Cholera Comes to Manchester

“The characteristic symptoms that define this disease are a constant vomiting and purging, the matter thrown up bilious attended with constant nausea and gripes and sometimes spasms of the legs. … most met with in the warm climates and brought on by an over flow of the bile, or eating a large quantity of ripe fruit, and also the sudden change from a warm to a moist air. The progress of the disease is very rapid and patients have died in 12 hours from the attack.” Comments on cholera from a manuscript of 1792 [MMM/23/1/10]

In 1831 cholera was spreading across continental Europe and worrying health authorities in Britain who met late in the year to discuss the potential problem and possible measures to keep it out of the country. However, the first cases were reported in Sunderland in October 1831 and it soon spread across the country taking hold in Manchester in 1832. Doctors at the time were in general disagreement as to the nature of the spread of the disease with some believing it was contagious and others attributing it to general uncleanliness. We now know the most common cause to be contaminated food and water.

In response, the authorities in Manchester established a hospital for the treatment of cholera victims at Knott Mill, Jordan Street, just behind Deansgate Train Station. Dr Edward Stephens was appointed one of the Cholera Medical Officers for the city and treated patients at Knott Mill and accounts of his life report how he was deeply affected by the effects the disease had and the rapidity with which some of his patients died.

John Windsor, another prominent Manchester surgeon at the time, recorded the details surrounding some of the patients he treated in a case book dedicated specifically to cholera victims. Although only a relatively small number of cases are recorded in this manuscript the addresses he supplies show all of his patients to be based either in the area surrounding Sackville Street or in Ancoats. We can also see that some died within 24 hours of Windsor’s first visit and few survived more than a couple of days. The first case reads as follows:

“James White’s wife, age 31, under 60 Silver St, 5 months advanced in pregnancy was seized with cramps, vomiting, and purging with the other symptoms of the prevailing epidemic at 9 o’clock AM 8^th July. She only returned from Liverpool the preceding day but had not while there visited any one labouring under cholera. No remedies were used until I was called in at 4PM. She then was in excessive pain and screaming violently from the severity of the cramps in her legs and thighs, pulse indistinct and not to be counted, countenance shrunk and bluish, tongue cold, sickness severe, alvine evacuations frequent and exhibiting the usual white flocculent appearance … Ordered hot bricks to the feet, a mustard poultice to the epigastrium and hydragyri submuriatis [mercury (I) chloride] and opium with two tablespoonfuls of the following mixture between each dose of the pills, [aromatic confection, tincture of cinnamon, aromatic ammonia spirit, tincture of opium, & mint water], drinking occasionally one teaspoonful of brandy to a tablespoonful of mint tea …She continued in the same state asking repeatedly for drink until 2 o’clock AM when throwing out her arms and without uttering any complaints she expired. No inspection of the body was made.” Cholera Case Book [MMM/4/2/1/2]

There was little the medical community could do in the face of such an epidemic, yet certain treatments were very popular and held to be effective in fighting cholera. The use of opium had been highly recommended for several years at this point in addition to emetics, mercury, and wine. Windsor also treated one of his patients with prussic acid, or hydrogen cyanide. With such a concoction of hazardous substances on offer it is no wonder patients had little hope of survival and medical men were satirised for their efforts.