Cholera in Hampstead and spread of disease

THIS IS NOT ABOUT our current plague, the covid19 pandemic, but an earlier one that occurred occasionally in the 19th century. In many countries today, millions of people live with plague and disease and might even accept it as a part of daily life. Fortunately, until recently this was not the case in the UK. However, in the 19th century when diseases and their transmission were less well understood than currently, living conditions in the UK were considerably less healthy than today, disease was rife, and life expectancy was not great. While walking amongst the picturesque steeply sloping back streets of Hampstead village in North London in late November 2020, we spotted a carved stone plaque high on a wall of a house, currently Heathside Preparatory School, on New End (at the point where the street makes a right angle and becomes north-south instead of east-west).

The plaque reads:

“This building was erected by voluntary contributions for a dispensary and soup kitchen. It was intended as a thank-offering to Almighty God for his special mercy in sparing this parish during the visitation of cholera in the year 1849. The site was purchased in 1850 and the building completed in 1853.

He shall deliver thee from the noisome pestilence. Thomas Ainger M.A. incumbent”

As you will discover soon, not everyone in Hampstead was spared from cholera in 1849. One of those, who was afflicted, not in 1849 but five years later, unwittingly made a great contribution to science.

Thomas Ainger (1799-1863), who was born in Whittlesea, Cambridgeshire and studied at Cambridge University, was awarded ‘perpetual curacy’ of St Mary’s Hampstead in 1841, a position he held until his death (http://hampsteadparishchurch.org.uk/data/magazines_2013.php?id=897). He was:

“An energetic parish priest and poor-law guardian; helped to found schools and a dispensary; enlarged his church and promoted the building of new churches in the district around Hampstead.” (https://venn.lib.cam.ac.uk/).

Today, we can have injections that radically reduce the chances of suffering from cholera, but that was not the case back in 1849, when the mechanism by which the disease spreads was not yet understood. One case of the disease that significantly helped to further knowledge of its spread occurred in Hampstead in 1854.

Dr John Snow (1813-1858), who led the way in hygiene and anaesthesia, suspected that cholera was spread via drinking water. He demonstrated that cases of the disease were clustered around particular water sources. During an outbreak of cholera in 1854 in London’s Soho district, which was centred around a pump in Broad Street, now Broadwick Street, he found that by removing the handle from the pump so that the locals could no longer draw their drinking water from there, the local outbreak of cholera was brought to an end. The pump in Broad Street was only three feet away from a leaking cess pit and its water was contaminated by waste matter (www.ph.ucla.edu/epi/snow/broadstreetpump.html). Snow theorised that the cause of cholera was not as previously thought a ‘miasma’ in the air, but something in drinking water. Now, let Stephanie Snow continue the story (International Journal of Epidemiology, 2002; vol.31: pp 908–911):

“In 1849, the London Medical Gazette had suggested that in regard to Snow’s theory, the experimentum crucis [i.e. critical experiment] would be that the water conveyed to a distant locality where cholera had been hitherto unknown produced the disease in all who used it. One of the cholera victims Snow had traced through his Broad Street investigation was a widow who lived in Hampstead. She had a regular delivery of water from the Broad Street pump as she preferred its taste. Her last delivery was made on 31 August and by 2 September, having drunk the water, she had died from cholera. Snow regarded this as ‘the most conclusive’ of circumstances in proving the connection between the water pump and the cholera outbreak.”

The widow had lived at ‘West End’, which until the 19th century was that name of what is now West Hampstead.

The plaque in New End suggests that Hampstead Parish was ‘spared’ from the cholera in 1849. That was almost true. In that year, Hampstead had 8 deaths from cholera per 10,000, whereas many areas of London reported between 100 and 200 deaths from cholera per 10,000 (www.ph.ucla.edu/epi/snow/publichealth118_387_394_2004.pdf). The rate of cholera fatalities in its area was determined by the location of its drinking water supply.  The uppermost rates of deaths from cholera in 1849 were exceedingly high compared with even the highest rates of covid19 infection anywhere in the UK during the second half of 2020.  

John Snow had been alerted to the existence of the widow in Hampstead by Reverend Henry Whitehead (1825-1896), a vicar in London’s Soho district, who was at first sceptical of Snow’s theory of the water-borne transmission of cholera (http://www.ph.ucla.edu/epi/snow/whitehead.html) and favoured the idea that cholera existed as an airborne ‘miasma’. Although Snow and Whitehead differed on their ideas on the transmission of cholera, they decided to work together. Peter Daniell and David Markoff provide more detail (www.choleraandthethames.co.uk/cholera-in-london/cholera-in-soho/) about the widow in Hampstead:

“Whitehead was able to tell Snow about a widow living in Hampstead, who had died of cholera on the …  2nd September [i.e. 1854], and her niece, who lived in Islington, who had succumbed with the same symptoms the following day. Since neither of these women had been near Soho for a long time, it was impossible that they could have contracted the disease through breathing in the polluted air of the area. Intrigued, Dr Snow rode up to Hampstead to interview the widow’s son. He discovered from him that the widow had once lived in Broad Street, and that she had liked the taste of the well-water there so much that she had sent her servant down to Soho every day to bring back a large bottle of it for her by cart. The last bottle of water—which her niece had also drunk from—had been fetched on 31st August, at the very start of the Soho epidemic. This was just the sort of evidence he needed to prove the argument of the miasmatists wrong.”

If we had not noticed the plaque in Hampstead, I doubt that I would have become aware of the West End widow’s role in the unravelling of the method of transmission of cholera. Below the plaque and on the same wall, there is a pink granite object, which looks like a broken drinking fountain. This bears the date ‘1859’, five years after the large outbreak in Soho, and I hope that people did not contract cholera by drinking from it. It was in that year, that Joseph Bazalgette (1819-1891) began his programme of improving London’s sewerage system. This helped to reduce the out breaks of cholera, but there was at least one more in the East End of London in 1866.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s