From Rapid Change to Stasis: Official Responses to Cholera in British-Ruled India and Egypt: 1860 to c. 1921

In the years before the territorial settlements following World War I, nation states in the world's North used their organizational skills and their science and technology to build up huge empires in the world's South. Yet progress in Northern science was sometimes subject to abrupt reversal. ²

One of these reversals, extremely costly in non-white lives and earlier ignored by historians, took place in the middle months of 1868. The reversal involved attitudes in Britain . . . and cholera. Cholera was thought to be endemic (constantly present) at the mouth of the River Ganges, in Bengal, in India. It touched down briefly in Britain and Europe and North America in the 1830s, 1860s, and at other times in the nineteenth century. Cholera was a strange disease that killed around half the people who became sick. Until the 1940s, no one knew how to cure it. ³

My paper begins with the observation that in the 1850s (several years before the great reversal of 1868) the old-style medical understanding of cholera was rendered obsolete. This old understanding had held that a person dying from cholera (exhibiting rice-water stools, vomiting, general dehydration, and systems collapse) was probably in the last stages of some fever-like disease which possibly had started off with only a runny tummy (the modern concept of "disease specificity" had yet to be developed). Yesteryear's understanding had also held that cholera might well be caused by the contaminated air or soil found in a particular locale and be set off by weather conditions (heavy rain, thunder and lightning, drought), and that it was spread from one location to another by winds. ⁴

The new position, which in the 1850s represented the consensual view of European and North American medical scientists at the cutting edge of their profession, held that the cholera causal agent was some sort of poison, probably a living germ (the actual organism was not effectively discovered until 1883). The new understanding held that this causal agent was carried in the gut, and in the fecal matter and vomit of a cholera victim. If spread about, this dejecta might infect water supplies (and possibly the soil) and so move on to infect new human victims. The 1850s position insisted that cholera was spread by the movement of infected people ("human agency") from one place to another. From this it followed that if human movement were blocked, through a cordon of troops, the quarantine of ships, or other forceful interventions, a cholera epidemic could be prevented from spreading beyond the locale in which it had first broken out. ⁵

This then was the Europe-wide 1850s position that was reversed in mid-1868 by government in England, with effect in the subcontinent of India. India at the time was the most heavily populated part of the British Empire, with a population of around 200 million, compared to England's 20 million. What I want to do in this paper is to explore why and how this reversal in cholera policy took place and then to examine some of the consequences.

It is useful to point out here that, over the years, the British government and its apologists gave the appearance of being unaware that a cholera policy reversal had ever happened. To maintain general amnesia, they silenced critics at the Royal Army Medical College at Netley who knew what the score was. ⁶ They kept inconvenient documentary evidence, written before the policy change, under wraps and in some cases may have destroyed it. ⁷ They rewrote recent colonial/medical history, purposefully omitting to mention the name of the medical officer who had successfully used standard European interventionist techniques against cholera in India immediately before...