of the disease were buried in grounds between Park Hill and Norfolk Park adjoining Clay Wood. Money from the treasurers of the Board of Health was set aside for a monument for the site.

Cholera was regarded by many as the worst of the killer diseases that swept through our towns and cities in the 19th century.

It was often referred to as “Deadly” or “King Cholera” and is an infection caused by contaminated food and water.

The main symptoms are diarrhea and vomiting, and if untreated will continue until the patient becomes severely dehydrated. In the final stages a cholera victim will bring up what was called rice water and is almost clear liquid with fishy smell and resemble living skeletons.

Its impact was always going to be worst in the overcrowded and unsanitary parts of the city where large numbers were crowded together in back to back housing and narrow enclosed courts.

New Wakefield Street, 2004

There are vivid descriptions of these places in the 1840s by writers like Frederick Engels, Leon Faucher and Dr Kay, as well as official reports.

The Report of the General Board of Health on the Epidemic Cholera of 1848 & 1849, drew attention to the fact that in the Market Street district of Manchester half the cases of Cholera were from the inhabitants of courts and cellar dwellings, which were in close proximity to open privies where the water supply was of a “poor quality” often served several cottages and was generally only “turned on for an hour day”.

More revealing is the case notes of Dr Henry Gaulter who experienced the first outbreak of Cholera during the May to December of 1832. He kept a detailed record of the first three hundred patients he attended describing their physical condition, the onset of the disease and their living conditions but was forced to abandon the exercise as the numbers increased.

Little Ireland, 1844

 Here is the fit, not so fit and in many cases undernourished residents of streets which were overcrowded and dirty, like Martha Chorlton aged 57 of 10 John Street Ancoats, who lived in a “locality, crowding, filth, &c. Street in a very populous and poor neighbourhood.” *

Or Thomas Cavanagh aged 5 and his mother Elizabeth who lived at 5 Wakefield-street Little Ireland which “fronted an open area but an impure stream whose channel does the function of a sewer, passes by the door to adjoining field where it collects and stagnates: house and inhabitants very filthy: three children and two adults on a straw bed.”

And so, it goes on but not all the streets were dirty and not all those who would contract the disease were poor.

The rich had servants who may have had relatives in the more depressed parts of the city and might walk the disease in by the servant’s entrance.

Span Court, 1965

Nor should we forget that the wealthy often lived near run down areas. So that very posh set of late 18th century houses on St John Street off Deansgate was just next door to Span Court and surrounded by roads where there was overcrowding and Cholera.

Perhaps also we should be careful not to overstate the impact of the disease on the city.

There were just over 142,000 people in the city of which according to Gaulter 1,325 died.  But then there is the danger of falling into that callous numbers game which judges deaths in terms of statistics while for the individual just one death is a tragedy.

And the chances were that for those who contracted it death was a pretty strong outcome. So, for those who caught Cholera in Manchester over 50% would die while in Chorlton on Medlock the figure was 38% and in Salford 30%. These are not odds that I would fancy.

Nor I think should we feel that it was just the cities and towns that suffered. Rural areas were equally unsanitary and diseases like typhus and typhoid were according to the Poor Law Commissioners real threats in the countryside.

So where are Manchester’s memorials.?  I can think of the inscription on the foot of the cross in St John’s Gardens, and the plaque in St Michael’s Fields in Angel Meadow, but I am stumped as to a specific Cholera one.

That said I bet there is, and someone will tell me.

I hope so.

Picture; Cholera Monument, Sheffield, Gregory Deryckère, 2006,** New Wakefield Street, Little Ireland 2004, from the collection of Andrew Simpson,Little Ireland, 1844, from the OS of Manchester & Salford, 1844, courtesy of Digital Archives Association, http://digitalarchives.co.uk/  and Span Court, south side of Artillery Street, J. Ryder, 1965 m00211, courtesy of Manchester Libraries, Information and Archives, Manchester City Council, http://images.manchester.gov.uk/index.php?session=pass 

 *Gaulter Henry, The Origin and Progress of the Malignant Cholera, 1833, London, & Appendix A, To the Report of the General Board of Health on the Epidemic Cholera of 1848 & 1849, 1850, London

**Gregory Deryckère, permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License, Version 1.2 or any later version published by the Free Software Foundation