1533. During the same time Gateshead with a population of 26,000, had 433

deaths, or in a ratio nearly equal to that of Newcastle. On the other hand Tynemouth, with a population of 30,000, had only twelve deaths, several of them in vagrants or other arrivals from Newcastle, the rest in a cluster of pitmen’s cottages on the outskirts of North Shields. It was freely rumoured at the time, and was even repeated with much unction in so dry and deliberate a work as the report of the Registrar-General, that the cholera at Newcastle and Gateshead in September, 1853, was owing to the sudden contamination of the town’s water with sewage. The facts about the water-supply are as follows: Previous to 1848, Newcastle was supplied with Tyne water pumped up at Elswick, and passed through the settling tanks and filtering beds. In 1848 the Whittle Dean Water Company, incorporated in 1845, had their new supply ready, and the old company, with its pumping station at Elswick, was superseded. The new supply was collected from landward sources, and was apt to be peaty. There was a great demand upon it, especially for public works (it was supplied to comparatively few houses), so that the distribution in 1853 had increased 2½ times since the company began in 1848. They had extended their collecting area to meet this demand; but, owing probably to the drought, they found it necessary on the 6th of July, 1853, to resort to the old pumping-station at Elswick for about a third part of all the water that flowed daily through the mains. This had gone on for eight weeks before the epidemic began, and was promptly discontinued on 15 September, as soon as the possible danger from Tyne water was realized. The pumping-station was higher up the river than the only one of the Newcastle sewers that discharged in its vicinity. There were complaints about the water, but these appear to have been chiefly of the peaty colour or flavour, which came from the Whittle Dean part of the mixture. The water from the mains was not equally bad at all points, as if the suspected contamination might have occurred in its transit through the town. Also the water of some wells was complained of as offensive at the same time, which was the season of the year when the springs are lowest. Gateshead was also supplied by the mains of the Whittle Dean Company. It is clear from the report of the Commissioners that they considered the water of Newcastle and Gateshead to have been a very subordinate factor, if a factor at all, in the epidemic of cholera. The Cholera of 1854 in England. The great epidemic at Newcastle and Gateshead was over by November, 1853, those towns having no share in the general epidemic in England in 1854, although it visited their near neighbour Tynemouth. The interest of the cholera of 1854 centres chiefly in London[1565]. Few of the great foci of infection in 1849 were visited severely. Liverpool, which never escaped, had a moderate epidemic, Merthyr Tydvil also had about a fourth part of its 1849 mortality, Dudley had the disease somewhat severely, while some towns, such as Norwich, Wisbech and Sheffield, had more than usual. But Plymouth, Hull, Bristol, Manchester, Leeds, the towns of the Black Country and nearly all the populous places that had suffered heavily either in 1832 or in 1849, or on both occasions, escaped in 1854 with little cholera or none[1566]. The table shows the incidence of the epidemic (as well as that of 1866) according to counties. _Cholera Mortality in England and Wales in 1854 and 1866._ 1854 1866 Rate Rate per per Deaths 1000 Deaths 1000 England and Wales 20097 14378 ----------------------------------------------- London 10738 4·3 5596 1·9 Surrey, part of 252 1·2 82 Kent, part of 1056 2·1 284 Sussex 94 ·3 79 Hampshire 130 ·3 417 ·9 Berkshire 49 ·2 3 Middlesex, part of 380 2·4 51 Hertfordshire 97 ·5 9 Buckinghamshire 68 ·5 10 Oxfordshire 183 1·0 4 Northamptonshire 152 ·7 7 Huntingdonshire 18 ·3 1 Bedfordshire 61 ·4 22 Cambridgeshire 270 1·3 7 Essex 513 1·4 471 1·0 Suffolk 67 ·2 15 