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Cholera
History
In the 19th century cholera became the world's first truly global disease in a series of epidemics that proved to be a watershed for the history of plumbing. Festering along the Ganges River in India for centuries, the disease broke out in Calcutta in 1817.
India's traditional, great Kumbh festival at Hardwar in the Upper Ganges triggered the outbreak. The festival lasts three months, drawing pilgrims from all over the country. Those from the Lower Bengal brought the disease with them as they shared the polluted water of the Ganges and the open, crowded camps on its banks.
When the festival was over, they carried cholera back to their homes in other parts of India. Cholera raged along the trade routes to Iran, Baku and Astrakhan and up the Volga into Russia, where merchants gathered for the great autumn fair in Nijni-Novgorod. When the merchants went back to their homes in inner Russia and Europe, the disease went along with them.
Cholera sailed from port to port, the germ making headway in contaminated kegs of water or in the excrement of infected victims, and transmitted by travelers. The world was getting smaller thanks to steam-powered trains and ships, but living conditions were slow to improve. By 1827 cholera had become the most feared disease of the century.
Symptoms and Signs
The disease is stunning in its rapidity. The onset of extreme diarrhea, sharp muscular cramps, vomiting and fever, and then death - all can transpire within 12-48 hours.
Acute dehydration turns victims into wizened caricatures their former selves. The skin becomes black and blue, the hands and feet drawn and puckered. The German poet Heinrich Heine described an outbreak in Paris in a letter to a friend: "A masked ball in progress ... suddenly the gayest of the harlequins collapsed, cold in the limbs, and underneath his mask, violet blue in the face. Laughter died out, dancing ceased and in a short while carriage-loads of people hurried from the Hotel Dieu to die, and to prevent a panic among the patients were thrust into rude graves in their dominoes [long, hooded capes worn with a half-mask). Soon the public halls were filled with dead bodies, sewed in sacks for want of coffins ... long lines of hearses stood in queue..."
Etiology and Epidemiology
We know cholera is caused by ingesting water, food or any other material contaminated by the feces of a cholera victim Casual contact with a contaminated chamberpot, soiled clothing or bedding, etc., might be all that's required.
The worldwide cholera epidemic was aided by the Industrial Revolution and the accompanying growth of urban tenements and slums. There was little or no provision at all for cesspools or fresh water supplies. Tenements rose several stories high, but cesspools were only on the ground floor with no clear access to sewers or indoor running water. In most cases, barrels filled with excrement were discharged outside, or contents of chamber pots flung from open windows - if there were any - to the streets below. Epidemiologists finally discovered the link between sanitation and public health, which provided the impetus for modem water and sewage systems.
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