Daily Life in the Nineteenth Century439epidemic between 1823 and 1926. In that century,
5.5 million Russians contracted cholera and 2.1 million
of them died.
A cholera epidemic of 1831–33 was especially se-
vere. It initially moved from India to Persia to Russia.
The Russian army sent to suppress the Polish revolution
of 1830–31 carried cholera into central Europe. This bio-
logical tax on military action took 1,835 lives in Berlin
(nearly 1 percent of the population) before moving west-
ward. The epidemic reached Glasgow (population
202,000) in February 1832, and before it left, 1.6 percent
of the city had died. When the epidemic struck Paris, it
killed 2.5 percent of the population (19,000 people). If a
catastrophe had that impact on New York City in 1990,
it would kill 183,000 people in ten months.
Such numbers were basic facts of life in the nine-
teenth century. London had 20,000 cholera deaths in
1849–53, chiefly because the city dumped untreated
sewage into the Thames River and collected drinking
water nearby. Between 1853 and 1856, cholera killed
52,000 people in Britain and 140,000 in France, not
counting 18,000 Anglo-French soldiers who died of
cholera during the Crimean War. After an English doc-
tor, John Snow, proved that cholera was spread by con-
taminated water, sewer systems and water filtration
plants spared Britain and France the worst ravages of
later epidemics. This lesson, like smallpox vaccination,
was only accepted slowly, however. Snow’s message
might have prevented the epidemic of 1884–85, which
killed more than 120,000 people in Spain, or the epi-
demic of 1892–93, which ravaged the German port of
Hamburg, killing 8,600 people in a few months (see
table 23.3). A study of the Hamburg epidemic has
highlighted the correlation between social class and
disease: The higher a person’s annual income, the lower
the chance of catching cholera or of dying from it. The
poor died at a rate twelve to thirteen times higher than
the rich did. Both Hamburg and its more affluent sub-
urb of Altona took their water from the same source,
but Altona had a filtration system. Hamburg had a
death rate of 13.4 per thousand; Altona, 2.1. The rich
and famous did die—the composer Peter Tchaikovsky
died later in that same epidemic—but the public health
standards for their neighborhoods spared them much of
the suffering found in cities.Medicine, Public Health, and the Conquest of Disease
In 1800 the medical profession was virtually powerless
to prevent diseases, the foremost exception being Jen-
ner’s smallpox vaccine, announced in 1798. Physicians
had no power over infectious diseases because they did
not know what caused them. They also had limited
ability to control pain or to perform surgery because
they lacked anesthetic drugs. During the vital revolu-
tion of the nineteenth century, those facts changed:
Scientists proved the germ theory of disease transmis-
sion (which led to antiseptic surgery and to the con-
quest of many infectious diseases) and they discovered
effective anesthetics. Nothing in all of modern history
is more important than these facts for the improved
quality of daily life.
The germ theory of disease transmission held that
organisms invisible to the naked eye caused contagiousAnnual income in marks Percentage who Percentage
(1 mark 25¢) Number of people caught cholera who died
800–1,000 28,647 11.4 6.2
1,000–2,000 32,848 10.0 5.5
2,000–3,500 14,544 4.7 2.7
3,500–5,000 6,125 4.0 2.2
5,000–10,000 5,649 3.1 1.6
10,000–25,000 3,328 1.8 1.0
25,000–50,000 1,182 1.7 1.1
50,000 834 0.6 0.5
Source: Richard J. Evans, Death in Hamburg(Oxford: Oxford University Press, 1987), p. 408. Used by permission of the publisher.TABLE 23.3The Hamburg Cholera Epidemic of 1892