Norfolk 381 ·8 15 Wiltshire 60 ·2 11 Dorset 45 ·2 6 Devon 188 ·3 525 ·9 Cornwall 24 ·06 21 Somerset 21 ·04 68 Gloucestershire 260 ·6 39 Herefordshire 1 ·01 2 Shropshire 13 ·05 17 Staffordshire 426 ·6 30 Worcestershire 103 ·4 36 Warwickshire 89 ·2 15 Leicestershire 14 ·06 3 Rutlandshire 9 ·08 -- Lincolnshire 134 ·3 48 Nottinghamshire 80 ·3 1 Derbyshire 17 ·06 20 Cheshire 141 ·3 391 Lancashire 1775 ·8 2600 1·0 West Riding 470 ·3 283 East Riding 70 ·3 54 North Riding 84 ·4 21 Durham[1567] 2·9 352 ·6 Northumberland[1568] 5·7 224 Cumberland 35 ·2 32 Westmoreland 1 ·02 1 Monmouth 18 ·1 204 South Wales 887 1·4 2033 2·9 North Wales 34 ·08 256 Principal centres in each county 1854 1866 England and Wales London South of Thames, Eastern Eastern parishes 3691 parishes Surrey, part of Kent, part of Sussex Hampshire Portsea Island 20, Portsea Island 129, Southampton 48 Southampton 41 Berkshire Middlesex, part of Brentford 196 Hertfordshire Buckinghamshire Oxfordshire Northamptonshire Towcester 86 Huntingdonshire Bedfordshire Cambridgeshire Wisbech 176, Ely 46 Essex West Ham 124, Romford West Ham 389 113, Maldon 102 Suffolk Norfolk Norwich 193, Yarmouth 41 Wiltshire Dorset Devon Plymouth 59, Stonehouse Exeter and St Thomas 247, 15, Devonport 2, Newton Abbot 57, Bideford 46 Totnes 146 Cornwall Somerset Gloucestershire Bristol 76, Clifton 92, Gloucester 48 Herefordshire Shropshire Staffordshire Dudley 256, Wolverhampton 80 Worcestershire Worcester 45 Warwickshire Leicestershire Rutlandshire Lincolnshire Great Grimsby 68 Nottinghamshire Worksop 27, Nottingham 16 Derbyshire Cheshire Chester Lancashire Liverpool 1084, W. Derby Liverpool and W. Derby 206, Wigan 158 2122, Wigan 137 West Riding Sheffield 126, Dewsbury 66, Leeds 48 East Riding Hull 27 North Riding Whitby 33, Guisboro’ 30 Durham Stockton, Auckland, Durham Northumberland Newcastle 1431, Gateshead 525, Tynemouth 203 Cumberland Westmoreland Monmouth South Wales Merthyr Tydvil 455, Swansea 521, Neath 520, Cardiff 255, Neath 54, Llanelly 232, Merthyr Brecon 54 Tydvil 229 North Wales The London cholera of 1854, like that of 1832 and of 1849, fell most upon the southern (Southwark etc.), eastern and southeastern parishes (Table, p. 858). But it fell somewhat unequally upon these; and for Southwark and Lambeth the water supply was seized upon as the thing that made the difference. There were two water companies in South London, the Lambeth company and the Southwark and Vauxhall company. The parish of Christ Church, Lambeth, chiefly supplied by the Lambeth company, had a death-rate from cholera in 1854 of only 0·43 per 1000 inhabitants; whereas the parish of St Saviour, supplied by the Southwark and Vauxhall company, had a death-rate of 2·27 per 1000. In 1849 there had been no such disparity between them, the death-rate of Christ Church being if anything the higher of the two. Now it happened that in the interval of the two epidemics of cholera the Lambeth company had removed their intake works from opposite Hungerford Market to Thames Ditton, whilst the Southwark and Vauxhall company still continued to draw their supply from the Thames near Vauxhall. Here was a fine instance of the logical method of difference. Farther, within the parish of Christ Church itself, it was sought to show that the cholera followed the lines of old water supplies, and did not follow the mains from Thames Ditton. After 1854 the Southwark and Vauxhall company also made their intake at Thames Ditton. According to the water-hypothesis of cholera, it is not surprising, as we shall duly find, that the whole of the South London parishes, which had been the chief seats of the cholera in 1832, 1849, and 1854, escaped in 1866 with a very slight visitation. Newcastle was another chosen instance of cholera distributed by the water mains; but, as we have seen, that was improbable. Another instance was Exeter: its water supply in 1832, when part of it had a disastrous epidemic of cholera, was taken from the Exe, and was impure; in 1849, when it had only a tenth part of