Grounding Miasma, or Anticipating the Germ Theory of Disease in Victorian Cholera Satire

While the development of modern science and medicine has traditionally been seen as a scientific and institutional force, the role of public attitude has been overlooked. Satirical illustrations reacting to Britain's cholera epidemics are just such an example of the influence of public discourse on medical development. Cholera initially set foot on British soil in 1831 and ravaged Britain in four successive epidemics: 1831–32, 1848–49, 1853–54, and 1866–67 (Carpenter 35). As cholera took thousands of lives, various theories about its cause, transmission, and treatment circulated through the medical, official, and popular channels. Originally believed to be caused and spread by foul air, or miasma, the picture of cholera began to change with John Snow's theory of cholera as waterborne, inspired by his well-known investigation of the Broad Street water pump in the midcentury. However, it wasn't until Robert Koch, the father of modern microbiology, identified the cholera bacillus in 1884 that the image of cholera changed from invisible threat to manageable bacteria.

It is my contention that investigations of cholera in nineteenth-century Britain have overlooked the seminal role that satirical illustrations surrounding the disease played in the development of medicine in the nineteenth century. I argue that the popular satirical illustrations of the early and mid nineteenth century actively engaged with, and even anticipated, the scientific breakthroughs of Snow and Koch. The illustrations discussed here feature varying humorous representations of disease or the physical and political apparatuses around contracting and combating disease. While the dates of the images' publications do generally correspond to the successive cholera epidemics between the 1830s and 1860s, their more important correspondence is to the developing contradictory theories of disease transmission that evolved in tandem with the progressing cholera epidemics. Thus, there is an insistence on the importance not only of the disease itself in these illustrations, but also on water and the developing tools—for example, the microscope—that changed both the field of professional medicine and also the public's perception of the health of its environment. In so doing, the satirical representations rather anticipate Snow's and later Koch's influential contributions to the study and prevention of cholera before these theories had been medically accepted.

Although statistically cholera was by no means the most lethal disease circulating in Great Britain in the nineteenth century—endemic diseases such as fever, tuberculosis, and influenza claimed many more victims than cholera—the drama that accompanied its arrival and repeated visits raised it to a uniquely terrifying level (O'Connor 32). Because of the novelty of the disease, the rapidity with which its victims died, and its mysterious proliferation, cholera was painted as a modern plague (Halliday 74). Over its four visits, cholera claimed more than 120,000 British lives (O'Connor 25). As many critics have noted, despite the national trauma that cholera caused, it also inspired the sanitation reforms that both refined England and define the governmental changes of the nineteenth century.¹

The public health and sanitation reforms, especially in the sewage-overrun capital, were partially inspired by the predominant miasma theory of disease propagation. While London's sanitation was originally run by night soil men, whose job it was to empty the privy cesspools and recycle the waste as agricultural fertilizer, changes in the manure trade, the water closet system, and quality of human waste quickly put the night soil trade out of business (Halliday 133–34).² As London's cesspools filled up and overflowed into the streets, new legislation was introduced to standardize sanitation in London; all cesspools were connected to London's old and leaking underground sewage system, which was in turn improved and directed to dump its contents into the River Thames, where the sewage could then reenter London's system through the drinking water (Halliday 133–35).³

The miasma theory was born especially out of this filth in the growing urban centers. With so many people packed into increasingly cramped spaces that were not adequately equipped with the sanitation measures necessary for such large populations...