Cholera is a particularly nasty disease. Its main symptoms are profuse watery diarrhea and vomiting. Rapid loss of bodily fluids can lead to dehydration and shock. Without treatment, especially the replenishment of fluids, death can occur within hours of the symptoms appearing. Tales abound of victims who wake up in the morning full of vigor but are dead by nightfall.
The primary cause of cholera is contamination of drinking water by a bacterium that thrives in human feces. Cholera epidemics used to be common in the U.S. during and prior to the 19th century, before our modern sanitation systems were developed. Former U.S. President James Polk is among many famous people thought to have perished from cholera. Prior to modern plumbing, medieval kings and queens were no more protected against cholera’s scourge than peasants.
Many of you who have spent time in Europe no doubt have visited some of the imposing medieval castles that dot its landscape. You may have taken note of the little anterooms that served as privies, with openings to the outside through which human waste was deposited in the surrounding moat. Think of how foul those moats must have smelled to the royals and their courts living within the walls. (On a positive note, their foul content at least made invaders hesitant about trying to breach those otherwise unimposing water barriers!)
As the industrial revolution unfolded in Europe and America, cities became overcrowded, unsanitary hellholes. The English colloquial term for a privy, “loo,” supposedly arose from a mispronunciation of the French expression, gardez l’eau (“watch out for the water”), which was the customary warning of tenement dwellers as they emptied their chamber pots on the streets outside.
A breakthrough in the elimination of cholera from advanced societies occurred in 1854, when an English physician, John Snow, traced a local epidemic in London to a public water pump that had been installed near an old cesspit. He deduced the association between cholera and contaminated water. A few years later Louis Pasteur published his germ theory of disease, which pinpointed bacteria as the cause of many ailments. It took several decades to become widely accepted, but by the 1870s public health official finally understood the implications and began to build sanitation systems in cities throughout the U.S. and other advanced countries. This spawned our modern plumbing industry.
Cholera outbreaks still routinely occur in underdeveloped nations throughout the world. The World Health Organization estimates that cholera causes 3-5 million deaths a year around the globe, though nobody knows for sure because it occurs mainly in places with poor public health reporting networks.
Here is how it was summed up by a great medical researcher, the late Dr. Lewis Thomas, writing in the Spring 1984 edition of the journal Foreign Affairs.
“There is no question that our health has improved spectacularly in the past century. One thing seems certain: It did not happen because of medicine, or medical science, or even the presence of doctors.
“Much of the credit should go to the plumbers and engineers of the Western world. The contamination of drinking water by human feces was at one time the greatest cause of human disease and death for us; it remains so, along with starvation and malaria, for the Third World. Typhoid fever, cholera and dysentery were the chief threats to survival in the early years of the 19th century in New York City, and when the plumbers and sanitary engineers had done their work in the construction of our cities, these diseases began to vanish. Today, cholera is unheard of in this country, but it would surely reappear if we went back to the old-fashioned ways of finding water to drink.”