Responses to cholera

We now know that cholera is a bacterial infection spread through contaminated food or water. Human waste could enter drinking-water supplies in overcrowded industrial towns. However, early nineteenth-century responses were shaped by uncertainty about its cause, rather than this modern understanding.

Religious and moral responses

Many people believed cholera was a punishment from God. Religious responses therefore aimed to obtain forgiveness, not to remove contamination from water. The king proclaimed a national day of fasting and humiliation on 21 March 1832, asking people to humble themselves before God and seek pardon for their sins. Special prayers were also used in churches and chapels.

These responses showed continuity with earlier reactions to epidemics: people still understood disease partly through religion and moral behaviour. Authorities also warned against drunkenness. In Oxford in 1832, notices cautioned people attending St Giles’ Fair against drinking, revelling and crowded gatherings. Such advice promoted temperance, but it did not identify the actual cause of cholera.

Trying to remove ‘bad air’

The most widely accepted explanation was miasma theory: the idea that poisonous, foul-smelling air caused disease. Cholera often appeared in dirty neighbourhoods with open drains and accumulated waste, so the association between bad smells and illness seemed convincing.

Responses followed this reasoning. Barrels of tar were burned in the streets of Exeter to purify the air. Elsewhere, people paid to have rubbish removed. In Oxford, a July 1832 leaflet urged residents of narrow courts and alleys to whitewash their houses and use freely distributed lime to remove foul smells. Chloride of lime was purchased and distributed through parish authorities as a disinfectant.

These actions were not all equally useful. Burning tar did not stop people drinking contaminated water. Removing waste could improve surroundings, but concentrating on smells meant that the danger in an apparently ordinary water supply could still be overlooked. A cleaner smell was not proof of safe drinking water.

Remedies and organised local action

Fear also created demand for treatments. Newspapers and notices recommended herbal remedies, keeping warm and avoiding alcohol. Patent medicines promised cures, while poultices applied to the skin and tinctures swallowed or rubbed onto the body were common treatments. These did not provide a reliable cure for cholera.

Government action extended beyond advice to individuals. Towns were encouraged to establish local boards of health, although this was voluntary rather than universally enforced. Boards monitored outbreaks and printed advice posters. This represented some movement away from laissez-faire, but action remained uneven between places.

Oxford’s response in 1832 shows what local organisation could involve. Its Board of Health arranged a temporary hospital at Pepper Hill and a recovery house at Bartlemas in Cowley. A House of Observation in St Aldates offered somewhere for people considered at risk to stay while their homes were fumigated.

These measures provided organised care and temporary accommodation, rather than leaving every household to cope alone. Nevertheless, fumigation still reflected concern about dangerous air. Oxford recorded 184 cases, with a mortality rate of 52%: substantial local activity did not mean that the disease was understood or controlled successfully.

John Snow: investigating water rather than smells

John Snow, a London doctor, challenged the prevailing explanation. After the 1848 epidemic, he published his argument that cholera spread through water in On the Mode of Communication of Cholera. His ideas met resistance because miasma theory remained influential.

During the 1854 outbreak in Soho, Snow investigated deaths by visiting households and mapping where victims had lived. Many had obtained water from the Broad Street pump. The important step was not simply spotting a cluster of deaths: he investigated what linked the people affected.

Contrasting cases strengthened his explanation. Workers at a nearby brewery, who drank beer rather than pump water, escaped the outbreak. A woman living outside the neighbourhood died after water from the Broad Street pump was sent to her because she liked its taste. These cases suggested that drinking the water mattered more than breathing the neighbourhood’s air.

Snow persuaded the local authorities to remove the pump handle, preventing further use of that supply. A nearby leaking cesspit was later identified as the source of contamination. His investigation offered a practical response aimed at the route of transmission, rather than at smells or supposed sinful behaviour.

What changed—and what persisted?

Responses to cholera combined old beliefs with new methods. Prayer, fasting and moral warnings continued, while miasma theory directed much cleaning and disinfection. At the same time, local boards organised advice and care, and Snow used patterns of illness and comparisons between groups to challenge accepted explanations.

Urbanisation made contaminated supplies especially dangerous because many people depended on shared water sources. Wealth and poverty also shaped responses: paid rubbish removal required money, whereas Oxford’s free lime distribution and temporary accommodation provided assistance beyond what households could buy themselves. Cholera encouraged greater public action, but scientific evidence did not immediately replace established beliefs.