its last cholera mortality, its water supply had been greatly improved; in 1854 it had 10 deaths; but in 1866, Exeter with the registration district of St Thomas had 247 deaths, and Totnes had 146,--for their size about the most severely visited towns in England. In the London cholera of 1854 a very sudden and simultaneous explosion in the district of Soho attracted much notice[1569]. The district stands high, which did not save it from being the scene of the first outbreak in the great plague of 1665. In the subdistricts of St Anne, Golden Square and Berwick Street, with a population of 42,000, many of them well-to-do families, there were 537 deaths from cholera, a rate of 12·8 per 1000, contrasting with the rate of 6 per 1000 for all London. The attacks and fatalities were remarkably numerous for one or two days, falling at once thereafter to about a half. There was a pump in Broad Street, in the centre of this district, which was supposed to have dispersed cholera broadcast in its contaminated water; a death had occurred in Swain’s Lane, at the foot of Highgate Hill, of a person who had drank the water of the Broad Street pump. The whole incident was seized upon and worked up by Dr Snow, who had written a speculative essay in 1849 upon the probability of cholera being conveyed by water, according to the similar theory of Parkin in 1832[1570]. The Board of Health, having very full data before them of the Soho outbreak in all its aspects (including a whole biological treatise upon the organisms found in water), did not adopt Snow’s conclusion, although he had enthusiastic followers at the time, and has probably more now[1571]: “In explanation of the remarkable intensity of this outbreak within very definite limits, it has been suggested by Dr Snow that the real cause of whatever was peculiar in the case lay in the general use of one particular well, situate at Broad Street in the middle of the district, and having (it was imagined) its waters contaminated by the rice-water evacuations of cholera patients. After careful inquiry we see no reason to adopt this belief. We do not find it established that the water was contaminated in the manner alleged; nor is there before us any sufficient evidence to show whether inhabitants of the district, drinking from that well, suffered in proportion more than other inhabitants of the district who drank from other sources.” The Cholera of 1853-54 in Scotland and Ireland. The cholera of 1853-54 in Scotland has not been so fully recorded as either of the two preceding epidemics. It is said to have caused about six thousand deaths, of which 3892 were in Glasgow alone, and a considerable part of the remainder in Edinburgh and Dundee. The infection began to appear in the end of September, having been derived probably from the dreadful explosion at Newcastle. A few early cases occurred at Dunse, in Berwickshire. On the 16th September, 1853, the old Cholera Hospital at Edinburgh, in Surgeons’ Square, was opened, but received only 45 cases until the beginning of June, 1854, when it was closed. In the autumn of 1854 the real epidemic began, the hospital being re-opened on 24th August, from which date until the 30th November the admissions were 198. These hospital figures indicate for Edinburgh a milder epidemic than that of the winter of 1848, which was itself milder than that of 1832. The cases came mostly from the very same localities of the old town as in 1848. There were 145 females to 97 males; the deaths were 117 in 243 cases admitted[1572]. The epidemic at Dundee was a late autumnal or winter one, in the end of 1853, and of great severity, the mortality having probably exceeded 500. The Glasgow epidemic had a course very nearly parallel to that of 1832, and quite unlike the extraordinary winter explosion of 1848-9. It began, indeed, in winter--about the 15th of December, 1853, and had caused 849 deaths to the 27th of February; there was a sharp rise of the mortality from the 13th to the 24th of March, the total deaths to that date being